Item 478 | First Year - FY2027 | Second Year - FY2028 |
|---|---|---|
| Plan Management (40800) | $708,732,934 | $558,536,578 |
| Federal Health Benefit Exchange Plan Management (40801) | FY2027 $134,817 | FY2028 $134,817 |
| State Health Benefit Exchange Plan Management (40802) | FY2027 $206,506,685 | FY2028 $56,460,329 |
| Commonwealth Health Reinsurance Program (40803) | FY2027 $502,091,432 | FY2028 $501,941,432 |
| Fund Sources: | ||
| General | FY2027 $170,573,599 | FY2028 $20,573,599 |
| Special | FY2027 $150,000 | FY2028 $0 |
| Dedicated Special Revenue | FY2027 $56,067,903 | FY2028 $56,021,547 |
| Federal Trust | FY2027 $481,941,432 | FY2028 $481,941,432 |
Authority: §§ 38.2-316.1 and 38.2-326, Code of Virginia; § 42.18041 c, United States Code.
A. There is hereby appropriated to the State Corporation Commission $115,176 the first year and $115,176 the second year from the general fund to pay for the plan management functions authorized in §§ 38.2-316.1 and 38.2-326.
B.1. Notwithstanding the provisions of § 4-3.02 of this act, the Secretary of Finance may authorize either a working capital advance or an interest-free treasury loan in an amount not to exceed $40,000,000 for the State Corporation Commission to fund start-up costs and other costs associated with the implementation of a State Health Benefit Exchange. The Secretary of Finance may extend the repayment plan for any such working capital advance or interest-free treasury loan for a period longer than twelve months.
2. The State Corporation Commission may use a portion of the user fees collected from health insurance carriers participating in the State Health Benefit Exchange to repay the working capital advance or interest-free treasury loan authorized in B.1.
C. Out of this appropriation, $20,000,000 the first year and $20,000,000 the second year from the general fund shall be transferred to the Commonwealth Health Reinsurance Program Special Fund State Corporation Commission, established pursuant to § 38.2-6604, Code of Virginia.
D. Notwithstanding any other provision of law, the state-mandated health benefit required by § 38.2-3418.21 shall apply to all qualified health plans offered in the Commonwealth.
E. The State Corporation Commission shall set the payment parameters for the Commonwealth Health Reinsurance Program at levels to achieve the premium reduction target of 15 percent.
F. Out of this appropriation, $150,000 the first year from the Commonwealth Health Reinsurance Program Special Fund is provided for development and submission of a state innovation waiver extension request pursuant to § 1332 of the Patient Protection and Affordable Care Act, to extend the Commonwealth Health Reinsurance Program for five years, and to implement the provisions for the program.
G. There is hereby appropriated to the State Corporation Commission the sum of $150,000,000 the first year from the general fund to create a non-reverting special fund known as the Virginia Health Insurance Affordability Fund. The Virginia Health Benefit Exchange (Exchange) shall develop and operate a program for plan year 2027 to reduce the monthly health insurance premiums for Virginia consumers of Qualified Health Plans sold through the Virginia state-based marketplace operated by the Exchange. Amounts in the Fund shall only be used for premium reduction payments under this program. The Exchange shall develop eligibility rules for the program that reduces the average monthly net premium by as much as 70 percent for individuals and families with household incomes greater than or equal to 138 percent of the federal poverty level and less than 250 percent of the federal poverty level. The Exchange is authorized to adjust the monthly premium reduction payment amount up or down as enrollment and fund balances change to maximize the use of the Fund consistent with the objective of this program. The Exchange shall develop other rules and parameters reasonably necessary to implement and operate this program. Any unexpended balances for the purposes specified in this paragraph which are unexpended on June 30, 2027, shall not revert to the general fund but shall be carried forward and reappropriated in fiscal year 2028.