Assembly Bill 1216 mandates the establishment and operation of a state-based health insurance exchange by the Office of the Commissioner of Insurance (OCI) in Wisconsin. Currently, the state utilizes a federally facilitated exchange under the Affordable Care Act (ACA). The bill outlines a transition plan where OCI will initially operate the exchange using the federal platform and then move to a fully state-run exchange by 2030. It also allows OCI to enter into agreements with the federal government to facilitate this transition and requires the imposition of user fees on insurers offering plans through the exchange.

The bill amends existing statutes to include provisions for the operation of the state-based exchange, including the establishment of user fees at different rates depending on the operational status of the exchange. Specifically, a user fee of 0.5 percent will be applied during the initial phase using the federal platform, while the first two years of the fully state-run exchange will see fees equivalent to those of federally facilitated exchanges. After that, the fee rates will be determined by OCI. Additionally, the bill creates a new section in the statutes to define the exchange and its operational requirements, ensuring that the state-based exchange meets federal standards.

Statutes affected:
Bill Text: 20.145(1)(g)(intro.), 20.145