Chief Patron: Hanger
Establish Virginia Health Benefits Exchange Authority (language only)

Item 489.10 #1s

Language
Page 368, after line 33, insert:
"The Virginia Health Benefits Exchange Authority is hereby established as a political subdivision of the Commonwealth.  Nothwithstanding any other provision of law, the Administration shall begin the process to create a Virginia Health Benefits Exchange in a timely manner under the requirements of the Affordable Care Act in order to (1) Apply for any federal grants that may be available to assist in this effort, (2) To insure that Virginia operates its own exchange and is not forced to comply with a federal option, and, (3) To insure, to the maximum extent possible, Virginia's exchange is designed to address Virginia citizen's unique needs in a comprehensive and cost effective manner.  
The Authority shall establish and operate health benefit exchanges for qualified individuals and small businesses, collectively referred to as the Exchange. The Authority shall perform, or provide for the performance by other state agencies of, duties associated with the operation of the Exchange as required by the federal Patient Protection and Affordable Care Act, and implement the intent set forth in Chapter 823 of the 2011 Acts of Assembly that Virginia create and operate its own health benefits exchange to preserve and enhance competition in the health insurance market.
The Authority is authorized to enter into agreements with the State Corporation Commission and Departments of Medical Assistance Services, Health, and Social Services regarding the performance of duties related to the conduct of the Exchange. The Exchange shall be funded by assessments on health insurers offering plans in the Exchange.  Persons who file information that is known to be false or misleading, or willfully and knowingly violate any provision of the Act, are subject to a civil penalty of not more than $5,000.  The same market rules shall apply to health plans sold inside and outside the Exchange.  Mandated health benefits applicable to plans offered outside the Exchange shall also apply to plans offered through the Exchange. Insurance companies shall offer the same health plans, for the same price, inside and outside the Exchange.  Insurers are prohibited from offering bronze level plans outside the Exchange unless they also offer such plans through the Exchange.  The State Corporation Commission shall ensure that insurance agents and brokers are not provided with financial incentives to direct persons either to the Exchange or outside the Exchange.  
The provisions in this Item shall expire in the event that a court of proper jurisdiction invalidates the Patient Protection and Affordable Care Act, or the Patient Protection and Affordable Care Act is repealed."

Explanation
(This language amendment creates the Virginia Health Benefits Exchange Authority as a political subdivision of the Commonwealth and authorizes the Authority to apply for federal funding to establish a state-run exchange that is designed to address Virginia citizen's unique needs in a comprehensive and cost effective manner. The Authority is authorized to establish and operate health benefit exchanges for qualified individuals and small businesses, as required by the federal Patient Protection and Affordable Care Act, and consistent with Chapter 823 of the 2011 Acts of Assembly. The Authority may enter into agreements with other state agencies regarding the performance of duties related to the conduct of the Exchange. The Exchange is funded by assessments on health insurers offering plans in the Exchange. The same market rules shall apply to health plans sold inside and outside the Exchange. Mandated health benefits applicable to plans offered outside the Exchange shall also apply to plans offered through the Exchange. Insurance companies shall offer the same health plans, for the same price, inside and outside the Exchange. Insurers are prohibited from offering bronze level plans outside the Exchange unless they also offer such plans through the Exchange. The State Corporation Commission shall ensure that insurance agents and brokers are not provided with financial incentives to direct persons either to the Exchange or outside the Exchange. This amendment expires if a court invalidates the Patient Protection and Affordable Care Act, or the Patient Protection and Affordable Care Act is repealed.)