Vote Smart's Synopsis:

Vote to concur with Senate amendment and pass a bill that establishes individual market stabilization within healthcare.

Highlights:

• Specifies that this act only applies to a health benefit plan that covers eligible employees of small employers in the state and issued or renewed on or after July 1, 1994, if (Sec. 1):

• Any part of the premium or benefits is paid by or on behalf of the small employer;

• Any eligible employee or dependent is reimbursed, through wage adjustments or otherwise, by or on behalf of the small employer for any part of the premium;

• The health benefit plan is treated by the employer or any eligible employee or dependent as part of a plan or program under the United States Internal Revenue Code; or

• The small employer allows eligible employees to pay allows eligible employees to pay for the health benefit plan through payroll deductions.

• Specifies that this act applies to any health benefit plan offered by an association, a professional employee organization, or any other entity, including a plan issued under the laws of another state, if the health benefit plan covers eligible employees of one or more small employers and meets the requirements of this section (Sec. 1).

• Requires the Maryland Health Insurance Coverage Protection commission to consist of the following members, including, but not limited to (Sec. 2):

• 1 representative of behavioral health providers, appointed jointly by the president of the Senate and Speaker of the House;

• 1 member of the public appointed jointly by the President of the Senate and Speaker of the House;

• 1 member of the public appointed by the Governor;

• 1 representative of a group model health maintenance organization that participates in the individual market, appointed by the governor; and

• 1 representative of the league of life.

• Requires the Commission to do the following (Sec. 2):

• Monitor potential and actual federal changes to the ACA, Medicaid, the Maryland Children’s Health Program, Medicare, and the Maryland All-Payer Model;

• Assess the impact of potential and actual federal changes to the ACA, Medicaid, the Maryland Children’s Health Program, Medicare, and the Maryland All-Payer Model; and

• Provide recommendations for State and local action to protect access of residents of the state to affordable health coverage.

• Requires the duties of the Commission to include a study that includes the following (Sec. 2):

• An assessment of the current and potential adverse effects of the lost of health coverage on the residents, public health, and economy of the state resulting from changes to the ACA, Medicaid, the Maryland Children’s Health Program, Medicare, and the Maryland All-Payer Model;

• An estimate of the costs to the State and the State residents of adverse effects from changes to the ACA, Medicaid, the Maryland Children’s Health Program, Medicare, and the Maryland All-Payer Model and the resulting loss of health coverage;

• An examination of measures that may prevent or mitigate the adverse effects of changes to the ACA, Medicaid, the Maryland Children’s Health Program, Medicare, and the Maryland All-Payer Model and the resulting loss of health coverage on the residents, public health, and economy of the State; and

• Recommendations for laws that may be warranted to minimize the adverse effects associated with changes to the ACA, Medicaid, the Maryland Children’s Health Program, Medicare, and the Maryland All-Payer Model and will assist residents in obtaining and maintaining affordable health coverage.

• Requires the commission to study and make recommendations for individual and group health insurance market stability, including (Sec. 2):

• The components of one or more waivers under the ACA to ensure market stability that may be submitted by the state;

• Whether to pursue a standard plan design that limits cost sharing;

• Whether to merge the individual and small health insurance markets in the state for rating purposes;

• Whether to pursue a basic health program;

• Whether to pursue a medicaid buy-in program for the individual market;

• Whether to provide subsidies that supplement premium tax credits or cost-sharing reduction described in the ACA; and

• Whether to adopt a state-based individual health insurance mandate and how to use payments collected from individuals who do not maintain minimum essential coverage, including use of the payments to assist individuals in purchasing health insurance.  

• Defines “short-term limited duration insurance” as health insurance coverage provided under a policy or contract with a carrier and that (Sec. 1):

• Has a policy term that is less than 3 months after the original effective date of the policy or contract;

• May not be extended or renewed;

• Applies the same underwriting standards to all applicants regardless of whether they have previously been covered by short-term limited duration insurance; and

• Contains the notice required by federal law prominently displayed in the contract and in any application materials provided in connection with enrollment.

Full Bill Text