LRB-1145/P2
KRP:emw
2023 - 2024 LEGISLATURE
DOA:......Lessner, BB0177 - WIHSP Spending Limit Adjustment
For 2023-2025 Budget -- Not Ready For Introduction
An Act ...; relating to: the budget.
Analysis by the Legislative Reference Bureau
Insurance
Wisconsin Healthcare Stability Plan spending limit
This bill directs the commissioner of insurance to index for inflation the annual maximum expenditure amount under the Wisconsin Healthcare Stability Plan (WIHSP). Under current law, WIHSP makes a reinsurance payment to a health insurance carrier if the claims for an individual who is enrolled in a health benefit plan with that carrier exceed a threshold amount, known as the attachment point, in a benefit year. WIHSP is administered by OCI and operates under specific terms and conditions of a waiver agreement between OCI and the federal Department of Health and Human Services, which was dated July 29, 2018. Currently, the commissioner is limited to spending $230,000,000 for WIHSP from all revenue sources in a year, unless JCF increases the amount.
Beginning in 2025, the bill directs the commissioner to annually adjust the annual expenditure limit based on the increase, if any, in the medical care index of the consumer price index. The bill also specifies that OCI's authority includes the authority to operate WIHSP under any waiver extension approvals.
For further information see the state fiscal estimate, which will be printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
Section
1. 601.83 (1) (h) of the statutes is renumbered 601.83 (1) (h) (intro.) and amended to read:
601.83 (1) (h) (intro.) In 2019 and in each subsequent year Unless the joint committee on finance under s. 13.10 increases the amount upon request by the commissioner, the commissioner may expend no more than $200,000,000 the following amounts from all revenue sources for the healthcare stability plan under this section, unless the joint committee on finance under s. 13.10 has increased this amount upon request by the commissioner.:
(he) The commissioner shall ensure that sufficient funds are available for the healthcare stability plan under this section to operate as described in the approval of the federal department of health and human services dated July 29, 2018, and in any waiver extension approvals.
Section
2. 601.83 (1) (h) 1. and 3. of the statutes are created to read:
601.83 (1) (h) 1. In 2019, 2020, and 2021, $200,000,000.
3. In 2025 and in each year thereafter, the maximum expenditure amount for the previous year, adjusted to reflect the percentage increase, if any, in the consumer price index for all urban consumers, U.S. city average, for the medical care group, as determined by the U.S. department of labor, for the 12-month period ending on December 31 of the year before the year in which the amount is determined. The commissioner shall determine the annual adjustment amount for a particular year in January of the previous year. The commissioner shall publish the new maximum expenditure amount under this subdivision each year in the Wisconsin Administrative Register.
Section
3. 601.83 (1) (hm) of the statutes is renumbered 601.83 (1) (h) 2. and amended to read:
601.83 (1) (h) 2. Notwithstanding par. (h), in In 2022 and in each year thereafter, the commissioner may expend from all revenue sources
, 2023, and 2024, $230,000,000 or less for the healthcare stability plan under this section.
(End)
