HOUSE BILL NO. 3136 103RD GENERAL ASSEMBLY
INTRODUCED BY REPRESENTATIVE KNIGHT.
6935H.01I JOSEPH ENGLER, Chief Clerk
AN ACT To repeal section 376.1186, RSMo, relating to state-based health benefit exchanges.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Section 376.1186, RSMo, is repealed, to read as follows: [376.1186. 1. No state-based health benefit exchange may be 2 established, created, or operated within this state in order to implement Section 3 1311 of the federal health care act, 42 U.S.C. Section 18031, or any other 4 provision of the federal health care act that relates to the creation and operation 5 of a state-based health benefit exchange, unless the authority to create or 6 operate such an exchange is enacted into law through: 7 (1) A bill as prescribed by Article III of the Missouri Constitution; 8 (2) An initiative petition as prescribed by Article III, Section 50 of the 9 Missouri Constitution; or 10 (3) A referendum as prescribed by Article III, Section 52(a) of the 11 Missouri Constitution. 12 2. In no case shall the authority for establishing, administering, or 13 operating a state-based health benefit exchange in Missouri be based upon an 14 executive order issued by the governor of Missouri. 15 3. No department, agency, instrumentality or political subdivision of 16 the state of Missouri shall establish any program, promulgate any rule, policy, 17 guideline or plan or change any program, rule, policy or guideline to 18 implement, establish, create, administer or otherwise operate a state-based 19 health benefit exchange described in the federal health care act unless such 20 department, agency, instrumentality or political subdivision has received 21 statutory authority to do so in a manner consistent with subsection 1 of this 22 section. No department, agency, instrumentality or political subdivision of the 23 state of Missouri shall act as an eligible entity as described in Section 1311(f) 24 (3)(B) of the federal health care act to perform one or more of the
EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language. HB 3136 2
25 responsibilities of a state-based health benefit exchange unless authorized by 26 statute or a regulation validly promulgated pursuant to such statute. 27 4. No department, agency, instrumentality, or political subdivision of 28 this state shall apply for, accept or expend federal moneys related to the 29 creation, implementation or operation of a state-based health benefit exchange 30 or a federally facilitated health benefit exchange unless such acceptance or 31 expenditure is authorized by statute or an appropriations bill. 32 5. No department, agency, instrumentality, political subdivision, public 33 officer or employee of this state shall enter into any agreement or any 34 obligation to establish, administer, or operate a federally facilitated health 35 benefit exchange described in Section 1321(c)(1) of the federal health care act 36 unless such department, agency, instrumentality, political subdivision, public 37 officer or employee of this state has received statutory authority to enter into 38 such agreements or obligations. No department, agency, instrumentality, 39 political subdivision, public officer or employee of this state shall provide 40 assistance or resources of any kind to any department, agency, public official, 41 employee or agent of the federal government related to the creation or 42 operation of a federally facilitated health benefit exchange unless such 43 assistance or resources are authorized by state statute or a regulation 44 promulgated thereto or such assistance or resources are specifically required 45 by federal law. 46 6. Any taxpayer of this state or any member of the general assembly 47 shall have standing to bring suit against the state of Missouri or any official, 48 department, division, agency, or political subdivision of this state which is in 49 violation of this section in any court with jurisdiction to enforce the provisions 50 of this section. The court shall award attorney's fees, court costs, and all 51 reasonable expenses incurred by the taxpayer or member of the general 52 assembly if the court finds that the provisions of this section have been 53 violated. Such attorney's fees, court costs, and reasonable expenses shall be 54 paid from funds appropriated to the department, division, agency, or any 55 political subdivision of this state determined to have violated, in whole or in 56 part, the provisions of this section. In no case shall the award of attorney's 57 fees, court costs, or reasonable expenses be paid from the legal defense fund, 58 nor shall any department, division, agency, or political subdivision of this state 59 request, or be granted, additional appropriations in order to satisfy an award 60 made under this section. 61 7. As used in this section, the term "federal health care act" shall mean 62 the federal Patient Protection and Affordable Care Act, Public Law 111-148, 63 as amended by the federal Health Care and Education Reconciliation Act of 64 2010, Public Law 111-152, and any amendments thereto, or regulations or 65 guidance issued under such federal acts. 66 8. As used in this section, the term "state-based health benefit 67 exchange" means a governmental agency or nonprofit entity established by the 68 state of Missouri and not the federal government that meets the applicable 69 requirements of Section 1311 of the federal health care act and regulations 70 promulgated thereto and makes qualified health care plans available to 71 qualified individuals and qualified employers. The term "state-based health 72 benefit exchange" includes regional or other interstate exchanges and HB 3136 3
73 subsidiary exchanges as described in Section 1311(f)(1) and (2) of the federal 74 health care act. The term "federally facilitated health benefit exchange" means 75 a health benefit exchange established and operated by the Secretary of Health 76 and Human Services under Section 1321(c)(1) of the federal health care act, 77 either directly or through agreement with a not-for-profit entity.]
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Statutes affected: