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Health Insurance Reform State Laws 2013

2011 - 2014 Health Insurance Reform Enacted State Laws Related to the Affordable Care Act

States Implement Heallth Reform NCSL bannerUpdated June 17, 2014

The 2010 federal Affordable Care Act (ACA) established a series of “early market reforms” - uniform, 50-state requirements and additional options that build on existing state regulation of health insurance policies.  The law requires implementation timetables that began with a dozen provisions in September 2010, with options and implementation throughout 2011-2013.  The culmination of these health insurance laws apply to the launch of health insurance Marketplaces or Exchanges, which went live within all 50 states as of October 1, 2013, and sell policies that take effect for purchasers and individual enrollees beginning January 1, 2014.  [Latest: see new laws that took effect Jan. 1, 2014]

The issues involving states include standard-price insurance coverage for individuals with pre-existing conditions, family coverage that includes dependent members up to age 26, expanded review of premium rates, required ratios of insurer expenditures on health services, consumer assistance or ombudsman offices, reduced employer shares for retirees between ages 55-64, and patients’ rights to appeal denied coverage. 

A dozen features have already taken effect under the ACA, along with permissible exceptions and optional federal grants to states. Provisions include preventive screenings and services with no co-payments; more uniform mandated or required "essential benefits," no lifetime or annual limits on standard policies and options for multi-state or out-of-state health insurance purchasing.  

While many states have enacted laws related to market reforms, this does not mean that the state has regulatory or enforcement power to oversee the numerous specific insurance provisions in the ACA.  In fact, a report released February 2013 by the Commonwealth Fund, concludes, “that-without new legislation-some states face limitations in fully enforcing these reforms.

For essential health benefits, 19 states and D.C. selected a “benchmark plan” that is based on an existing state-regulated “small group plan”, 4 states selected a benchmark plan consistent with an existing state non-Medicaid HMO plan, and 3 states picked a state employee health plan as their benchmark plan; the other 24 states were assigned the “largest small group plan” benefit mandates list.  These packages are currently regulated by insurance departments in virtually all states.  However, states may need more explicit legal authority to have that enforcement power apply to all new federally-required insurance.

The ACA establishes numerous requirements and standards, as noted above but generally it does not directly preempt existing state laws and regulations. For example, existing state mandates remain a valid and enforceable part of state insurance regulation, unless the state chooses to alter, repeal or expand them.  This report tallies state laws that “relate” to the ACA but includes measures not intended to simply conform to or enforce the federal law.  Some measures may relate to the ACA but establish a different or even contradictory policy.

The following are separate NCSL reports on closely-related policy areas affecting health insurance policy:

  • "State Actions to Implement the American Health Benefit Exchange" - Exchanges are a central element of insurance reform, but that legislation is identified and listed separately.  NCSL database users can obtain a single list that combines both groups of bills.
  • "Challenging and Alternatives" legislation, opposing health reform, also affects health insurance policy.  This approach is described in a separate NCSL online report, and is not included in this report on laws.

Affordable Care Act - consolidated full text [PDF]

NCSL Health Insurance Sessions at 2013 Health Reform Task Force Meetings

  • Commissioner Sandy Praeger, Kansas Insurance Department, Kansas; Chair, NAIC Insurance & Managed Care Committee) -PowerPoint: Marketplaces. (August 2013)
  • Karen Ignagni, AHIP  -PowerPoint: Marketplaces (August 2013)
  • Joshua Goldberg, health policy and legislative advisor, National Association of Insurance Commissioners (NAIC), Washington, D.C. - PowerPoint (PDF 7 pages) (May 2013)
  • Christopher Watts, partner, Mercer Health and  Benefits, LLC, Denver, Colorado - PowerPoint (PDF 7 pages) (May 2013)
  • Mark Pratt, AHIP, America's Health Insurance Plans [PowerPoint] (December 2013)
  • Lynn Quincy, Senior Policy Analyst, Consumers Union/Consumer Reports, Washington, D.C. - PowerPoint (PDF 10 pages)  (December 2013)
  • Brian Webb,National Association of Insurance Commissioners (NAIC), Washington, D.C. - Presentation handout - 50-state table of decisions on state health regulation- (PDF 2 pages).  (December 2013)

Reports and Guidance, 2013-2014:

Health Insurance Marketplace (Exchange) Premiums for 2014 - Released by HHS September 25, 2013.   This report summarizes the health plan choices and premiums that will be available in the Health Insurance Marketplace. It contains new information, current as of September 18, 2013, on qualified health plans in the 36 states in which the Department of Health and Human Services (HHS) will support or fully run the Health Insurance Marketplace in 2014. [NCSL Note: this omits all 14 state-run exchanges.] Plan data is in final stages but is still under review as of September 18 and may be revised in HHS systems before being displayed for consumers, so this information is subject to change. This analysis also includes similar information that is publicly available from 11 states and the District of Columbia that are implementing their own Marketplace. This report focuses on the plans with the lowest premiums in each state, as consumers are expected to shop for low-cost plans. Nearly all consumers (about 95%) will have a choice of 2 or more health insurance issuers (often many more) and nearly all consumers (about 95%) live in states with average premiums below earlier estimates.  Online Printer friendly version in PDF format (15 pages).

Implementing the Affordable Care Act: The State of the States . A report on state-selected roles with health insurance market reforms, published Feb. 1, 2014 by Commonwealth Fund.   Interactive 50-state map - 2014.

The Requirement to Buy Coverage Under the Affordable Care Act Beginning in 2014 - Kaiser Family Foundation, January 30, 2013

The Office of Personnel Management (OPM) published a final rule on the Multi-State Plan Program (MSPP), establishing standards for the MSPP and OPM’s approach to MSPP implementation.  - March 1, 2013



Health Affairs posted a series of summaries and interpretation of HHS/CCIIO regulation about the implementation of the Affordable Care Act on:

Implementing the Affordable Care Act: State Action on the 2014 Market Reforms -  Commonwealth Fund, February 1, 2013

CMS Fact Sheet: Individual Shared Responsibility For Health Insurance Coverage and Minimum Essential Coverage Proposed Rules - Centers For Medicare and Medicaid Services, Jan. 30, 2013

2011-2013 Legislative Actions

At least 46 states have enacted and signed more than 175 laws specific to ACA health insurance implementation. They cover a wide variety of issues in at least 19 categories.

  • During the 2011 legislative sessions more than 300 bills and resolutions were filed in 47 different states. 
  • During the 2012 legislative sessions more than 330 bills and resolutions were filed in 42 different states.
  • During the 2013 legislative sessions more than 157 bills and resolutions have been filed in 42 different states
  • During the 2014 legislative sessions, as of June 17, 437 bills and resolutions were filed in 43 states and DC.
  • Effective Dates of 2013 Enacted Laws: Six states have health insurance reform laws (tracked and reported below,) that take effect legally on Jan. 1, 2014 - Minnesota (H 5, H 779), Nevada (A 425), North Carolina (H 649), Oregon (S 375), Vermont (H 152, H 107); Texas (S 1367), Virginia (H 1900).  [dates compiled as of 12/16/2013]

  • Federal deadlines extended or delayed:  In response to failures and errors affecting consumers trying to buy coverage on Marketplace/Exchange websites, latest developments include the 1-day extended Dec. 24 deadline (announced 12/23/2013) if individuals want to be covered on Jan. 1.  There also is a new agreement with most insurers that first payments can be extended until Jan. 10, 2014. Figures released mid-December show state-run exchanges still have the major share of individuals who have actually enrolled in a specific commercial plan.

For details see the summaries of laws in Table 2 and Table 3 below. Note that state legislation often varies and may not have the same intent or effect from state to state. 

NCSL has a comprehensive 2011-2013 Health Reform State Legislative Tracking Database. This online feature includes latest listings with individual bill summaries and status.
► Select "Health Insurance Reform" for an updated state-by-state listing on this topic. 


Table 1 - Summary of 2011 - 2014 Laws

Policy Addressed in 2011 - 2012 and 2013 State Law

 States: 2011 - 2012

# of States

States: 2013  

 # of
States

      2014: 78 laws enacted - view complete list in NCSL 2014 State Database online 28

 Adult dependents - requiring family policies to allow coverage for adult dependents up to age 26 [NCSL Fact Sheet]

Delaware, Kentucky, Minnesota, South Dakota, Virginia

5

 Delaware

 1

 Any willing provider - certain providers or facilities must be able to participate in health insurance benefit delivery

2

 

 

 Basic Health Plan - creation or steps toward     New Mexico ('14), New York ('14), Oregon ('14) 3

 Child-only health policies to be offered by health insurers serving the individual market

Arkansas, Colorado, Georgia, Washington

4

 

.

 Confidentiality protection for providers

Tennessee

1

 

 

 Consumer protections/ coverage for pre-existing conditions, and others  [NCSL Report]

HawaiiIndiana, Maryland, Oklahoma

4

Virginia ('13),  Washington ('14)

2

 Essential Health Benefits 

California, Maryland, Oregon, Utah, Vermont, Washington

6

California, Hawaii, Maine ('14), Montana, Nevada, New York, Oregon, South Dakota, Virginia ('13 & '14), Washington

10

 External review or independent appeal of coverage denials for consumers  [NCSL Report]

Delaware, Hawaii, Iowa, Nevada, North Dakota, Ohio, OregonVirginia, Washington

9

 

 

 General insurance reforms, requiring coordination with ACA - Broad implementation of ACA insurance provisions, 2011-2014

Also see: 50-state table of decisions on state health regulation- December 2013 by the National Association of Insurance Commissioners (NAIC), -(PDF 2 pages; link added 12/16/2013)

California, Connecticut, Indiana, Illinois, Maine, Maryland, Michigan,  Minnesota, New Hampshire, New York, North Carolina, North Dakota,  Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Washington

19

Arizona, Arkansas, California, Colorado, Delaware, FloridaGeorgia, LouisianaMinnesota, Nebraska, Nevada, New Mexico, North Carolina, Oregon, Texas, Vermont, Virginia

 17

 Health/Wellness Program coverage within health policies

Tennessee

1

 

 

 High Risk Pools: the federal "Pre-existing Condition Insurance Program"    [NCSL Report]

IllinoisKansas, Nebraska, Oklahoma, Oregon, South Dakota, Washington

7

Alabama ('14) , Arkansas, Colorado, Delaware, Florida, Minnesota, New Hampshire, TexasUtah, Washington, Wyoming

11

 HSA’s/high deductible health policies integrated with ACA

2

 Illinois

 1

 Mandates defining or requiring health insurance coverage or services [examples; additional mandate laws in Table 3]

Arkansas, California, Colorado, Louisiana, Montana, Rhode Island, Utah, West Virginia
 

8

 West Virginia

 1

Additional mandate laws, not referencing ACA.  A Full list of mandate laws is in Table 3 below.

Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Indiana, Illinois, Louisiana, Maryland, Michigan, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, Oregon, Rhode Island, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia

28

 

 

 Medical Loss Ratios (MLR) defining minimum expenditures on health services [NCSL Report]

Connecticut, Georgia, Idaho, Maine, Maryland, Michigan, Nebraska

7

 

 

 Premium Rate Review, coordinating state and federal requirements  [NCSL Report]

Maine, New Mexico, North Carolina, North Dakota, South DakotaTennessee, Vermont, Washington

8

 Montana, New Hampshire, Vermont

 3

 Single payer universal coverage as an alternative to ACA provisions

Illinois, Vermont

2

 

 

 Small employer health coverage

ArizonaDelaware, Missouri, Vermont

4

 Hawaii

 1

 State / public employee health plans coordinated with ACA

Connecticut, Georgia, Idaho, Massachusetts, Nevada, Wisconsin, Utah

7

 Florida, Utah, Washington (14)

 2

 Out-of-State policies available for in-state sale [NCSL Report]

Georgia, Kentucky, Maine

3

 

 

 Other

Arizona, Delaware, Hawaii, Illinois, Maine, Massachusetts, Mississippi, New JerseyOklahoma, Rhode Island, Virginia, Washington

12

Colorado, Florida, Georgia, Kansas, Louisiana, Maine, Massachusetts, New Jersey, Oklahoma, Pennsylvania, West Virginia

11

For a detailed academic analysis of 2010-2011 state actions see "State Action on Early  Market Reforms" described below
 

United States map of 2013 State Laws Implementing Insurance Market Reform

Table 2A - 2014 Enacted Laws by State

State

Law / Date / Summary / Links

Topic

Alabama (AL) S. 123, Enacted and signed as Act No. 2014-219, 4/2/2014.  
Authorizes the Alabama Health Insurance Plan (high-risk pool) to cease operations upon the availability of guaranteed issue health policy under federal law, giving time to current participants to transition out of the plan, provides for the transfer of unspent funds to the State General Fund. 
 

