The proposed bill, known as Substitute Bill No. 3, establishes the Connecticut Affordable Health Care Trust Fund, which will be funded through contributions, grants, and gifts, and will be managed independently by the Treasurer. The fund aims to support the Connecticut Option affordable health care program, which will provide health insurance coverage to eligible residents, including a state health care premium subsidy. The program is set to begin on July 1, 2026, and will be overseen by the Secretary of the Office of Policy and Management, who will also be responsible for soliciting economic analyses of various health insurance policy options. The bill also defines "eligible individuals" for a basic health program and creates a new "basic health program account" to fund this initiative, emphasizing the importance of maximizing federal funding.

In addition to establishing the trust fund and health care programs, the bill introduces significant amendments to existing laws regarding health carrier prior authorization requests, ensuring timely determinations and enhancing consumer protections. Key insertions include provisions for deeming prior authorization requests approved if not acted upon within specified timeframes, as well as requirements for health carriers to provide comprehensive notices regarding adverse determinations. The bill also modifies the grievance process for institutions aggrieved by decisions made by the commissioner, allowing for rehearings and binding arbitration. Overall, the bill aims to improve access to affordable health care, streamline administrative processes, and enhance protections for consumers navigating health insurance coverage.

Statutes affected:
Committee Bill:
HS Joint Favorable:
File No. 447:
APP Joint Favorable: