HB612 Alabama 2021 Session

Summary

Primary Sponsor

Kerry Rich

Republican

Session

Regular Session 2021

Title

Insurance, state health insurance exchange, Commissioner of Insurance to estab. for individual coverage under fed. Affordable Care Act, Comm. to apply to fed. gov't for waivers for reinsurance program relating to this act, Secs. 10A-20-6.16, 27-21A-23 am'd.

Summary

HB612 would let Alabama create a state health insurance exchange to replace the federal ACA exchange and establish a state-based reinsurance program to stabilize individual market premiums, funded by dedicated exchange and reinsurance funds and supported by federal waivers.

What This Bill Does

The bill lets the Alabama Commissioner of Insurance create a state health insurance exchange for the individual market to replace the federal ACA exchange. It also authorizes applying for federal waivers to implement a state reinsurance program to stabilize premiums and maximize federal funding. It creates the Alabama Health Insurance Exchange Fund and the Reinsurance Fund to pay for the exchange and reinsurance program, and requires audits, reports, and data privacy protections.

Who It Affects

• Individuals purchasing health insurance in Alabama's individual market, who could see more stable premiums and more plan options.
• Health insurers offering ACA-compliant plans in Alabama's individual market, which would participate in the reinsurance program and must provide data and meet care management requirements.

Key Provisions

• Authorizes the Commissioner to establish the Alabama Health Insurance Exchange Fund to operate a state-based exchange for the individual market, replacing the federal ACA exchange.
• Authorizes seeking Section 1332 waivers to establish a state reinsurance program and to maximize federal funding; specifies use of exchange fund and federal funds.
• Creates two special funds: the Alabama Health Insurance Exchange Fund and the Reinsurance Fund; money is non-lapsing and dedicated to exchange and reinsurance activities.
• Establishes reinsurance program parameters (attachment point, reinsurance cap, coinsurance rate) to be set annually in consultation with carriers; payments to carriers on reinsurance-eligible plans; netting of other payments.
• Requires confidentiality protections, HIPAA/HITECH compliance, and limited sharing of de-identified data for reinsurance administration.
• Implements annual audits and reports: independent audits, posting on public website, and reporting of rate impact and program operations to the legislature.
• Contains sunset provisions if ACA provisions are repealed or invalidated or if the state determines the program is not in consumers' best interest; requires notice and steps to cease operations.
• Preserves Alabama sovereignty over health insurance regulation and allows the commissioner to adopt rules; enables administration by the commissioner and contracting as needed.

AI-generated summary using openai/gpt-5-nano on Feb 22, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Insurance Department