Arkansas  (AR)

H 1053, Enacted and signed as Act 276, 3/13/2014.
Appropriates federal funds for the 2014-2015 fiscal year for personal services and operating expenses associated with the Federal-State Partnership Health Insurance Exchange of the State Insurance Department.  Restricts ACA-related activities by providing the State Insurance Department shall not allocate, budget, expend, or utilize any appropriation authorized by the General Assembly for the purpose of advertisement, promotion, or other activities designed to promote or encourage enrollment in the Arkansas Health Insurance Marketplace or the Health Care Independence Program, including unsolicited communications mailed to potential recipients; television, radio, or online commercials; billboard or mobile billboard advertising; advertisements printed in newspapers, magazines, or other print media; and Internet websites and electronic media. Also would prohibit responding to an inquiry regarding the coverage for which a potential recipient might be eligible, including without limitation providing educational materials or information regarding any coverage for which the individual might qualify. Also see S 111.
General Insurance Reform

"

H 1098, Enacted and signed as Act 180, 2/25/2014.. Provides for the state Office of Health Information Technology appropriation for the 2014-2015 fiscal year, for personal services and operating expenses of the State Health Alliance for Records Exchange (SHARE) and the Office of Health Information Technology for the fiscal year ending June 30, 2015, a total of $8.2 million, which can apply to Medicaid and health insurance regulation.  Effective through June 30, 2015.

General Insurance Reform

California  (CA)

A 369, Enacted and signed as Act 4, 3/20/2014..  Requires a health insurer and health plan to arrange for the completion of covered services by a nonparticipating (out-of-network) provider for a newly covered enrollee and a newly covered insured under an individual health care service plan contract or an individual health insurance policy whose prior coverage was terminated between whose prior coverage was withdrawn from the market between December 1, 2013, and March 31, 2014, for various chronic or acute conditions. Network adequacy

Colorado (CO)

H 1053, Enacted and signed as Act 7, 2/20/2014.. Provides that the Commissioner of Insurance may adopt rules to ensure consistent requirements for pediatric dental benefits in health benefit plans offered in the State regardless of the method by which a plan is purchased (both the Exchange and the commercial market.) Signed into law Feb. 19, 2014.

EHB
Maryland (MD)

S 134 and S 153, Enacted and signed 1/30/2014..  Alters the purpose of the State Health Insurance Plan to include decreasing uncompensated care costs by providing access to affordable, comprehensive health benefits for specified bridge eligible individuals; repeals portion of the plan that closes the plan to a person not enrolled as of a certain date; provides enrollment shall be closed to bridge eligibles under certain conditions; authorizes the extension of closing certain enrollment; requires the adoption of related rules and regulations.

Consumer protections

Maine (ME)

 

S 217, Enacted and signed as Act 449, Feb 26, 2014.  Relates to the affordability and accessibility of chemotherapy treatment in the State; directs the Department of Professional and Financial Regulation, Bureau of Insurance and the Department of Health and Human Services, and the State Center for Disease Control and Prevention to jointly convene a work group to review and report on insurance coverage as it relates to the affordability and accessibility of chemotherapy treatment.

EHB, Study
Mississippi (MS) H. 1281,Eacted and signed, 3/26/2014.  Provides that no health coverage plan shall restrict coverage for prescribed treatment based upon the insured's diagnosis with a terminal condition, provides that no health benefit paid with state funds specifically Medicaid and the state insurance plan shall restrict coverage for physician prescribed treatment based upon the individual's diagnosis with a terminal condition.   
Nebraska (NE)
L 47 & L 76, Enacted and signed 2/14/2014. Adopts the Health Care Transparency Act; creates an advisory committee; relates to the health care data base to provide objective analysis of health care costs and quality, promote transparency for health care consumers, and facilitates the reporting of health care and health quality data; provides for the facilitation of value-based, cost-effective purchasing of health care services by public and private purchasers and consumers; includes provisions regarding claims and eligibility standards  
Study
New Mexico (NM) S 3131, Enacted and signed as Act 63, 3/13/2014. Makes general appropriations and authorizing expenditures by state agencies: provides for an audit of insurance premium tax collections. The office of superintendent of insurance includes $50,000 to study the impact of a basic health plan in New Mexico.  Basic Health
New York (NY)

S 6358, Enacted and signed as Act No. 58, 3/31/2014. The state commissioner "shall establish the managed care for persons with developmental disabilities advocacy program, hereinafter referred to as the advocacy program." which shall provide support to eligible individuals with developmental disabilities enrolling in developmental disability individual support and care coordination organizations. 

.Basic Health
 "

S 6914, Enacted and signed as Act No. 60, 3/31/2014: Authorizes the state to implement and operate a basic health plan, to provide subsidized health coverage for residents with annual income between 138%-200% of federal poverty. It is to be established in accordance with section 369-gg of the social services law, and in compliance with provisions of the ACA, as part of the state health and mental hygiene budget for the 2014-2015 state fiscal year. 

.Basic Health
Oregon (OR) H 4109, Enacted and signed 4/1/2014.  Requires Oregon Health Authority to commission an independent study of costs and impacts of expanding coverage by operating a basic health program in Oregon, consistent with the optional provision in the ACA, specifies goals of study, including number and characteristics of individuals who would be eligible to enroll in the basic health program, including legal resident aliens who are barred from Medicaid for five years, requiring report to Legislative Assembly by Nov. 30, 2014, appropriates $60,000 from General Fund to the authority for contract costs to conduct the study.  Basic Health
Tennessee (TN) S 1617, Enacted and signed as Act No. 583, 3/28/2014. 
Relates to health maintenance organization holding company systems, relates to enterprise risk, security holders, subsidiaries and investment authority, reinsurance agreements and consolidated tax allocation agreements. 
Other
Utah (UT) H 24 and signed.  Regulates health and accident insurance, designates insurance fraud investigators as law enforcement officers, preferred provider contracts, mental health and substance abuse disorders, and stop-loss insurance disclosure, relates to rebates and small employers.  Other
 " S 31, Enacted and signed as Act No. 371, 4/1/2014. Requires, in cooperation with the Insurance Department, the Department of Health, and the Department of Workforce Services, the state to create a Health Insurance Exchange that: (i) provides information to consumers about private and public health programs for which the consumer may qualify. (ii) provides a consumer comparison of and enrollment in a health benefit plan, would provide a consumer website and a call center.  Exchange; consumer protections
 " H 76, Enacted and signed as Act No. 300, 4/1/2014. Modifies the Insurance Code to address inducements, addresses when a de minimis gift or meal may be given, prohibits an insurer from inducing a person to continue or terminate an insurance contract by offering a benefit not specified or related to the insurance contract, provides that an insurer may not make an agreement of insurance that is not clearly expressed in the insurance contract to be issued or renewed, provides that a licensee under this title may not absorb any gross premium insurance tax.  Consumer protections
 " H 141, Enacted and signed as Act No. 425, 4/2/2014. Amends provisions related to health insurance and state and federal health care reform, amends the time in which an employee of a state contractor must be enrolled in health insurance to conform to federal law, facilitates coordination of eligibility, quality reports, conversions, health insurance navigators, Indian health center exceptions, the Comprehensive Health Insurance Pool, renewal of insurance plans, the Individual and Small Employer Risk Adjustment Act and premium tax credits for small employers.   
Vermont (VT) S 27, Enacted and signed, 03/21/2014.  Replaces offensive terms for individuals with a disability with respectful language, relates to the right to an interpreter, interchange of state employees, employment, guardianship, mental health proceedings, adoption, mandatory continued health insurance and Medicaid,  Other
Virginia (VA) H 33 & S 483, Enacted. Provides that a health carrier selling a health benefit plan in the small group or individual market  that does not include the minimum essential pediatric oral health benefits required under the federal Affordable Care Act shall be deemed to have obtained reasonable assurance that the pediatric oral health benefits are provided to the plan's purchaser.  EHB
Washington (WA) H 2572, Enacted 4/4/2014.  Seeks to improve ''the effectiveness of health care purchasing and transforming the health care delivery system by advancing value-based purchasing, promoting community health, and providing greater integration of chronic illness care and needed social supports.'' Would establish terms for the state innovation plan to include:  "(a) Improve health overall by stressing prevention and early detection of disease and integration of behavioral health, (b) Developing linkages between the health care delivery system and community, and (c) Supporting regional collaboratives for communities and populations, improve health care quality, and lower costs.'' Would require legislative oversight to coordinate services provided by the state-run exchange and other health-related programs.  value-based
 " H 6002, Enacted 4/4/2014.. Would order an analysis of the impacts of using the Washington health benefit exchange as a mechanism for providing health insurance for part-time K-12 public school employees. The analysis shall include a review of how the exchange, federal health premium tax credits and subsidies for out-of-pocket expenses administered through the exchange, and Medicaid expansion have impacted, or could impact, health care costs for individuals, school districts, and the state. The analysis shall also include a review of the cost of stand-alone dental plans.  State employee
 "

S 5931, Enacted and signed as Act 31, 3/17/2014. Requires health carriers offering health benefit plans that meet the definition of bronze level in the individual or small group market to also offer silver and gold level plans; requires nongrandfathered individual and small group health plans to conform with certain actuarial value tiers.

Consumer protections
" S 6016, Enacted as Act No. 84, 3/27/2014 . Provides that the state-run "exchange must provide electronic notification to the qualified health plan before the sixth of the month indicating an enrollee has not paid the premium." Consumer protections
 " S 6228, Enacted and signed as Act 224, 4/9/2014. Requires health carriers to offer transparency tools for members with certain price and quality information and to attest to the Office of the Insurance Commissioner that the tools meet certain requirements and that access is available on the health plans secured member web site, directs a stakeholder committee to identify and recommend statewide measures of health performance, requires state agencies to use the measures to inform and set benchmarks for their purchasing.  Consumer protections - price
 " S 6551, Enacted as Act No. 141, 3/28/2014. Requires the Insurance Commissioner to reauthorize the efforts to develop processes, guidelines, and standards to streamline health care administration, requires the Office of the Insurance Commissioner to establish a work group to develop recommendations for prior authorization requirements, prohibits health carriers from requiring prior authorization for routine health care services for which a person may self-refer, requires a carrier to disclose authorization methods and clinical protocols.  Consumer protections

Table 2B - 2013 Enacted Laws by State

State

Law / Date / Summary / Links

Topic

Arizona
(AZ)

H 2550; Enacted & signed by Governor as Chapter No. 215, 6/19/2013
Ensures that this state retains full authority to regulate policies, certificates, evidences of coverage and contracts that are issued or delivered by health insurers considering the enactment of the Patient Protection and Affordable Care Act.

General Insurance Reform

Arkansas
(AR)

S 1107; Enacted & signed into law as Act No. 713, 4/4/2013
Amends the comprehensive health insurance pool act to provide for the orderly cessation of operations

High Risk Pools

 

H 1143; Enacted as Chapter No. 1498, 4/23/2013
Creates the Health Care Independence Act of 2013; provides that the State through the Department of Human Services shall utilize a private insurance option for "low-risk" adults; ensures that private health care options increase and government-operated programs such as Medicaid decrease; relates to the State covering low-income Arkansans through offering new coverage opportunities, stimulating market competition, and offering alternatives to the existing Medicaid program.

General Insurance Reform

 

S 1020; Enacted as Chapter No. 1497, 4/23/2013
Creates the Health Care Independence Act of 2013; ensures that private health care options increase and government-oriented programs such as Medicaid decrease, and decisions about the design, operation and implementation of this option, including cost, remain within the purview of the State and not with Washington, D.C.

General Insurance Reform

California

(CA)

A 2a; Enacted & signed into law as Chapter No. 1, 5/9/2013
Requires a health plan or insurer to offer, market, and sell all of the plan's or insurer's health benefit plans that are sold in the individual market to all individuals and dependents in each service area in which the plan or insurer provides or arranges for the provision of health care services. Prohibits these plans from imposing any pre-existing condition upon any individual.

Essential Health Benefits, General Insurance Reform

 

S 2a; Enacted & signed into law as Chapter No. 2, 5/9/2013
Requires a plan or insurer to offer, market, and sell all of the plan's or insurer's health benefit plans that are sold in the individual market for policy years on or after a specified date, to all individuals and dependents in each service area in which the plan or insurer provides or arranges for the provision of health care services. Modifies small employer enrollment periods and coverage effective dates. Modifies guarantee issue requirements.

Essential Health Benefits, General Insurance Reform

Colorado

 

H 1015; Enacted as Chapter No. 38, 3/15/2013

Amends current state law that prohibits small group health plans from disclosing mental health history, diagnosis, or treatment services information received in an initial application for coverage, or in subsequent claims for benefits, without the written consent of the insured person, repeals this prohibition, enables small group carriers to report mental health claims to the all-payer claims database as a cost and quality program, while protecting the privacy of all patients in accordable with federal law.

Other

 

H 1266; Enacted & signed by Governor, 5/13/2013
Aligns the "Colorado Health Care Coverage Act" (Colorado law) with the federal "Patient Protection and Affordable Care Act of 2010" and the federal "Health Care and Education Reconciliation Act of 2010" (federal law) to give the insurance commissioner the necessary authority to regulate health insurers with respect to new requirements of the federal law.

General Insurance Reform

 

H 1115; Enacted & signed by Governor, 5/28/2013
Terminates health care coverage for the Colorado high risk pool program, including all CoverColorado participants effective April 1, 2014, as part of the transition to health insurance coverage regardless of preexisting medical conditions under the federal ACA.

High Risk Pools

Delaware

H 162; Enacted & signed by Governor as Chapter No. 99, 7/15/2013
Brings the health insurance provisions of the State Insurance Code in compliance with the Patient Protection and Affordable Care Act; reflects the requirement that dependents be covered up until the age of 26; reflects the requirement that coverage not be denied due to preexisting conditions; prohibits imposing lifetime and annual benefits limits; sets such limits for policies prior to a specified date; regards guaranteed availability of coverage; prohibits certain insurance discrimination.

General Insurance Reform, Adult Dependents, Pre-existing conditions

Florida

S 1842; Enacted & signed as Chapter No. 2013-101, 6/3/2013
Authorizes the Office of Insurance Regulation to review forms and conduct market conduct examinations for compliance with the Patient Protection and Affordable Care Act and to report potential violations to the federal Department of Health and Human Services; provides for the licensure of navigators. Also requires health insurers and health maintenance organizations to provide a one-time notice to individual and small group policyholders of nongrandfathered health plans that describes the estimated impact of ACA on monthly premiums, when the policy is issued or renewed on or after January 1, 2014, and must first be filed with the state by September 1, 2013. Also provides for the future repeal of the Florida Comprehensive Health Association (high risk pool).

General Insurance Reform
High Risk Pools
 

 

S 1844; Enacted & filed as Chapter No. 2013-110, 6/6/2013
Authorizes the Florida Health Choices, Inc., to accept funds from various sources to deposit into health benefits accounts, subsidize the costs of coverage, and administer and support the program; requires the corporation to manage the health benefits accounts and provide the marketplace of options that an enrollee in the program may use; provides for payment for achieving health living performance goals.

Other

 

S 648; Enacted & signed by Governor as Chapter 2013-174,  6/14/2013
Deletes requirements that a health insurer submit proposed marketing communications or advertising material to the Office of Insurance Regulation for review and approval.

Other

 

S 1802; Enacted & signed by Governor as Chapter No. 2013-52, 5/20/2013
Modifies that terms full time state employees and part-time state employee for the purposes of excluding persons from other-personal-services funds who work less that a certain number of hours per work from the state Group Insurance Program; defines seasonal worker; relates to employer contributions to employee health savings accounts; relates to employee eligibility to participate in the state group health insurance program.

State Employee Health Plans

Georgia

H 389; Enacted & chaptered as Act No. 278, 5/7/2013
Sunsets requirements to provide conversion and enhanced conversion rights and coverage, adds new provisions allowing for the discontinuance of conversion and enhanced conversion coverage, sunsets certain provisions related to the assignment system, adds new provisions allowing for the discontinuance of assignment system benefit plans, provides for related matters, repeals conflicting laws.

General Insurance Reform

 

S 236; Enacted & chaptered as Act No. 338, 5/7/2013
Requires insurers issuing accident and sickness policies in this state to indicate on their premium statement to consumers the amount of the premium increase, if any, attributable to the Patient Protection and Affordable Care Act.

Other

Hawaii

H 848; Enacted & signed by Governor as Act No. 2013-192, 6/25/2013
Creates a uniform network adequacy standard to be applied to all health insurers doing business in the State; reaffirms the existing definition of "small employer" to ensure the definition of "small employer" is applicable to the implementation of all provisions of the Affordable Care Act in Hawaii; and applies licensing requirements for insurance producers to health maintenance organizations and mutual benefit societies.

Small Employer

 

S 1073; Enacted & signed by the Governor as Act No. 2013-191. 6/25/2013
Requires all dental service corporations to comply with applicable federal law. Requires the commissioner to enforce the consumer protections and market reforms relating to insurance as set forth in the federal Patient Protection and Affordable Care Act, Public Law 111-148.

Essential Health Benefits

Illinois

S 3233; Enacted & signed into law as Public Act No. 1148, 1/24/2013
Amends the Health Maintenance Organization Act; changing specified definitions related to evidence of coverage; provisions of the act regarding deductibles and copayments of enrollees would apply to enrollees and does not limit health care plan payment for services provided by non-participating providers; also redefines the out-of-pocket expenses of a high deductible health plan under a health savings account (HSA).

General Insurance Reform, HSA

Kansas

 

H 2107; Enacted & signed by Governor, 4/16/2013
Concerns insurance, enacts the Electronic Notice and Document Act, allows the use of electronic notices and documents in lieu of any other provision of law for the sending of insurance notices and documents, relates to adverse underwriting decisions by an insurance company or health maintenance organization, allows return of premiums separate from notice.

Other

Louisiana

S 55; Enacted & signed by Governor as Act No. 212, 6/10/2013
Requires the Department of Health and Hospitals to submit an annual report to the legislature on the Louisiana Medicaid Bayou Health and Louisiana Behavioral Health Partnership and Coordinated System of Care programs; provides for Medicaid state plan amendments.

Other

 

H 638; Enacted & signed by Governor as Act No. 325, 6/17/2013
Provides for the cessation of enrollment and plan coverage; provides for the transition of plan members into the individual market; provides for notice of termination of coverage; provides for notice to stakeholders and claimants of deadlines regarding claims filing dates; provides for the cessation of the service charge to providers or health insurers; ends the assessment of fees on health insurers; relates to insurers' consideration of insured's obligations.

General Insurance Reform

Maine
(ME)

S 404; Enacted & chaptered without Governor's signature as Public Law 273, 6/15/2013
Suspends the authority of the Maine Guaranteed Access Reinsurance Association from January 1, 2014 to December 31, 2016 or until such time as the transitional reinsurance program administered by the federal Department of Health and Human Services pursuant to the federal Patient Protection and Affordable Care Act is no longer operational. The bill also directs the Board of Directors of the Maine Guaranteed Access Reinsurance Association to amend the association's plan of operation.

Other

Massachusetts

H 57; Enacted & signed by Governor as Chapter 3 of the Acts of 2013, 2/15/2013
Establishes the commonwealth Healthcare Payment Reform Fund.  The health policy commission shall be the trustee of the fund and may expend from the fund, without further appropriation, to carry out the purposes of chapter 224 of the acts of 2012.

Other

Minnesota

 

H 5; Enacted, signed by Governor and filed with the Secretary of State as Chapter No. 2013-9, 3/20/2013
Provides the commissioner of commerce, in consultation with the board of directors of the Minnesota Comprehensive Health Association, the authority to develop and implement the phase-out and eventual appropriate termination of coverage provided by the Minnesota Comprehensive Health Association under Minnesota Statutes, chapter 62E. The phase-out of coverage shall begin no sooner than January 1, 2014, or upon the effective date of the operation of the Minnesota Insurance Marketplace and the ability to purchase qualified health plans.

High Risk Pools

 

H 779; Enacted & signed by Governor as Chapter No. 2013-84
Conforms state law to federal requirements and establishes health plan market rules.

General Insurance Reform

Montana

 

H 87; Enacted as Chapter No. 334, 4/30/2013
Provides the state insurance commissioner with health insurance rate review authority.

Rate Review

 

H 22; Enacted as Chapter No. 169, 4/9/2013
Revises state auditor laws on insurance and amends provisions regarding insurance including the type of plans small employer carriers are required to offer to small employers.

Essential Health Benefits

Nebraska

L 336; Enacted & signed by Governor, 3/7/2013
Changes sickness and accident insurance provisions for policies subject to the federal Patient Protection and Affordable Care Act, provides not such policy subject to the Act shall be delivered or issued, nor shall an endorsement, rider, certificate, or application be used until a copy of the form and of the premium rates and of the classification of risks pertaining thereto has been filed with and approved by the Director of Insurance.

General Insurance Reform

Nevada

A 425; Enacted & signed by Governor as Chapter No. 541, 6/12/2013
Establishes licensure provisions for exchange enrollment facilitators, who will be licensed by the Commissioner of Insurance and appointed as navigators or assisters by the Silver State Health Insurance Exchange as part of the requirement that the Exchange implement a state-based health insurance exchange pursuant to the federal Patient Protection and Affordable Care Act.

General Insurance Reform

 

S 266; Enacted & signed by Governor as Chapter No. 375, 6/2/2013
Prohibits certain policies of health insurance and health care plans from making monetary limits on coverage for certain orally administered chemotherapy less favorable to the insured than other forms of chemotherapy; limits to total combined amount to any copayment, deductible or coinsurance for chemotherapy administered orally.

Essential Health Benefits

New Hampshire

S 148; Enacted and signed by governor as Chapter No. 2013-0272, 7/24/2013.  Addresses SHOP exchange, making changes to the statute applicable to health insurance carriers offering major medical health insurance coverage in the group and individual markets, regarding premiums charged.

Rate Review

 

H 526; Enacted & signed by governor as Chapter No. 2013-0200, 7/9/2013
Establishes a procedure for the termination of activities and dissolution of the association for the operation of the high risk pool; provides that health care coverage provided by the pool shall cease and no individual shall be eligible for coverage through the high risk pool.

High Risk Pools

New Jersey

S 2291; Enacted & signed by governor as Chaper No. 2013-78, 7/5/2013
Eliminates the requirement that every student who is enrolled full-time at a public or private institution of higher education in New Jersey maintain health insurance coverage which provides basic hospital benefits; eliminates the requirement that every full-time student annually present evidence of health insurance coverage and other provisions related to the health insurance coverage requirement.

Other

New Mexico

 

H 2; Enacted as Chapter No. 227
Makes general appropriations and authorizing expenditures by state agencies required by law.

General Insurance Reform

New York

S 2606; Enacted & signed by governor as Chapter No. 56, 3/28/2013
Amends various laws to provide for the enactment of the State Budget. Will address the health benefit exchange; navigators, insurers/providers and essential health benefits.

Essential Health Benefits

North Carolina

 

H 649 - Enacted and signed by governor, 7/25/2013.  Makes technical changes to the small employer group health coverage reform act to mitigate the effects of the federal affordable care act on North Carolina's small businesses

General Insurance Reform

Oklahoma

SJR 8; Enacted & signed by governor, 4/16/2013
Non-binding resolution, memorializes the President, vice-president and Congress to "work to eliminate or reform the Affordable Care Act's health insurance tax (2% tax on insurers) and other Affordable Care Act taxes."

Other

Oregon

 

H 2240; Enacted and signed by governor, 7/30/2013. Would align health insurance law with changes in federal law; would abolish the Office of Private Health Partnerships and end Family Health Insurance Assistance Program; would modify Health Care for all children program to terminate eligibility at 19 years of age, would allow Department of Human Services or Health Authority to specify eligibility requirements for private health option that are different from requirements for other medical assistance.

General Insurance Reform

 

H 3458; Enacted and signed by governor, 7/30/2013. Would establish the state Supplemental Reinsurance Program to be administered by the Medical Insurance Pool Board; would terminate the Medical Insurance Pool and Temporary High Risk Pool Program; would end the Supplemental Reinsurance Program; would provide for stabilization of rates for individual health benefit plans by providing state supplemental reinsurance payments to insurers from assessments; would provide for insurance under a portability plan, children's coverage, guaranteed availability and guaranteed renewability

Other/Reinsurance

 

S 169; Enacted as Chapter No. 333, 6/6/2013
Requires the Oregon Health Authority, Oregon Health Insurance Exchange Corporation, Oregon Educators Benefit Board and Public Employees' Benefit Board to identify activities that address diabetes, diabetes care and complications from diabetes; requires a report to Legislative Assembly on data, programs, outcomes and proposed next steps.

Essential Health Benefits

 

S 375; Enacted as Chapter No. 339, 6/6/2013
Allows coordinated care organizations to offer qualified health plans through health insurance exchange to individuals who are not medical assistance recipients.

Essential Health Benefits

Pennsylvania
(

H 818; Enacted & signed by governor as Act No. 2013-13, 6/17/2013
Amends Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, provides that the Commonwealth elects to prohibit certain abortion coverage in qualified health plans offered through the health insurance exchange; provides that no qualified health plan offered through the health insurance exchange shall include coverage for the performance of any abortion unless the reason is one for which the expenditure of public funds would be permitted, and no coverage for miscarriages or related complications.

Other

South Dakota

S 139; Enacted & signed by Governor, 3/8/2013
Regulates certain market activity in a health exchange. Any qualified health plan sold in South Dakota through a health care exchange, as mandated by the Patient Protection and Affordable Care Act of 2010, shall provide for placement through a licensed insurance producer upon enrollment. Any commission paid by a health insurance carrier for the sale of a health insurance plan through a health exchange shall be the same as commission paid by the same health insurance carrier outside the exchange for a similar plan.

Essential Health Benefits

Texas

S 1057; Enacted & signed by Governor, 6/14/2013
Makes changes to private health care insurance coverage and the health insurance exchange for individuals applying for certain Department of State Health Services programs and services.

General Insurance Reform

 

S 1367; Enacted & signed by Governor, 6/14/2013
Develops a plan for dissolving the Texas Health Insurance Pool.

High Risk Pools

Utah

H 47; Enacted & signed by Governor, 4/1/2013
Modifies the Insurance Code to include provisions regarding health benefit plan offerings, COBRA benefits and employer group coverage; addresses powers of the board related to the Utah Comprehensive Health Insurance Pool Act; amends lifetime maximum for covered benefits from the Comprehensive Health Insurance Pool.

High Risk Pools

 

H 193; Enacted as Chapter No. 109, 3/26/2013
Relates to a requirement that a state employer provide benefit information to specified employees; enacts a certain definition for purposes of the Public Employees' Noncontributory Retirement Act; modifies a provision relating to the designation of positions that are exempt from career service provisions; relates to hearing officer's decisions relating to agency actions in the context of a state employee grievance process and the number of hours of converted sick leave an employee may accrue.

State Employee Health Plans

Vermont

 

S 152; Enacted & signed by Governor as Act No. 54, 5/31/2013
Provides the Green Mountain Care Board with the sole authority for approving, modifying, and denying health insurance rate requests for major medical insurance policies. Permits the Commissioner of Financial Regulation and the Green Mountain Care Board to modify the allocation of expenses for carrying out their regulatory and administrative duties and would require them to report annually on the actual allocation of expenses for the previous calendar year.

Rate Review, Other

 

H 107; Enacted & signed by Governor as Act No. 79, 6/7/2013
Repeals the Catamount Health, Catamount Health Assistance, and VermontRx programs. Also makes minor technical and clarifying amendments to laws regarding health insurance, Medicaid, the Children's Health Insurance Program, VPharm, and the Vermont Health Benefit Exchange

General Insurance Reform

Virginia

H 1900; Enacted, became law without Governor's signature, 4/3/2013
Revises state law pertaining to the regulation of health insurance and related products in order to be consistent with relevant requirements of the federal ACA, effective January 1, 2014; including addressing premium rate restrictions on health benefit plans providing individual and small group health insurance coverage, prohibiting discrimination based on health status. Prohibits insurers from establishing any annual or lifetime limit on the dollar amount of essential health benefits (EHB), but would not prohibit annual or lifetime limits on benefits not defined as essential health benefits.

Consumer Protections, Essential Health Benefits

 

H 2138; Enacted as Chapter 709, 3/23/2013
Recommends what health benefits should be required to be included within the scope of the essential health benefits.

Essential Health Benefits

 

S 922; Enacted & signed into law as Chapter No. 679, 3/21/2013
Authorizes the State Corporation Commission, with assistance from the Virginia Department of Health, to perform plan management functions required to certify health benefit plans for participation in a federally facilitated health benefit exchange in Virginia.

General Insurance Reform

Washington
(

S 5449; Enacted & signed into law as Chapter No. 279, 5/16/2013
Makes eligibility modifications to the Washington state health high risk insurance pool, as of December 31, 2013 limiting eligibility to those who cannot qualify for Medicare or Medicaid, and who are denied coverage for other reasons, to remain enrolled through 2017, with a legislative study by 2015 of those who may still need state coverage.

High Risk Pools

 

H 1846; Enacted & signed by Governor as Chapter No. 325, 5/21/2013
Allows health maintenance organizations to provide coverage for certain pediatric oral services using non-contracted providers; subjects amounts paid for pediatric oral services that qualify as coverage for the minimum essential coverage requirement under the federal Patient Protection and Affordable Care Act to the premium tax; exempts amounts paid for other dental coverage offered by health maintenance organizations or life and disability insurers from the premium tax.

Essential Health Benefits

West Virginia

H 2960; Enacted & chaptered as Act No. 107, 5/15/2013
Relates to review of adverse determinations by health plan issuers; mandates utilization review and internal grievance procedures; provides for external review of adverse determinations; provides for judicial review of certain decisions; provides for continued benefits pending judicial review; provides for an award of attorneys fees; provides for no new causes of action; preserves existing causes of action; repeals similar provisions applicable to only health maintenance organizations.

Other

 

S 22; Enacted & chaptered as Act No. 104, 5/15/2013
Requires health insurance coverage of maternity services for all persons with insurance coverage under a health insurance policy if those services are covered under the policy; modifies required benefits for public employees insurance, accident and sickness insurance, group accident and sickness insurance, hospital medical and dental corporations, health care corporations and health maintenance organizations.

Mandate

Wyoming

 

S 84; Enacted & signed by Governor as Chapter No. 113, 3/1/2013
Freezes premiums for the Wyoming health insurance pool; provides that for the period July 1, 2013 through June 30, 2015, premium rates shall be the rates in effect on January 1, 2013, except the board may adjust those rates to reflect increases in the cost of claims and expenses.

High Risk Pools

2011 State Laws Implementing Health Insurance Market Reforms - MAP

Table 3 - 2011 and 2012 Enacted Laws by State

State

Law / Date / Summary / Links

Topic

 

 

Arkansas

 

H 1315; Enacted & signed into law as Act No. 196, 03/04/2011

Provides health insurance coverage for autism spectrum disorders. Specifies that on and after January 1, 2014, if these provisions require benefits that exceed the essential health benefits specified under the Affordable Care Act, the specific benefits that exceed the specified essential health benefits would not be required of a health benefit plan when the plan is offered by a health care insurer in the state through the state medical exchange, the provisions would continue to apply to plans offered outside the state medical exchange.

Mandate: Autism

 

H 1428; Enacted and signed into law as Act No. 269, 03/14/2011

2011 signed law, requires child-only individual market health insurance policies to be an option offered by all state regulated insurance companies, on a guaranteed-issue basis without any limitations or exclusions based upon the applicant's health status. Effective March 2011 through December 31, 2013.

Child-only

Arizona

S 1619; Enacted & signed into law as Chapter No. 31, 04/06/2011

Requires by December 31, 2012 the Arizona Health Care Cost Containment System administration (AHCCCS, the Medicaid agency) to transfer to the counties such portion, if any, as may be necessary to comply with section 10201(c)(6) of the Affordable Care act (P.L. 111-148), regarding the counties' proportional share of the state's contribution. Relates to 2011-2012 state budget reconciliation, to the duties and responsibilities of the (AHCCCS) administration, to the Children’s Rehabilitative Services Program, to Provider Rates and Hospital Reimbursement, to Cost Sharing, Covered Services and Eligibility, Prescription Drug Rebates, disproportionate Share Hospital Payments.

Medicaid only- General Insurance Reform

 

H 2016; Enacted & signed into law as Chapter No. 83, 4/13/2011

Provides that the state administration shall offer a health benefit plan on a guaranteed issuance basis to small employers as required, with all small employers qualified for this guaranteed offer of coverage. The program "shall consider age, sex, health status-related condition, group size, geographic area and community rating when it establishes premiums for the healthcare group program."

Small employer

 

H 2534; Enacted & signed into law as Chapter No. 122; 3/29/2012
Pertains to funding for particular programs using an 1115 Medicaid waiver; would require cost sharing from eligible individuals. Also would require the state health care cost containment system administration to request the Center for Medicare and Medicaid Services (CMS) to approve federal matching Medicaid funding for designated rural hospitals. Also authorizes that the state "shall administer a healthcare group program" to allow willing contractors to deliver health care services to for small employers and public employers.

Other

California

A 36; Enacted and Chaptered by Secretary of State as Chapter No. 17, 4/7/2011
Provides additional conformity with federal income tax laws by adopting specified provisions of the Affordable Care Act of 2010 relating to gross income exclusions for reimbursements for medical care expenses under specified plans for dependents.

General Insurance Reform

 

A 210; Enacted and Chaptered by Secretary of State as Chapter No. 508, 10/6/2011
The law requires every group health insurance policy to provide coverage for maternity services, which is defined to include prenatal care, ambulatory care maternity services, involuntary complications of pregnancy, neonatal care, and inpatient hospital maternity care, including labor and delivery and postpartum care. The law specifies that the definition of "maternity services" shall remain in effect until such time as federal regulations and guidance issued pursuant to the federal Patient Protection and Affordable Care Act (Public Law 111-148) define the scope of benefits to be provided under the maternity benefit requirement of that act, after which time the definition of that term under the federal act and associated regulations and guidance shall apply to these provisions.

 Mandate: Maternity

 

A 242; Enacted and Chaptered by Secretary of State as Chapter No. 727, 10/9/2011
Provides additional modified conformity to provisions of the federal Affordable Care Act relating to simple cafeteria plans for small businesses, health care benefits of Indian tribe members, free choice vouchers, therapeutic discovery project grants, student loan repayment programs, and deduction for self-employment taxes.

 

General Insurance Reform

 

A 922; Enacted and Chaptered by Secretary of State as Chapter No. 552, 10/7/2011
Creates the Office of Health Consumer Assistance and eliminates the Office of Patient Advocate, to provide outreach and education about health care coverage to consumers. The Office will receive and respond to all phone and in-person inquiries, complaints, and requests for assistance from individuals concerning all health care coverage available in California, including coverage available through the Medi-Cal program, the Exchange, and the Healthy Families Program.

 

General Insurance Reform

 

S 51; Enacted and Chaptered by Secretary of State as Chapter No. 644, 10/9/2011

Relates to provisions of the federal Affordable Care Act that prohibit a health insurance issuer from establishing lifetime limits or unreasonable annual limits on the dollar value of benefits for any participant or beneficiary and which require an issuer to provide an annual rebate to each enrollee based on certain issuer revenue expenditures. Requires health care service plans and health insurers to comply with such requirements to the extent required by federal law.

 

General Insurance Reform

 

S 136; Enacted and Chaptered by Secretary of State as Chapter No. 698, 10/9/2011
Amends the Knox-Keene Health Care Service Plan Act; requires health care service plan contracts and health insurance policies to provide coverage for tobacco cessation treatment that includes specified courses of treatment and medication; requests the University of California, as a part of the Health Benefit (mandate) Review Program, to prepare a report regarding any state savings as a result of this coverage requirement.

 Mandate: Tobacco Cessation Treatment

 

S 146; Enacted and Chaptered by Secretary of State as Chapter No. 381, 9/30/2011
Prohibits health care service plans offered through the state insurance exchange, from restricting members from selecting any professional clinical counselor, a licensed professional clinical counselor who has received specific instruction in assessment, diagnosis, prognosis, counseling, and psychotherapeutic treatment of mental and emotional disorders, which is equivalent to the instruction required for licensure. Mandates insurers to provide such provider coverage.

 

General Insurance Reform

 

S 222; Enacted and Chaptered by Secretary of State as Chapter No. 509, 10/6/2011
Requires every individual health insurance policy to provide coverage for maternity services for all insureds covered under that policy.

 Mandate: Maternity

 

S 946; Enacted and Chaptered by Secretary of State as Chapter No. 650, 10/9/2011
Makes technical changes to existing law in order to comply with a provision of the federal Patient Protection and Affordable Care Act that prohibits a health insurance issuer offering group or individual health insurance coverage from imposing any preexisting condition for children with respect to plan years beginning on or after September 23, 2010, and for adults with respect to plan years beginning on or after January 1, 2014.

 

General Insurance Reform

 

A 1083; Enacted and Chaptered by Secretary of State as Chapter No. 852, 9/30/2012
Amends the state role in the federal Affordable Care Act, the Knox-Keene Health Care Service Plan Act of 1975, and the Voluntary Alliance Uniting Employers Purchasing Program, changing definitions and criteria related to risk adjustment factors, age categories, health status-related factors and small employers. Also addresses employer contribution requirements and pre-existing conditions. Prohibits encouraging or directing employers to purchasing pools under the health benefit exchange.

General Insurance Reform

 

A 1453; Enacted and Chaptered by Secretary of State as Chapter No. 854, 9/30/21012
Requires the Board of Health Benefit Exchange to submit to the Assembly Committee on Health and the Senate Committee on Health a recommendation for an existing health plan to set the benchmark for items and services to be included in the definition of essential health benefits as contemplated under PPACA and a specified federal bulletin.

General Insurance Reform

 

A 1846; Enacted and Chaptered by Secretary of State as Chapter No. 859, 9/30/2012
Authorizes the Insurance Commissioner to issue a certificate of authority to a consumer operated and oriented plan (CO-OP) established under the Patient Protection Act. Specifies that a plan is subject to all other provisions of law relating to insurance. Provides any plan insurer and any solvency loan are subject to requirements imposed on mutual insurers. Authorizes a request for information regarding the loan. Would prohibit the conversion of a plan and authorizes certification revocation for a violation.

General Insurance Reform

 

S 122; Enacted and Chaptered by Secretary of State as Chapter No. 789, 9/29/2012
Conforms state law to the federal Affordable Care Act and the Knox-Keene Health Care Service Plan Act of 1975. Exempts from dependent coverage requirements plans or health insurance policies that provide only supplemental "excepted" benefits and retiree-only plans or policies

General Insurance Reform

 

S 728; Enacted and Chaptered by Secretary of State as Chapter No. 451, 9/22/2012
Requires the board of the California Health Benefit Exchange to work with the Office of Statewide Health Planning and Development, the Department of Insurance, and the Department of Managed Health Care to develop a risk adjustment system for products sold in the Exchange and outside of the Exchange, as specified.

General Insurance Reform

 

S 951; Enacted and Chaptered by Secretary of State as Chapter No. 866, 9/30/2012
States the intent of the Legislature to enact a law that would implement the essential health benefits as established under specified provisions of the Federal Patient Protection and Affordable Care Act.

General Insurance Reform, Essential Health Benefits

Colorado

S 128; Enacted as Chapter 133, 5/3/2011

Requires an insurance carrier that participates in the individual health insurance market in Colorado to issue child-only plans on a guaranteed-issue basis.

Child-only

 

H 1144; Enacted & signed into law as Session Law Chapter No. 65, 03/25/2011

Requires health insurance coverage for multidisciplinary evaluations of children suspected of having fetal alcohol spectrum disorders (FASD). Specifies that if the "essential benefits" provisions for exchanges under the federal health care reform act do not include FASD coverage, thereby triggering a potential cost to the state, the bill directs the state to study the coverage of FASD and to advise about whether the state should cover the costs for health care exchange enrollees.

Mandate: Fetal alcohol

Connecticut

 

H 6308; Enacted, became law without governor's signature, 7/1/2011

Establishes the Connecticut Healthcare Partnership as a pooled or combined health purchasing plan; allowing nonstate public employers, municipal-related employers, small commercial employers and nonprofit employers to join the state employee health plan. Also bars lifetime limits by state law and coordinates state and federal oversight of medical loss ratios (MLRs).

State employee health plans, Medical Loss Ratio

 

S 1240; Enacted & signed into law as Public Act No. 11-44, 6/13/2011

Creates a bureau of rehabilitative services and implementation of provisions of the budget concerning human services; relates to the hospital tax on net patient revenue, Medicare coinsurance, the state's insurance plan for the uninsured, premiums for health insurance coverage for autism spectrum disorders.

 

General Insurance Reform

 

H 5038; Enacted & signed into law, 6/15/2012
Would implement the Governor's budget recommendations concerning an all-payer claims database program.

General Insurance Reform

Delaware

S 35; Enacted & signed into law as Chapter No. 18, 5/4/2011

Enables any eligible child dependent, who is a full time student as of May 1, 2011, and covered under a parent's health insurance as of that date, to remain an 'eligible child dependent' until the age of 26, subject only to the limitations on dependent coverage in the federal Affordable Care Act of 2010.

Adult dependents

 

S 56; Enacted & signed by governor, 6/27/2011

Requires insurers administering CHIP buy-in programs in other states to cause similar childrens buy-in programs to be offered in Delaware if they should engage in insurance sales or affiliations with Delaware insurers or health service corporations.

Other
(CHIP buy-in programs)

 

H 160; Enacted & signed into law Chapter No. 159, 7/29/2011

Changes provisions for supplemental health insurance coverage for children of insureds, raising the age children may be covered by their parents or parents' health insurance to the age of 26; provides that the provisions of this Act shall have no force or effect if the health care bill passed by Congress and signed by the President of the United States in 2010 is declared unconstitutional by the Supreme Court of the United States of America.

 Adult dependents

 

H 161; Enacted & signed into law as Chapter No. 141, 7/25/2011

Provides that no individual health insurance policy, contract or certificate that is delivered or issued for delivery in this State by any health insurer, health service corporation or managed care organization which provides for hospital or medical expenses shall deny coverage to a child under the age of 19 because of a pre-existing condition.

 

General Insurance Reform

 

S 153; Enacted & signed into law as Chapter No. 226, 4/19/2012
Conforms state law to new federal law prescribing external review of adverse decisions by health carriers regarding denial, reduction or termination of benefits where the review may be conducted, and that written notice shall be mailed requesting delivery confirmation by the United States Postal Service.

External Review

 

H 170; Enacted & signed into law as Chapter No. 246, 5/22/2012
Allows qualified individuals who are covered by small employer plans to continue their coverage at their own cost, for up to 9 months after termination of coverage; also provides that the Act shall have no force or effect if the Health Care bill passed by Congress and signed by the President in 2010 is declared unconstitutional by the U.S. Supreme Court or the provisions addressed by this Act are preempted by federal law on January 1, 2014.

Small Employer

Georgia

H 47; Enacted & signed into law, 5/13/2011

Authorizes health insurers to offer "cross-border" or out-of-state individual sickness insurance policies in-state, that have been approved for issuance in other states; providing for minimum standards for such policies and allowing insurers authorized to transact insurance in other states to issue individual accident and sickness policies in the state.

Out-of state policies

 

H 78; Enacted & signed into law as Act No. 223, 5/12/2011

Reduce state funds within the FY 2012 state budget by implementing a minimum Medical Loss Ratio (MLR) of 87% and including the 2.25% state premium tax within the existing administrative percentage for Care Management Organization (CMO) cap rate. Line item vetoes did not affect these provisions.

Medical Loss Ratio

 

H 741; Enacted & signed into law as Act No. 406, 3/15/2012
State FY 2012 supplemental budget, increases public "employee premiums 6.2% due to increased costs as a result of the requirements of the Patient Protection and Affordable Care Act (ACA). Total Funds: $17,900,000."

State Employee Health Plans

 

H 1166; Enacted & signed into law as Act No. 634, 5/1/2012
Establishes that as a condition of issuing health insurance coverage in the individual market insurers must offer child-only policies during open enrollment until January 1, 2014.

Child Only

 

H 742; Enacted & signed into law as Act No. 775, 5/7/2012
FY 2013 state budget, increases public employee premiums 6.2% due to increased costs as a result of the requirements of the Patient Protection and Affordable Care Act (ACA) (Total Funds: $35,000,000).

State Employee Health Plans

Hawaii

S 1273; Enacted & signed into law as Act No. 15, 4/25/2011

Authorizes the state insurance commissioner to enforce the consumer protections and market reforms relating to health insurance, including HMOs, mutual and fraternal benefit societies, as set forth in the Affordable Care Act.

Consumer protections/market reforms

 

H 1134; Enacted & signed into law, 7/12/2011

Provides for the continuation of the Hawaii Prepaid Health Care Act, with its operational employer mandate, by deleting the existing provision that would terminate that plan once a national health plan is enacted. The bill states, "The legislature is supportive of the Affordable Care Act... However, the legislature continues to believe that the Hawaii Prepaid Health Care Act provides superior benefits for the people of Hawaii, and the legislature is wary that current efforts to rescind or amend the federal Affordable Care Act may jeopardize the Hawaii Prepaid Health Care Act."

Other
(Hawaii Prepaid Health Care Act)

 

S 1274; Enacted & signed into law, 7/12/2011

Provides uniform standards for external review procedures based on NAIC Uniform Health Carrier External Review Model Act, to comply with the requirements of the federal Affordable Care Act of 2010.

External Review

 

S 1276; Enacted & signed into law as Act No. 254, 7/6/2012
Prohibits any state entity from establishing a basic health program, pursuant to the Patient Protection and Affordable Care Act, without legislative authority to do so.

Other

Idaho

HJM 3; Adopted non-binding resolution, 3/21/2011

Adopted non-binding resolution, "urgently" requests the U.S. Department of Health and Human Services to remove health insurance agent and broker commissions from the medical loss ratio (MLR) calculation; also "strongly encouraging Congress" to amend the Affordable Care Act to remove agent and broker commissions from the MLR calculation.

Medical Loss Ratio

 

H 323; Enacted & signed into law as Chapter No. 292, 4/11/2011

FY 2011 Appropriations bill requires the director of administration to maintain grandfather status for state-administered health insurance for FY 2012.

State Employee plan

Illinois

HR 22; Adopted non-binding resolution, 4/6/2011

Adopted non-binding resolution urges Congress and the President to immediately consider enactment of a Single Payer option based on the Medicare model for adoption as an additional component of a national health reform plan.

Single payer

 

H 103; Enacted & Chaptered as Public Act No. 98, 7/14/2011

Requires the state Attorney General to post on its public website the summary pricing reports required from pharmaceutical manufacturers and group purchasing organizations under the transparency provisions of federal Patient Protection and Affordable Care Act.

General Insurance Reform

 

S 1313; Enacted & signed into law as Public Act No. 695, 6/21/2012
Amends the state high risk, Comprehensive Health Insurance Plan Act; deletes state-only subsidies of cost of health insurance coverage to coordinate with the federal pre-existing condition insurance plan (PCIP).

High Risk Pools

 

S 2885; Enacted & signed into law as Public Act No. 715, 6/28/2012 
Sets forth provisions concerning health care cooperatives; provides that in addition to all other provisions of the Article concerning domestic mutual companies, a company seeking to organize as a health care cooperative shall meet certain requirements; sets forth provisions concerning the naming of and applications for entities seeking to organize as health care cooperatives.

Other

Indiana

S 461; Enacted & Chaptered as Public Law No. 160-2011, 5/12/2011

To prepare for ACA, allows the office of Medicaid policy and planning to request federal approval to change how the state determines Medicaid eligibility for the aged, blind and disabled. Requires the Indiana Check Up Plan to include any federally required bench mark services; allows, instead of requires, the plan to include dental and vision services; makes specified changes concerning the plan beginning January 1,2014. Requires external review and appeals of health insurance denials consistent with the ACA.

Sec. 2 requires that a "state agency may not implement or prepare to implement the federal health care act," and may not adopt regulations unless authorized by state law. An agency may not apply for or accept a grant related to the ACA unless it is reviewed and recommended by the Legislative Council.

General Insurance Reform

 

H 1001; Enacted & Chaptered as Public Law No. 229-2011, 5/13/2011

Revises the eligibility requirements for the Indiana high-risk pool, run as the Comprehensive Health Insurance Association, requiring applicants to first apply for the federal Pre-existing Condition Insurance Plan (PCIP) or the Healthy Indiana insurance program.

Pre-existing conditions

Iowa

H 597; Enacted & signed into law, 4/28/2011

Provides procedures for external review of adverse determinations made by health carriers, as required by the federal Patient Protection and Affordable Care Act, as amended by the federal Health Care and Education Reconciliation Act of 2010, which amends the Public Health Service Act; provides that the new provisions apply to all requests for external review filed on or after July 1, 2011.

External review

Kansas

H 2075; Enacted & signed into law, 8/10/2011

Pertains to the payment of the premium for and coverage under group life insurance; relates to health care related claim adverse decision utilization reviews and external review organizations; adds individual eligibility criteria and an increase in the maximum lifetime benefit under the State Uninsurable Health Plan Act; provides that providers of coverage for health care benefits and the insurance exchange shall exclude elective abortions, and provides such coverage shall only be through an optional rider.

 

General Insurance Reform

 

S 14; Enacted & signed into law, 5/14/2012
Eliminates lifetime limits from Kansas high risk pool (Uninsurable Health Insurance Plan Act) and expands participation in the plan for children under 19 with pre-existing conditions.  Also provides by state law that "The government shall not interfere with a resident's right to purchase health insurance or with a resident's right to refuse to purchase health insurance" nor enforce fines or penalties for non-purchase of coverage.
 

High Risk Pools

Kentucky

 

SR 55a; Adopted Senate resolution, 4/6/2011

Adopted Senate resolution, expressing support to override the Governor's veto of an enacted budget section that provided that all receipts received by the state through the Early Retiree Reinsurance Program of the Affordable Care Act shall be deposited in a sub-account of the Public Employee Health Insurance Trust Fund for future appropriation by the General Assembly to cover a portion of health insurance premium increases in future plan years. The ACA Early Retiree fund earmark section was VETOED by the Governor on March 25, 2011, as contradicting an existing earmark allocation.

Early Retiree Reinsurance

 

H 255; Enacted & signed into law as Act No. 54, 03/16/2011

2011 signed law allows an exclusion from state gross income tax for health insurance premiums for family policies which permit parents to provide health insurance coverage for an adult child, up to age 27, who is not their tax dependent. The change aligns the state law with the eligibility and tax deductible coverage specified in the Affordable Care Act of 2010.

Adult dependents

 

H 265; Enacted & signed into law as Act No. 144, 4/13/2012
Authorizes the state to seek "to explore the feasibility of an Interstate Reciprocal Health Benefit Plan Compact (IRHBPC) with contiguous states" to allow Kentucky and residents of contiguous states to purchase health benefit plan coverage among the states participating with the compact. The purposes of this compact are, through means of joint and cooperative action among the compacting states to promote and protect the interest of consumers purchasing health benefit plan coverage. The compact generally is authorized in section 1333 of the PPACA.

Out-of-State

Louisiana

 

S 154; Enacted & signed into law as Act No. 144, 6/24/2011

Requires that all health care coverage plans which include prescription benefits as part of its policy or contract provide coverage for step therapy or fail first protocols.

Mandate: Rx Step therapy or fail first protocols.

 

H 771; Enacted & signed into law as Act No. 208, 5/23/2012
Amends the state's existing requirements related to coverage of the diagnosis and treatment of autism spectrum disorders. Specifies that any provisions of the proposed law that would exceed the essential health benefits provided pursuant to the federal Patient Protection Affordable Care Act would not be required of a health benefit plan that is offered by a health care insurer in the state.

