Utah Code § 31A-2-218.1

Current through the 2024 Third Special Session
Section 31A-2-218.1 - (Effective upon governor's approval). Section 1332 Waiver Study
(1) As used in this section:
(a) "Secretary" means the secretary of the United States Department of Health and Human Services.
(b) "Section 1332 waiver" means a waiver for state innovation under 45 C.F.R. Part 155, Subpart N.
(2) The commissioner shall conduct a study to determine the feasibility of a state-based program designed to:
(a) lower health benefit plan insurance premiums; and
(b) increase stabilization in the market.
(3) The commissioner, in the study described in Subsection (2), shall create a proposal for a Section 1332 waiver that includes:
(a) a list of provisions the state should seek to waive and the rationale for waiving each provision;
(b) data, assumptions, targets, and other information sufficient to determine that the proposed waiver will provide coverage at least as comprehensive as coverage that would be provided absent the waiver;
(c) coverage and cost sharing protections that keep premiums at least as affordable as would be provided absent the Section 1332 waiver;
(d) actuarial analyses, actuarial certifications, and financial modeling that:
(i) support the estimates that the proposal will comply with the comprehensive coverage requirements, the affordability requirement, the scope of coverage requirement, and the federal deficit requirement; and
(ii) include:
(A) a detailed 10-year budget plan that is deficit-neutral to the federal government;
(B) all costs to the state, including administrative costs, and other costs to the federal government; and
(C) a detailed analysis regarding the estimated impact of the Section 1332 waiver on health insurance coverage in the state;
(e) proposed legislative changes to provide the state authority to implement the proposed waiver;
(f) implementation plans with a timeline;
(g) categories of covered individuals with high-cost medical conditions who may be reinsured through the proposed waiver, including a recommendation for a multi-year phased-in approach;
(h) reinsurance parameters, including co-insurance, attachment points, or limits;
(i) set premium reduction targets;
(j) a detailed plan for a budget and program implementation; and
(k) a complete application for submission to the secretary.
(4) To carry out the requirements in Subsections (2) and (3) the commissioner may partner or contract with a person that the commissioner determines is appropriate, subject to Title 63G, Chapter 6a, Utah Procurement Code.
(5) On or before November 1, 2024, the commissioner shall submit to the Business and Labor Interim Committee a final written report describing the study described in this section.

Utah Code § 31A-2-218.1

Added by Chapter TBD, 2024 General Session ,§ 7, eff. 3/13/2024.