SB 563

On March 23, 2010, the federal government enacted the Patient Protection and

Affordable Care Act (PPACA), which, among other things, imposes requirements and

limitations on health insurance policies and health plans, requires the creation of

state-based health insurance exchanges through which individuals and small

employers can purchase insurance, changes the income eligibility criteria for

Medicaid (known as Medical Assistance in this state), and creates incentives for

improving access to health care. The insurance reforms, insurance exchange

requirements, and changes to Medicaid are located in Titles I and II and Subtitles

A and B of Title X of PPACA. This bill requires that, before a state agency takes any

action to implement Title I or II or Subtitle A or B of Title X of PPACA for which the

agency would typically promulgate a rule, the agency must request the Legislative

Reference Bureau to prepare legislation that allows the agency to take the action.

The agency must then submit the proposed legislation to each standing committee

of each house of the legislature that has jurisdiction over health or insurance

matters. The bill prohibits the agency from taking the action to implement Title I

or II or Subtitle A or B of Title X of PPACA until the legislation allowing the agency

to take the action takes effect. The bill also prohibits an agency from requesting a

grant or other moneys from the federal government to implement Title I or II or

Subtitle A or B of Title X of PPACA and from expending any state moneys, or federal

moneys passing through the state treasury, to assist the federal government in

implementing Title I or II or Subtitle A or B of Title X of PPACA. The bill specifies

that an agency is not prohibited from exchanging or providing information about,

communicating or advising about, or discussing PPACA with any person or agency;

reviewing, analyzing, or researching PPACA, or addressing consumer complaints

about PPACA. A secretary or commissioner of an agency is not prohibited from

serving on a board that discusses and considers the effects of PPACA. The bill also

specifies that if the Office of the Commissioner of Insurance (OCI) receives a report

of an insurer's medical loss ratio, OCI may review that medical loss ratio to

determine if the insurer is experiencing financial problems and may work with the

insurer to resolve those financial problems. As an exception to the requirements

under the bill, the bill allows an agency to request any grant or other moneys for

certain purposes specified under Title I or II or Subtitle A or B of Title X of PPACA

and to implement the project or program for which the grant or other moneys are

received and expend the grant or other moneys.

The bill requires agencies of the state to submit annually to the legislature a

report that describes the cost, since March 23, 2010, to that agency of implementing

PPACA and any federal moneys received after March 23, 2010, related to

implementing PPACA, with the first report due by September 1, 2012. In addition,

certain agencies must include certain information in their annual reports for that

year and in an analysis of any change in the information after March 23, 2010. DHS