Mandates Defining or requiring health insurance

Maine

H 979; Enacted & signed into law as Public Law 2011-90, 5/17/2011

Gradually modifies the community rating provisions for individual and small group health plans; expanding in 3 increments the rating bands from the current ratio of 1.5:1 to 3:1 by January 1, 2014; allows financial incentives except for emergency care services; maintains the requirement that plans must provide reasonable access to services for all members; allows plans to provide financial incentives to members to reward providers for quality and efficiency.  Also provides, “Notwithstanding any other provision of this Title, a domestic insurer or licensed health maintenance organization authorized to transact individual health insurance in this State may offer for sale in this State an individual health plan duly authorized for sale in Connecticut, Massachusetts, New Hampshire or Rhode Island by a parent or corporate affiliate of the domestic insurer or licensed health maintenance organization.

General insurance reforms; rate review, out-of-state policies

 

H 1140; Enacted & signed into law as Public Law 2011-364, 6/16/2011

Amends the state health insurance laws to incorporate changes to implement the requirements of the federal Affordable Care Act adopted in 2010, including that carriers may vary the premium rate due to smoking status (20%) and family membership; also a state 78% medical loss ratio (averaged over 3 years); and a bar on ost pre-existing condition exclusions.

General Insurance Reforms; Medical Loss Ratio

 

H 1243; Enacted & signed into law as Public Law 611, 4/9/2012
Provides that if an insurer does not include prescription drugs subject to coinsurance under the total out-of-pocket limit for benefits provided under a health plan, the carrier shall establish a separate out-of-pocket limit not to exceed a specified amount per year for prescription drugs subject to coinsurance provided under a health plan to the extent not inconsistent with the federal Affordable Care Act.

General Insurance Reform

 

S 569; Enacted & signed into law as Public Law 638, 4/17/2012
Extends the provisions of the law governing the Maine Guaranteed Access Reinsurance Association to insurers that offer small group health plans to groups of 10 or fewer members.

Other

Maryland

H 170; Enacted & signed into law as Chapter No. 4, 4/12/2011; also:
S 183; Enacted & signed into law as Chapter No. 3, 4/12/2011

Expands a person's right to a hearing and the right to an appeal from an action of the Maryland Insurance Commissioner, providing by state law that provisions of federal law apply to specified insurers, nonprofit health service plans, and health maintenance organizations, authorizing the Commissioner to enforce consumer rights, appeals and coverage requirement in the federal law, and expanded notification of enrollee rights.

Consumer protections/market reforms

 

H 286; S 484;  Enacted & signed into law as Chapter No. 74 and 75, 4/10/2012
Requires the Secretary of Health and Mental Hygiene to publish specified medical loss ratio (MLR) premium and profit information for managed care organizations participating in the Medicaid Program on the Web site of the Department of Health and Mental Hygiene.

Medical Loss Ratio

 

S 954; Enacted & signed into law as Chapter No. 326, 5/2/2012
Authorizes a covered entity to disclose protected health information as allowed under specified federal privacy laws; authorizes a medical laboratory to disclose the results of a laboratory examination under specified circumstances; establishes specified exceptions to the prohibition on the disclosure of specified medical records by an insurer, an insurance service organization, a nonprofit health service plan, or a Blue Cross or Blue Shield plan.

General Insurance Reform

 

H 443; Enacted & signed into law as Chapter No. 152, 5/2/2012
Requires the State Health Benefit Exchange to make specified qualified dental and qualified vision plans available to specified individuals and employers, requires the Exchange to modify the format to accommodate the differences in plan options, requires the Exchange to establish and implement navigator program, prohibits any vision plan that is not qualified, provides that the SHOP Exchange shall be a separate insurance market within the Exchange, requires a SHOP Exchange navigator program, establishes a state-run process to select the essential health benefits benchmark.

Essential Health Benefits

Massachusetts (

H 3318; Enacted and signed into law as Chapter 9, 4/13/2011

Requires all contracts issued by the state's Health Insurance Connector Authority (exchange) the state employee Group Insurance Commission, and Medicaid to a third party insurer to provide health care insurance paid for by the state must provide that the third party will withhold payments to any nonprofit community hospital or nonprofit community health center which fails to reimburse the state. The provision is contained within a larger FY 2011 supplemental state budget.

Other (insurance reimbursement)

 

H 3535; Budget enacted and  signed into law as Chapter 68, 7/11/2011

FY 2012 annual budget includes $3,500,000 for providing small business health insurance wellness subsidies pursuant to 2006 Connector, with up to 15% of eligible employer health care costs for credit by the federal government under the federal Affordable Care Act.

State employee plan

 

S 2148; Enacted & signed into law as Chapter No. 61 - 2012, 3/23/2012
Provides that a limited network health plan must continue to provide coverage for medically necessary services that are part of the treatment program for a patient, prior to joining the network, undergoing treatment at a comprehensive cancer center, pediatric hospital or a specialty unit, stating "the carrier shall cover the services out-of-network, for as long as the service is unavailable in-network." Also requires that an insurer offering a tiered network plan must "clearly and conspicuously indicate the cost-sharing differences for enrollees in the various tiers." Applies to policies offered in the "Connector" or exchange.

 

Michigan

 

S 348; Enacted & signed into law as Public Act 142, 9/20/2011

Creates Health Insurance Claims Assessment Act; provides an assessment from every carrier and third party administrator on paid claims; creates the Health Insurance Claims Assessment Fund; requires the Department of Treasury to develop and implement a dashboard to provide information to state citizens regarding the amount of revenue collected from carriers and third party administrators subject to the assessment.

General Insurance Reform

 

SR 181; Enacted, 11/28/2012
Non-binding resolution, expresses support for an congressional amendment to the ACA that will allow insurance companies to consider Health Savings Account (HSA) contributions toward the payment of benefits and premiums in the medical loss ratio (MLR) calculation

HSA. Medical Loss Ratio

Minnesota

 

H 79; Enacted & filed with Secretary of State as Chapter No. 8, 3/21/2011

Conforms state tax law to cover the federal extension of dependent health care coverage to adult children under age 27 for tax year 2010.

Adult dependents

 

S 1045; Enacted & signed into law as Chapter No. 108, 5/27/2011

Regulates pharmacy benefit managers, insurance coverages, adjusters and appraisers.

General Insurance Reform

Mississippi

 

H 1514; Enacted & signed into law, 4/06/2011

Authorizes the Mississippi Department of Insurance to receive, budget and expend federal funds up to $500,000 in order to comply with and as a result of the passage of the Affordable Care Act.

Other (Insurance Dept. funding)

Missouri
(MO)

H 45; Enacted & signed into law, 7/8/2011

Provides that "any federal mandate implemented by the state shall be subject to statutory authorization of the general assembly." Create a new $20,000 employer tax deduction for each new full-time jobs created with an annual salary of at least the average annual county wage if the small business also offers new employee health insurance and pays at least 50% of the health insurance premiums of all full-time employees who opt into the offered plan. Any new proposed rule must "Certify that the rule does not have an adverse impact on, or must exempt small businesses with fewer than fifty full- or part-time employees."

Small Employer

Montana

 

H 53; Enacted & signed into law as Chapter No. 54, 3/25/2011

Consolidates state mandated benefits for the state employee group benefit plan and the Montana University System benefit plan.

Mandated
benefits; State Employee

Nebraska

L 73; Enacted & signed into law, 5/17/2011

Changes the Comprehensive Health Insurance Pool Act (high risk pool), providing for a pool administrator to be selected by bid including the "ability to negotiate reduced health care provider reimbursement rates for benefits payable under pool coverage for covered services;" also establishes health care provider reimbursement rates at 125% of Medicare rates; repeals provisions regarding the taxation of insurers.

High Risk Pools

 

L 1158; Enacted & signed by governor, 4/11/2012
Provides for a minimum medical loss ratio of eighty-five percent on all medical assistance program contracts and agreements as related to at-risk managed care for behavioral health services.

Medical Loss Ratio

Nevada

 

A 74; Enacted & signed into law as Chapter No. 506, 6/17/2011

Existing law provides a set of procedures for the external review of an adverse determination by a managed care organization. (NRS 695G.241-695G.310) Sections 2, 3, 8, 9, 79-118.8, 123-127 and 129-131 of this bill amend the external review process to comply with the federal Patient Protection and Affordable Care Act (Public Law 111 - 148) and enact other related provisions necessary to comply with the minimum standards prescribed by federal law.

External Review

 

A 80; Enacted & signed into law as Chapter No. 453, 6/17/2011

Makes various changes relating to the Nevada Public Employees' Benefits Program; relates to health benefits, preexisting conditions, retired employees and the spouses of employees. Eliminates the exclusion for certain preexisting conditions, as provided for in the Affordable Care Act.

State Employee Health Plans

New Hampshire

 

H 601; Enacted & chaptered, became law without governor's signature, 7/14/2011

Requires that before establishing standards for enforcing the provisions of the federal Affordable Care Act, the insurance commissioner "shall obtain approval from the proposed N.H. legislature's Health Insurance Reform Oversight Committee. The provision applies "to any state official or agency that seeks to enforce the insurance provisions of the Act."

General Insurance Reform

New Jersey

 

SR 57; Adopted on 3/15/2012
Expresses support of federal policy that accommodates religious employers regarding contraceptive services required to be covered under federal Patient Protection and Affordable Care Act.

Other

New Mexico

S 208; Enacted and signed into law as Chapter No. 2011-144, 04/07/2011

Amends state insurance code to provide greater transparency and new standards in rate review of applications for health insurance premium rate increases, providing for public hearings and administrative and judicial review of determinations in health insurance premium rate review matters.

Rate review

New York

S 5800; Enacted & signed into law as Chapter No. 219, 7/20/2011

Expands pre-existing condition protection and preventive health care; increases the age of dependent children; provides for choice of health care providers; prohibits lifetime and annual coverage limits "of essential health benefits in an individual, group or blanket policy of hospital, medical, surgical or prescription drug expense insurance;" eliminates certain patient appeal requirements; allows commissioner to implement regulations.

General Insurance Reform

North Carolina

S 323; Enacted & signed into law as Session Law No. 2011-85, 5/23/2011

Provides for the provision of online services to applicants and licensees; establishes the Seniors' Health Insurance Information Program as a statewide health benefits counseling program for Medicare beneficiaries; relates to certificates of insurance, insurance premium rates, nondependent child coverage and open enrollment, domestic insurers, health organizations, life or health insurers, property or casualty insurers, company risk level, claims and adjusters, insurance boards, and self insurers.

 

General Insurance Reform; rate review

 

H 578, S 608; Enacted & signed into law as Session Law No. 2011-96, 5/26/2011

Allows the state health plan for teachers and state employees to provide the basic plan premium-free using available cash balance reserves; delays implementation of certain changes to the state health plan until September 2011; complies with the federal Affordable Care Act; clarifies the state health plan's subrogation rights; grants the state treasurer immediate access to confidential state health plan documents to plan for the transfer.

 

General Insurance Reform

 

S 496;  Enacted, Governor's veto overridden by Senate, 7/13/2011

Provides fraud and abuse provisions required by the federal Affordable Care Act of 2010.

General Insurance Reform

North Dakota

H 1125; Enacted & signed into law, 04/07/2011


 Provides that the state administer and enforce the provisions of the Affordable Care Act that apply to insurance companies subject to the Commissioner's jurisdiction and to the extent that the provisions are not under the exclusive jurisdiction of any federal agency.  Amends state insurance code to provide greater transparency and new standards in rate review of applications for health insurance premium rate increases, providing for public hearings and administrative and judicial review of determinations in health insurance premium rate review matters.

General Insurance Reform ; Rate review

 

H 1127; Enacted & signed into law, 4/27/2011

Establishes or expands health carrier external review, utilization review, and grievance procedures; and regulates limitations on health insurance company risks and independent external reviews; including a penalty for violations.

External review

 

 

H 1386; Enacted and signed into law, 4/20/2011

Establishes an "any willing provider" consumer freedom of choice for health care services; providing that a health care insurer may not prevent a beneficiary from selecting the health care service provider of their choice provided that the health care provider is licensed in the state; also provides that the insurer may not impose upon any beneficiary selecting a provider a copayment fee or other condition not imposed upon all other beneficiaries; providing penalties for denying any provider the right to participate as a preferred provider.

Any willing provider

 

S 2237; Enacted & signed into law, 4/26/2011

Prohibits specific practices in the health insurance business; making or permitting any unfair discrimination between individuals of the same class and equal expectation of life in the rates charged for any contract of life insurance or of life annuity; includes unfair discrimination based on an individual's history or status as a subject of domestic abuse, disability, or geographic location.

Rating restrictions

Ohio

 

H 218; Enacted & signed into law as Session Law No. 2011-48, 9/26/2011
Revises health insurance plan external review processes to meet ACA requirements.

External Review

Oklahoma
(

S 563; Enacted & signed into law as Chapter No. 175, 5/9/2011

Modifies the state Health Insurance High Risk Pool Act, adding the federally funded "Pre-existing Condition Insurance Plan" (PCIP) as creditable health insurance coverage and modifying determination of certain premium rates.

