EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
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SENATE BILL 5
J5 5lr1634
(PRE–FILED) CF HB 297
By: Senators Lam, Feldman, and Hayes
Requested: November 1, 2024
Introduced and read first time: January 8, 2025
Assigned to: Finance
Committee Report: Favorable
Senate action: Adopted
Read second time: February 7, 2025
CHAPTER ______
AN ACT concerning 1
Maryland Health Benefit Exchange – State–Based Young Adult Health 2
Insurance Subsidies Pilot Program – Sunset Repeal 3
FOR the purpose of renaming the State–Based Young Adult Health Insurance Subsidies 4
Pilot Program to be the State–Based Young Adult Health Insurance Subsidies 5
Program; repealing the termination date of certain provisions of law that establish 6
and govern the funding for the Program; authorizing rather than requiring the 7
Maryland Health Benefit Exchange to establish and implement the Program; 8
prohibiting the Exchange from implementing the Program if certain funds are not 9
available; and generally relating to health insurance subsidies for young adults. 10
BY repealing and reenacting, without amendments, 11
Article – Insurance 12
Section 31–107(a) 13
Annotated Code of Maryland 14
(2017 Replacement Volume and 2024 Supplement) 15
BY repealing and reenacting, with amendments, 16
Article – Insurance 17
Section 31–107(b), (f)(1)(iv), and (g)(1) and 31–122 18
Annotated Code of Maryland 19
(2017 Replacement Volume and 2024 Supplement) 20
BY repealing and reenacting, with amendments, 21 2 SENATE BILL 5
Chapter 778 of the Acts of the General Assembly of 2021, as amended by Chapters 1
256 and 257 of the Acts of the General Assembly of 2023 2
Section 2 3
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 4
That the Laws of Maryland read as follows: 5
Article – Insurance 6
31–107. 7
(a) There is a Maryland Health Benefit Exchange Fund. 8
(b) (1) The purpose of the Fund is to: 9
(i) provide funding for the operation and administration of the 10
Exchange in carrying out the purposes of the Exchange under this subtitle; 11
(ii) provide funding for the establishment and operation of the State 12
Reinsurance Program authorized under this subtitle; 13
(iii) provide funding for the Medical Assistance Program and the 14
Senior Prescription Drug Assistance Program; 15
(iv) provide funding for the establishment and operation of Health 16
Equity Resource Communities under Title 20, Subtitle 14 of the Health – General Article; 17
and 18
(v) provide funding for the establishment and operation of the 19
State–Based Young Adult Health Insurance Subsidies [Pilot] Program authorized under 20
this subtitle. 21
(2) The operation and administration of the Exchange, the State 22
Reinsurance Program, the State–Based Young Adult Health Insurance Subsidies [Pilot] 23
Program, and the Qualified Resident Enrollment Program may include functions delegated 24
by the Exchange to a third party under law or by contract. 25
(f) (1) The Fund may be used only: 26
(iv) for the establishment and operation of the State–Based Young 27
Adult Health Insurance Subsidies [Pilot] Program. 28
(g) (1) The Board shall maintain separate accounts within the Fund for 29
Exchange operations, for the State Reinsurance Program, and for the State–Based Young 30
Adult Health Insurance Subsidies [Pilot] Program. 31
31–122. 32 SENATE BILL 5 3
(a) In this section, [“Pilot Program”] “PROGRAM” means the State–Based Young 1
Adult Health Insurance Subsidies [Pilot] Program. 2
(b) (1) [The] SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , THE 3
Exchange, in consultation with the Commissioner and as approved by the Board, [shall] 4
MAY establish and implement a State–Based Young Adult Health Insurance Subsidies 5
[Pilot] Program to provide subsidies to young adults for the purchase of health benefit plans 6
in the individual health insurance market. 7
(2) THE EXCHANGE MAY NOT IMPL EMENT THE PROGRAM FOR 8
CALENDAR YEARS IN WH ICH FUNDS FROM THE DISTRIBUTIO N OF THE ASSESSMENT 9
UNDER § 6–102.1 OF THIS ARTICLE ARE NOT AVAILABLE . 10
(c) The [Pilot] Program required under this section shall be designed to: 11
(1) reduce the amount that young adults pay for health benefit plans in the 12
individual health insurance market; and 13
(2) target young adults who are not directly impacted by the State 14
Reinsurance Program. 15
(d) (1) [For calendar years 2022 through 2025] FOR EACH CALENDAR YEAR , 16
the Exchange, in consultation with the Commissioner and as approved by the Board, shall 17
establish subsidy eligibility and payment parameters for the [Pilot] Program. 18
(2) In determining the subsidy eligibility and payment parameters 19
required under paragraph (1) of this subsection, the Exchange shall consider: 20
(i) young adults at least 18 years old and under the age of 41 years; 21
and 22
(ii) income groups between 133% and 400% of the federal poverty 23
level. 24
(e) (1) Subject to available funds and paragraph (2) of this subsection, in each 25
[of] fiscal [years 2022 through 2026] YEAR, the Exchange may designate funds from the 26
Fund to be used for the [Pilot] Program so that annual subsidies may be provided to young 27
adults who meet the subsidy eligibility and payment parameters established under 28
subsection (d) of this section. 29
(2) (I) For each of calendar years 2024 and 2025, the funds designated 30
under paragraph (1) of this subsection may not exceed $20,000,000 plus any unspent funds 31
designated for subsidies for young adults in a previous calendar year. 32
4 SENATE BILL 5
(II) FOR CALENDAR YEAR 2026 AND EACH CALENDAR YE AR 1
THEREAFTER , THE EXCHANGE, IN CONSULTATION WITH THE COMMISSIONER , MAY 2
DESIGNATE FUNDS FROM THE FUND TO PROVIDE ANNUA L SUBSIDIES TO YOUNG 3
ADULTS WHO MEET THE SUBSIDY ELIGIBILITY AND PAYMENT PARAMETE RS 4
ESTABLISHED UNDER SU BSECTION (D) OF THIS SECTION. 5
(f) The Exchange shall adopt regulations implementing the provisions of this 6
section. 7
(g) The Exchange shall adopt regulations to provide a subsidy to cover 100% of 8
the cost of the premium for young adults who have a 0% expected contribution under the 9
subsidy eligibility parameters established under subsection (d) of this section. 10
(h) (1) The Exchange shall track on a monthly basis expenditures on subsidies 11
provided under the [Pilot] Program, including: 12
(i) the average number of young adults receiving subsidies under 13
the [Pilot] Program; and 14
(ii) the average subsidy amount received by young adults under the 15
[Pilot] Program. 16
(2) The Exchange shall track: 17
(i) the impact the [Pilot] Program has on rates in the individual 18
insurance market; and 19
(ii) the impact of covering 100% of the cost of premiums for qualified 20
participants on effectuation rates and termination for nonpayment rates. 21
(3) The information tracked by the Exchange under paragraphs (1) and (2) 22
of this subsection shall be: 23
(i) posted on the website of the Exchange; and 24
(ii) included in the annual report required under § 31–119(d) of this 25
subtitle. 26
Chapter 778 of the Acts of 2021, as amended by Chapters 256 and 257 of the Acts 27
of 2023 28
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 29
1, 2021. [It shall remain effective for a period of 5 years and, at the end of June 30, 2026, 30
this Act, with no further action required by the General Assembly, shall be abrogated and 31
of no further force and effect.] 32
SENATE BILL 5 5
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 1
1, 2025. 2
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.