HSB 721 (LSB 5505XL (7) 91)

SENATE/HOUSE FILE _____

BY  (PROPOSED GOVERNOR BILL)

A BILL FOR

An Act relating to the establishment of a state-based exchange, creation of a state-based exchange fund, state innovation waivers, and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  NEW SECTION.  505.18B  State-based exchange —— fund.
   1.  As used in this section, unless the context otherwise requires:
   a.  “Commissioner” means the commissioner of insurance.
   b.  “State-based exchange” means a state, federal, or partnership exchange or marketplace operating in the state pursuant to, including regulations issued pursuant to, section 1311 of the federal Patient Protection and Affordable Care Act, Pub. L. No. 111-148, as amended.
   2.  a.  The commissioner shall develop and submit an application for a state innovation waiver pursuant to section 505.18A on or before December 31, 2026.
   b.  At the direction of the governor, the commissioner shall have the authority to create, establish, implement, administer, or otherwise operate a state-based exchange and, if the application for a state innovation under paragraph “a” is approved, shall do so in accordance with the approved state innovation waiver.
   3.  a.  A state-based exchange fund is created in the state treasury under the control of the division. Notwithstanding any provision of law to the contrary, the fund shall consist of moneys appropriated by the general assembly for purposes of this section and any other moneys that are lawfully available to the division for purposes of this section, including but not limited to moneys obtained or accepted by the division from the federal government, user fees, and grants. The fund shall be used by the division for purposes of this section.
   b.  Notwithstanding section 8.33, moneys appropriated in this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated. Notwithstanding section 12C.7, subsection 2, interest or earnings on moneys in the fund shall be credited to the fund.
   4.  a.  Except as provided in this subsection, all documents, materials, complaints, investigations, or other information in the possession or control of the division for purposes of this section, or for purposes of complying with federal requirements for a federal health insurance exchange, shall be confidential records not subject to disclosure pursuant to chapter 22, shall not be subject to subpoena, and shall not be subject to discovery or be admissible in evidence in any private civil action in which the division is a named party. However, the division is authorized to use the confidential information without further disclosure to carry out the division’s duties under this chapter and, to the extent authorized by law, in the furtherance of any regulatory or legal action brought as part of the commissioner’s official duties.
   b.  Notwithstanding paragraph “a”, the commissioner may do any of the following:
   (1)  Share confidential information with a state-based exchange of another state, a regulatory authority, a state department, a law enforcement agency, or a federal authority provided that the recipient agrees in writing to maintain the confidentiality and privileged status of the document, material, or other information.
   (2)  Receive documents, materials, or information, including otherwise confidential and privileged documents, materials, or information, from a state-based exchange of another state, regulatory authority, state department, law enforcement agency, or federal authority and shall maintain as confidential or privileged any documents, materials, or other information received with notice or the understanding that the documents, materials, or other information received is confidential and privileged under the laws of the jurisdiction that is the source of the documents, materials, or other information.
   (3)  No waiver of any applicable privilege or claim of confidentiality in the confidential information shall occur as a result of disclosure or sharing of confidential or privileged documents, materials, or other information authorized by this section.
   c.  This subsection shall not prohibit the commissioner from releasing a final, adjudicated order, including but not limited to a certification, recertification, decertification, or suspension of a qualified health plan if the order is otherwise subject to public disclosure, to a database or other clearinghouse service maintained by a federal authority.
   5.  The commissioner may adopt rules pursuant to chapter 17A to administer this section. The commissioner may adopt emergency rules under section 17A.4, subsection 3, and section 17A.5, subsection 2, paragraph “b”, to administer this section and the rules shall be effective immediately upon filing unless a later date is specified in the rules. Any rules adopted in accordance with this section shall also be published as a notice of intended action as provided in section 17A.4.
    Sec. 2.  EFFECTIVE DATE.  This Act, being deemed of immediate importance, takes effect upon enactment.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill relates to the establishment of a state-based exchange and the creation of a state-based exchange fund.
   The bill defines “state-based exchange” as a state, federal, or partnership exchange or marketplace operating in the state pursuant to section 1311 of the federal Patient Protection and Affordable Care Act, Pub. L. No. 111-148.
   The bill requires the commissioner of insurance (commissioner) to develop and submit an application for a state innovation waiver pursuant to Code section 505.18A on or before December 31, 2026. Under the bill, at the direction of the governor, the commissioner shall have the authority to create, establish, implement, administer, or otherwise operate a state-based exchange and, if the application for a state innovation is approved, shall do so in accordance with the approved state innovation waiver. A state-based exchange fund (fund) is created in the state treasury under the control of the insurance division (division) and shall consist of moneys appropriated by the general assembly and any other moneys that are lawfully available to the division to be used for purposes of the bill, including but not limited to moneys obtained or accepted by the division from the federal government, user fees, and grants.
   All documents, materials, complaints, investigations, or other information in the possession or control of the division for purposes of the state-based exchange, or for complying with federal requirements for a federal health insurance exchange, are confidential records not subject to subpoena or discovery, or admissible into evidence, as provided in the bill, unless an exception enumerated in the bill is applicable.
   The commissioner may adopt rules, including emergency rules, to administer the bill.
   The bill, being deemed of immediate importance, takes effect upon enactment.