High Risk Pools; Pre-existing conditions

 

H 1554; Enacted & signed into law, 5/2/2011

Creates the Oklahoma Options Counseling for Long-term Care Program within the Department of Human Services Aging Services Division and administered within the Aging Services Division Aging and Disability Resource Consortium. The program and its partner community agencies will provide individuals or their representatives, or both, with long-term care options consultation. Legislation requires that the Program not be used to implement any provisions of the federal Affordable Care Act (a permissible state choice under federal law).

Other (Long Term Care)

Oregon

S 88; Enacted & signed into law as Chapter No. 69, 5/19/2011

Requires the Director of Department of Consumer and Business Services to adopt internal and external review procedures for denial of long term care insurance claims. Requires insurer to notify insured of review procedures. Extends prompt payment requirements and interest on unpaid claims for health benefit plans to long term care insurers.

External review

 

S 89; Enacted & signed into law, 6/23/2011

Authorizes the state to enforce health insurance requirements of federal law; modifying definitions of health benefit plan and including student health insurance within definition; prohibits health insurers from canceling, rescinding or refusing to renew policy on or after September 23, 2010, except for fraud or intentional misrepresentation of material fact. Also requires health insurers to notify covered persons and departments regarding rescinded policies.

General Insurance Reform

 

S 104; Enacted and signed into law as Chapter No. 70, 5/19/2011

Updates authorization for the federally-funded Temporary High Risk Pool Program, established to ensure health insurance coverage for individuals who are uninsured and are not enrolled in the Oregon Medical Insurance Pool or other publicly funded medical assistance.

High Risk Pools

 

S 1509; Enacted & signed into law as Chapter No. 80, 3/27/2012
Provides that dentists and dental hygienists that meet specified requirements may practice in the state without a valid license issued by the State Board of Dentistry; also provides that a fully capitated health plan (HMO), physician care organization, or coordinated care organization may not discriminate with respected to participation against any willing health care provider who is acting within the scope of the provider's license or certification under state law.

Any Willing Provider

 

H 4164; Enacted & signed into law as Chapter No. 38, 3/12/2012
Requires State Health Insurance Exchange Corporation to establish and deposit moneys into accounts in federally insured depositories, removes this requirement but still permits excess moneys collected by the corporation from insurers and state programs to be held and invested to offset future net losses, prescribes investments to be made with excess charges that are held and invested, authorizes the corporation to borrow money and give guarantees under specified conditions, establishes a state-run process to select the essential health benefits benchmark.

Essential Health Benefits

Pennsylvania

 

S 1336; Enacted & signed into law as Act No. 2011-134, 12/22/2011

Amends the act of December 18, 1996 (P.L.1066, No.159), known as the Accident and Health Filing Reform Act; divides the act into Federal compliance and Commonwealth exclusivity; provides in Federal compliance for required filings, for review, for disapproval, for record maintenance, for public comment, for penalties, for regulations and for expiration; provides in Commonwealth exclusivity for regulations and for action by the Insurance Commissioner.

General Insurance Reform

 

Rhode Island

 

S 107; Enacted & signed into law as Public Law 2011-175

Requires that health insurance contracts and plans issued or renewed in Rhode Island as of January 1, 2012, provide coverage for the screening, diagnosis, and treatment of autism spectrum disorders.

Mandate: Autism spectrum disorder

 

H 7909, S 2887; Enacted & signed into law as Public Law No. 256, 262, 6/18/2012
Establishes health insurance rules and standards in addition to, but not inconsistent with, the health insurance standards established in the Patient Protection and Affordable Care Act of 2010, as amended by the Health Care and Education Reconciliation Act of 2010. These rules and standards include, but are not limited to, prohibitions on rescission of coverage, discrimination in coverage, and prohibitions on annual and lifetime limits of coverage unless such limits meet set minimum amounts.

General Insurance Reform

 

H 7982, S 2888; Enacted & signed into law as Public Law No. 385, 361; 6/21/2012
Makes various amendments to healthcare chapters to ensure consistency with applicable federal law; including preexisting condition exclusions, dependent coverage, the merger of the individual health insurance market into the small employer market, premium rate restrictions and community rating areas, construction industry association rates, and marketing requirements.

General Insurance Reform

 

H 7784; Enacted & signed into law as Public Law No. 390, 6/21/2012
Directs the health insurance commissioner to establish a workgroup of health care providers and insurers for the purpose of developing processes, guidelines and standards to streamline health care administration in the state.

Other

South Dakota

 

S 43; Enacted & signed into law as Chapter No. 216, 3/14/2011

Revises health insurance standards, provides that no health insurer may terminate coverage of any person younger than 26, or 29 if a full-time student, provides for continuation, provides for filing of insurance rates, provides that no one under nineteen is subject to a preexisting condition limitation, requires low-dose mammography coverage, provides that genetic information may not be treated as a preexisting condition, requires rate filing before a small employer carrier rate increase.

Adult dependents,

Pre-existing conditions, rate review

 

H 1220; Enacted & signed by governor, 3/12/2012
Repeals certain provisions establishing network adequacy standards, quality assessment and improvement requirements, utilization review and benefit determination requirements, and grievance procedures for managed health care plans, and certain standards for managed health care plans if the Patient Protection and Affordable Care Act is found to be unconstitutional.

General Insurance Reform

Tennessee

S 484; Enacted & signed into law, 4/12/2011

Provides certain confidentiality protections from court-ordered discovery to certain health care organizations and providers for activities of quality improvement committees (QICs).

Confidentiality

 

S 1119; Enacted and signed into law as Chapter No. 118, 4/25/2011

Authorizes insurers to use incentives and rewards to encourage or reward participation in a health promotion program.

Health/Wellness Program

 

S 1539; Enacted & signed into law, 5/30/2011

Requires rate review, with medical service corporations and hospitals to submit premium rates and risk classifications to commissioner of commerce and insurance prior to any group policies being issued.

Rate review

Utah

H 18; Enacted & signed into law as Chapter No. 148, 03/22/2011

2011 signed law requires state employees hired after July 1, 2011 to be enrolled in a high deductible health insurance plan (consumer directed health plan) with a Health Savings Account, unless they select an alternative plan. Plans offered by the act must "promote appropriate utilization of health care, including preventive services." State employers must design trainings and require employees to attend training regarding such plans.

State employee plan

 

 

H 404; Enacted & signed into law as Chapter No. 373, 03/29/2011

Directs a committee to study the way the state provides health insurance to its employees and retirees, requiring the committee to coordinate its study of health insurance benefits for state employees with the study by the Health System Reform Task Force of the operations of the Health Insurance Exchange, also would require the Public Employees' Benefit and Insurance Program to provide assistance and information to the interim committee.

State employee plan

 

 

H 128; Enacted & signed into law as Chapter No. 400, 3/31/2011

Relates to health care reform to include third party payors, physician and clinic quality data, the Health Insurance Exchange brokers and the large group market, dental coverage under CHIP, state contractor employee health plans, group health plans premium rates, mental health insurance, NetCare, group premiums based on gender, insurance customer representatives practices, the Health Care System Reform Task Force, and health insurance actuarial reviews.  Effective 2011, gives the Utah Insurance Commissioner authority to require health insurers to comply with ACA provisions on lifetime and annual limits; prohibition of rescissions; coverage of preventive health services; coverage for a child or dependent; pre-existing condition coverage for children; insurer transparency of consumer information including plan disclosures, uniform coverage documents, and standard definitions; premium rate reviews; essential benefits; provider choice; waiting periods and appeals processes.

General Insurance Reform

 

S 138; Enacted as Chapter No. 127, 4/2/2012
Amends the Accident and Health Insurance Policy chapter of the Insurance Code, applies a health insurance mandate that is enacted by the state after January 1, 2012, to a public school district, charter school, or a state funded institution of higher education, requires the state to evaluate the cost of an insurance mandate enacted after January 1, 2012, for the state employees' risk pool, a public school district, a charter school, and state funded institutions of higher education.

State Employee Health Plans

 

H 272; Enacted as Chapter No. 402, 3/26/2012
Amends the Public Employees' Benefit and Insurance Program Act to create a pilot program to provide coverage for treatment of autism spectrum disorders; would require the Public Employees' Benefit and Insurance Program to establish a pilot program to provide coverage for treatment of autism spectrum disorders; describes minimum coverage amounts and limits for the autism coverage required by this bill.

Autism Spectrum Disorder

 

H 144; Enacted & signed into law as Chapter No. 279, 5/8/2012
Amends provisions in the Health Code and Insurance Code related to the state's strategic plan for health system reform.  Establishes the Legislature as the entity to determine the benchmark for an essential health benefit plan for the state.

General Insurance Reform; Essential Health Benefits

Vermont

H 65; Enacted & signed into law as Act No. 3, 02/17/2011

Adjusts state insurance rate review to be consistent with the Affordable Care Act by deleting the specific provision that required "maintaining the premiums at levels due on June 15, 2008."

Rate review

 

H 202; Enacted & signed into law, 5/26/2011

Establishes a strategic plan for creating a single-payer and unified health system; establishing a board to ensure cost-containment in health care, to create system-wide budgets, and to pursue payment reform; also establishes a health benefit exchange for Vermont as required under federal health care reform laws; creating a public-private single-payer health care system to provide coverage for all Vermonters after receipt of federal waivers. Also see S. 57.

Single payer

 

 

 

H 438; Enacted & signed into law as Act No. 21, 5/19/2011

Makes various amendments to the Vermont statutes pertaining to insurance, securities, and health care administration; authorizes the Superintendent of Insurance to adopt and amend rules, establishes standards and enforces federal statutes and regulations in order to carry out the purposes of the Affordable Care Act. Defines "insured" as a member of a health benefit plan not otherwise subject to department's jurisdiction which has voluntarily agreed to use the external review process; also updates medical loss ratio requirements.

General insurance reforms

 

H 558; Enacted & signed into law as Act No. 75, 3/7/2012
Makes adjustments in the fiscal year 2012 appropriations act; creates emergency rules regarding insurance rate reviews, a health care information technology reinvestment fee from health insurers, and health insurance claims assessment; also modifies necessary rules related to eligibility and services to implement the family planning option of section 2303 of the PPACA.

Premium Rate Review

 

H 559; Enacted & signed into law as Act No. 171, 5/16/2012
Implements a number of changes to Vermont's health insurance, health coverage, and health care provider regulatory frameworks, including defining a small employer for the first three years of the Vermont health benefit exchange as an employer with 100 employees or fewer, merging the individual and small group insurance markets, expanding the duties and clarifying the role of the Green Mountain Care board, and giving the Green Mountain Care board authority over the health insurer rate review.

Small Employer Health Coverage, General Health Insurance Reform, Essential Health Benefits

Virginia

H 1928; Enacted & signed into law, 04/06/2011

2011 signed law expands the scope of Virginia's process for independent reviews of a health insurer's adverse decision regarding covered consumer health care benefits, in compliance with requirements of the federal Affordable Care Act, also eliminating the minimum eligibility threshold and $50 filing fee for appeals hearings. Also expands situations eligible for an independent external review to include covered persons of all licensed health carriers.

External review

 

H 1958; Enacted & signed into law as Chapter 882, 4/29/2011

Conforms inconsistent and conflicting requirements of Virginia's health insurance laws to corresponding provisions of the federal Affordable Care Act that became effective on September 23, 2010; requiring employers that offer dependent coverage to provide coverage for dependents of employees who do not have access to other employer-based health care.

Dependent coverage

 

H 343; Enacted & signed into law as Chapter No. 693, 4/9/2012
Creates the Virginia All-Payer Claims Database in order to facilitate data-driven, evidence-based improvements in access, quality, and cost of health care through understanding of health care expenditure patterns and operation and performance of the health care system.

Other

Washington

H 1220; Enacted & signed into law as Chapter No. 312, 5/11/2011

Modifies insurance provisions, eliminating the Insurance Commissioner's authority to review and disapprove rates for individual products. Also affects public inspection of actuarial formulas, statistics, and assumptions, credit history and insurance scores, and certain items required to be filed with the Insurance Commissioner by insurers or rating organizations or by title insurers.

Rate review

 

S 5371; Enacted & signed into law as Chapter No. 315, 5/11/2011

Expands access to commercial health insurance coverage for persons under age 19, requiring sale of child-only policies to individuals under age 19 through the state-administered high risk pool.

Child-only

 

S 5122; Enacted & signed into law as Chapter No. 314, 5/11/2011

Implements provisions of the Affordable Care Act; makes changes relating to coverage of dependents under disability insurance and health maintenance contracts, preexisting conditions, requirements that insurers offer certain medical plans, emergency services, adverse determinations, grievances, denials or termination of coverage, independent review organization recordkeeping requirements, loss ratio filings, contracts of the State Health Insurance Pool, and regulation of health care sharing ministries.

General insurance reforms

 

H 2523; Enacted as Chapter No. 211, 3/30/2012
Enacted statute regulating insurers and insurance products. Updates provisions regarding health insurance portability and internal and external review processes; prohibits a waiting period for outpatient prescription drugs for enrollees in the State Health Insurance Pool; changes the solvency trigger for Insurance Commissioner action for health insurers and life insurers.

External Review

 

S 6412; Enacted as Chapter No. 64, 3/23/2012
Relates to health carrier requirements of persons applying for individual health benefit plans; provides that if a person is seeking an individual health benefit plan, or enrollment in a basic health plan as a nonsubsidized enrollee, because his or her carrier is discontinuing coverage, completion of a standard health questionnaire shall not be a condition of coverage if certain criteria are met; makes changes concerning coverage in catastrophic health plans and preexisting condition waiting periods.

Other, Preexisting Conditions

 

H 2319; Enacted as Chapter No. 87, 3/23/2012
Provides for the further implementation of the health benefit exchange and related provisions of the Affordable Care Act that includes the offering of individual health plans and catastrophic health plans outside the state health benefit exchange, the levels of plans offering under the exchange, the certification of a plan under the exchange, plan premium rate methods, deductibles and out-of-pocket expenses, exchange status reports, and high risk pool coverage.  Provides that consistent with federal law, the  insurance commissioner, in consultation with the board and the health care authority, shall, by rule, select the largest small group plan in the state by enrollment as the benchmark plan for the individual and small group market for purposes of establishing the essential health benefits in Washington state under P.L. 111-148 of 2010, as amended.
 

General Insurance Reform, Essential Health Benefits

 

S 5940; Enacted & signed by Governor, 5/2/ 2012
Requires school districts to modify their benefits for employees to require every employee to pay a minimum premium for the medical benefit coverage, subject to collective bargaining; requires school districts offering medical, vision, and dental benefits to include specified options that are similar to those of required for state employees; requires the Superintendent of Public Instruction to limit a school district's authority to offer employee benefits for failing to report specified information.

Other

Wisconsin

S 2a; Enacted & signed into law as Act No. 2011-1, 01/24/2011

Creates a nonrefundable individual state income tax credit for certain amounts relating to health savings accounts (HSAs) that may be deducted from, or are exempt from, federal income taxes.

HSA

 

 

A 11a, Enacted & signed into law as Act No. 2011-10, 03/11/2011

Requires the director of Office of State Employment Relations (OSER) and the secretary of Employee Trust Funds to study the feasibility of requiring state employees to receive health care coverage through a health benefits exchange established pursuant to the federal law and creating a health care insurance purchasing pool for all public employees and individuals receiving health care coverage under the Medical Assistance (Medicaid) program. No later than June 30, 2012, the director and secretary must report their findings and recommendations to the governor.

State employee plan

 

Governor’s Executive Order #10, ordered 3/1/2011

By 2011 Governor's Executive Order, creates the Office of Free Market Health Care, jointly directed by the Department of Health Services and the Commissioner of Insurance. The Office is required to conditionally develop a plan for the design and implementation of a "Wisconsin health benefit exchange that utilizes a free-market, consumer driven approach," and explore all opportunities and alternative approaches that would free Wisconsin from establishing a health benefit exchange, including federal waivers.

HSA

West Virginia

(

H 2693; enacted & signed into law as Chapter No. 13, 4/1/2011; Effective 7/1/2011

Requires insurance coverage for autism spectrum disorders in individuals ages three through eighteen years for a applied behavioral analysis by a licensed physician or licensed psychologist.

Mandate: Autism spectrum disorder

 

H 4260; Enacted & signed by governor, 4/2/2012
Modifies existing insurance coverage mandate for autism spectrum disorders; specifies application of benefit caps; adds evaluation of autism spectrum disorder to included coverage; clarifies diagnosis, evaluation and treatment requirements; provides that coverage is no longer mandated if determined to not be counted as an essential benefit under the PPACA of 2010.

Mandate:  Autism Spectrum Disorder

 

Table 4 - Health Insurance Mandates: Laws Enacted in 2011 - 2013

The following 59 signed laws in 28 states, added or changed state health insurance mandated coverage or benefits between 2011 and 2013. They are listed separately because many do not reference the federal Affordable Care Act. For additional information on existing state mandates, and the pending provisions for the "essential health benefits package," see NCSL's report, "State Health Insurance Mandates and the ACA." The latest HHS guidance and bulletin provides new options for all states in defining essential health benefits based directly on state-enacted mandates in effect for the first quarter of 2012 - this included some new laws listed below. NCSL's Report has been updated for 2013.

 

State

Law

Alabama

S 283; enacted & signed into law as Act No. 298, 5/8/2012

Autism Spectrum Disorder

Alaska

S 74; enacted, became law without Governor's signature as Chapter No. 2012-63, 6/27/2012

Autism Spectrum Disorder

Arkansas

H 1315; enacted & signed into law as Chapter No. 196, 3/4/2011; Effective 10/1/2011
Autism Spectrum Disorder

H 14

28; enacted & signed into law as Chapter No. 269, 3/14/2011; Effective upon approval of Governor
Child-only plans

H 1915; enacted & signed into law as Chapter No. 1042, 4/1/2011; Effective 90 days after adjournment sine die, 7/26/2011

Gastric Pacemakers

S 213; enacted & signed into law as Chapter No. 1119, 4/4/2011; Effective 90 days after adjournment sine die, 7/26/2011
In Vitro Fertilization

S 66; enacted & signed into law as Chapter No. 855, 3/31/2011; Effective 1/1/2012
Morbid obesity diagnosis and treatment, including; gastric bypass surgery, and duodenal switch biliopancreatic diversion.

California

A 210; Enacted and Chaptered by Secretary of State as Chapter No. 508, 10/6/2011; Effective 7/1/2012

Maternity Services

S 136; Enacted and Chaptered by Secretary of State as Chapter No. 698, 10/9/2011

Tobacco Cessation

S 222; Enacted and Chaptered by Secretary of State as Chapter No. 509, 10/6/2011; Effective 7/1/2012

Maternity Services

S 946; Enacted and Chaptered by Secretary of State as Chapter No. 650, 10/9/2011

Behavioral health treatment for a pervasive developmental disorder or autism

Colorado

H 1186; enacted & signed into law as Chapter No.97, 4/8/2011; Effective 1/1/2012
Acupuncture Services

S 128; enacted & signed into law as Chapter No. 133, 4/29/2011; Effective upon passage, 4/29/2011
Child-only plans

H 1144; enacted & signed into law as  Chapter No. 65, 03/25/2011; Effective 90 days after adjournment sine die, 8/10/2011
Fetal alcohol spectrum disorders (FASD)

Connecticut

H 5032; enacted & signed into law as Public Law 11-88, 7/8/2011; Effective 1/1/2012
Health Insurance Coverage for Bone Marrow Testing

S 10; enacted & signed into law as Public Law 11-67, 7/8/2011; Effective 1/1/2012
Magnetic resonance imaging

S 923; enacted & signed into law as Public Law 11-83, 7/8/2011; Effective 1/1/2012
Lung cancer screening tests

S 396; enacted & chaptered as Public Law 11-225, 7/13/2011; Effective 1/1/2012
Screening and treatment of prostate cancer

S 18; enacted & chaptered as Public Law 11-171, 7/13/2011; Effective 1/1/2012
Breast magnetic resonance imaging

S 12; enacted & signed into law as Public Act No. 12-61
Colorectal Cancer Screening

S 97; enacted & signed into law as Public Act No. 12-150
Breast Ultrasound Screening

Delaware

S 98; enacted & signed into law as Chapter No. 194, 9/14/2011

Evidence-based preventive services, immunizations and recommended vaccinations, health screenings and children's wellness visits

Georgia

S 17; enacted & chaptered as Act No. 78, 5/11/2011; Effective 2/1/2012
Establishes the Special Advisory Commission on Mandated Health Insurance Benefits; provides for review of proposed legislation containing a mandated health insurance benefit or provider.

Indiana

H 1467; enacted & chaptered as Public Law 133-2011, 5/9/2011; Effective 7/1/2011
Physical Medicine and Rehabilitative Services

Illinois

H 1191; enacted & signed into law as Public Act No. 91, 7/11/2011; Effective 1/1/2012
Cancer Clinical Trial Insurance Coverage

Louisiana

S 154; enacted & signed into law as Chapter No. 144, 6/24/2011; Effective 1/1/2011
Step therapy or fail first protocols

H 693; enacted & signed into law as Act No.410, 6/1/2012
Orally Administered Anti-Cancer Medications

Maryland

H 888, S 701; enacted & signed into law as Chapter No. 525, 524; 5/19/2011; Effective 10/1/2011
Prescription eye drops refills

H 452; enacted & signed into law as Chapter No. 527, 5/19/2011; Effective 10/1/2011
Hearing Aids

S 154; enacted & signed into law as Chapter No. 425, 5/19/2011; Effective 1/1/2012
Ambulance Services Payment

S 179; enacted & signed into law as Chapter No. 4, 4/10/2012; Effective 10/1/2012

Orally administered cancer chemotherapy

Michigan

S 414; Enacted & signed into law as Public Act 99, 4/18/2012

Autism Spectrum Disorder

S 415; Enacted & signed into law as Public Act 100, 4/18/2012

Autism Spectrum Disorder

S 981; Enacted & signed into law as Public Act 101, 4/18/2012

Autism Spectrum Disorder

Montana

H 53; enacted & signed into law as Chapter No. 54, 3/25/2011; Effective 10/1/2011
Consolidates state mandated benefits for the state employee group benefit plan and the Montana University System benefit plan.

Nebraska

L 882; enacted & signed by governor, 4/6/2012

Orally administered anticancer medication

New Hampshire

H 31; enacted & signed into law as Chapter No. 133, 6/7/2011; Effective 1/1/2012
Ambulance Payments and Bone Marrow Testing

New Jersey

S 1834; enacted & signed into law as Chapter No. 2011-188, 1/17/2012

Oral Cancer Drugs

New Mexico

S 385; enacted & signed into law as Chapter No. 55, 4/4/2011; Effective 6/17/2011
Orally Administered Anticancer Medication

S 81; enacted as Chapter No. 27, 3/3/2012

Prescription eye drop refills

New York

S 5851; enacted & signed into law as Chapter No. 220, 7/20/2011
Expands medical assistance coverage for speech, physical and occupational therapies to persons with traumatic brain injury.

S 3988; enacted & signed into law as Chapter No. 599, 9/23/2011

Orally Administered Chemotherapy Treatments Coverage

Oregon

S 787; enacted & signed into law as Chapter No.312, 6/9/2011; Effective 1/1/2012
Telemedical health service provided in connection with the treatment of diabetes

S 89; enacted & signed into law as Chapter No. 500, 6/23/2011; Effective 1/1/2012
Preventive Health Services

H 4128; enacted as Chapter No. 21, 3/5/2012

Medically necessary dental or orthodontic services for treatment of craniofacial anomalies

Rhode Island

S 107; enacted & signed into law as Public Law 2011-175, 6/30/2011; Effective upon passage

Autism Spectrum Disorder

H 5275; enacted & signed into law as Chapter No. 2011-159, 6/30/2011; Effective upon passage
Autism Spectrum Disorder

Tennessee

H 761; enacted & signed into law as Chapter No. 199, 5/18/2011; Effective 1/1/2012
Hearing aids for dependent children

Texas

H 438; enacted & signed into law as Chapter No. 105, 5/21/2011; Effective 9/1/2011
Orally Administered Anticancer Medication

Utah

H 272; Enacted as Chapter No. 402, 3/26/2012

Autism Spectrum Disorder

H 37; enacted & signed into law as Chapter No. 107, 5/8/2012

Telemedicine Services

S 223; enacted & signed into law as Chapter No. 158, 5/16/2012

Autism Spectrum Disorder

 

Vermont

S 15; enacted & signed into law as Chapter No. 35, 5/18/2011; Effective 10/1/2011
Midwifery services and home births

Virginia

H 2467, S 1062; enacted & signed into law as Chapter No. 876, 878; 4/29/2011; Effective 7/1/2011

Autism Spectrum Disorder

S 450; H 1273; enacted & signed into law as Chapter No. 641, 4/5/2012

Orally administered anticancer medication

Washington

H 1517; enacted & signed into law as Chapter No. 159, 4/22/2011; Effective 7/22/2011
Orally Administered Anticancer Medication

West Virginia

H 2693; enacted & signed into law as Chapter No. 13, 4/1/2011; Effective 7/1/2011
Autism Spectrum Disorder

H 4260; Enacted & signed by governor, 4/2/2012; Effective Ninety days after passage

Autism Spectrum Disorder

S 22; Enacted & chaptered as Act No. 104, 5/15/2013
Requires health insurance coverage of maternity services for all persons with insurance coverage.

Authors:  Richard Cauchi, Program Director and Steve Landess, (former Research Analyst, 2011-July 2013)  NCSL Health Program, Denver, Colorado.

Acknowledgments: Information published by the National Association of Insurance Commissioners (NAIC) has been of great value to those seeking to know the decades-long history of state insurance regulation.  [Visit: www.naic.org/]  Reports, releases and online posted regulations and guidance published by the Center for Consumer Information and Insurance Oversight (CCIIO) at CMS/HHS are important to any understanding of the insurance provisions in the Affordable Care Act. [Visit: http://cciio.cms.gov/]

Updates online:  This report has been updated several times a month during the 2011, 2012 and 2013 legislative sessions.

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