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--- version:As Introduced+++ version:(document, no version)@@ -1,224 +1,60 @@- S.B. 97+Committee Action:+ Do Pass __________+ Amend & Do Pass __________+ Other __________-- *SB97*+Senate Committee on Commerce and Labor+This measure may be considered for action during today’s work session.+SENATE BILL 97+Makes revisions to the Silver State Health Insurance Exchange. (BDR 57-346)+Sponsored By: Senate Committee on Commerce and Labor (On Behalf of the Joint+Interim Standing Committee on Health and Human Services)+Date Heard: April 4, 2025+Fiscal Notes: Effect on Local Government: No.+ Effect on the State: Contains Appropriation not included in+Executive Budget.+Senate Bill 97 requires the Executive Director of the Silver State Health Insurance+Exchange, in collaboration with the Director of the Department of Health and Human+Services, the Director of the Department of Business and Industry and the Commissioner of+Insurance, to:+• Apply for a federal waiver to authorize any natural person to purchase a qualified+health plan on the Exchange, regardless of his or her immigration status, if the+natural person otherwise qualifies to purchase such a plan on the Exchange; and+• Conduct an actuarial analysis to determine whether a federal waiver meets certain+federal conditions;+The bill makes an appropriation of $1,000,000 to the Exchange for the costs of the actuarial+analysis and other administrative tasks related to applying for and implementing the waiver.+Finally, SB 97 requires the Senate Majority Leader and the Speaker of the Assembly to each+appoint one additional voting member to the Board of Directors of the Silver State Health+Insurance Exchange.+Amendments:+Brett Scolari, S360, representing the Reno-Sparks Indian Colony proposed the attached+conceptual amendment during the bill hearing. In summary, the amendment deletes all+sections but retains Section 3, subsection 2(a) to provide that one of the five members+appointed by the Governor to the Board of Directors of the Exchange shall be a member of+a Nevada Indian Tribe with expertise in tribal health care administration in Nevada.-SENATE BILL NO. 97–COMMITTEE ON COMMERCE AND LABOR--(ON BEHALF OF THE JOINT INTERIM STANDING COMMITTEE-ON HEALTH AND HUMAN SERVICES)--PREFILED JANUARY 14, 2025-____________--Referred to Committee on Commerce and Labor--SUMMARY—Makes revisions to the Silver State Health Insurance-Exchange. (BDR 57-346)--FISCAL NOTE: Effect on Local Government: No.- Effect on the State: Contains Appropriation not included-in Executive Budget.--~--EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.--AN ACT relating to health insurance; requiring the Executive-Director of the Silver State Health Insurance Exchange to-apply for a federa l waiver to allow certain persons to-access health plans offered on the Exchange; expanding-the number of voting members of the Board of Directors-of the Exchange; making an appropriation; and providing-other matters properly relating thereto.-Legislative Counsel’s Digest:- Existing law establishes the Silver State Health Insurance Exchange to facilitate 1-the purchase of subsidized health plans by certain small employers and natural 2-persons who are citizens of the United States or otherwise lawfully present in the 3-United States. (Chapter 695I of NRS) Section 1 of this bill requires the Executive 4-Director of the Exchange, in collaboration with the Director of the Department of 5-Health and Human Services, the Director of the Department of Business and 6-Industry and the Commissioner of Insurance, to: (1) apply for a federal waiver to 7-authorize any natural person to purchase a qualified health plan on the Exchange, 8-regardless of his or her immigration status, if the natural person otherwise qualifies 9-to purchase such a plan on the Exchange; and (2) conduct, or contract with an 10-independent actuary to conduct, an actuarial analysis before applying for the waiver 11-to ensure that such waiver will comply with certain federal requirements. (42 12-U.S.C. § 18052(b)) Section 2 of this bill makes a conforming change to indicate 13-that the waiver, if approved, would authorize natural persons who are not lawfully 14-present in the United States to purchase qualified health plans. Section 4 of this bill 15-makes an appropriation of $1,000,000 to the Exchange for the costs of the actuarial 16-- – 2 –--- *SB97*-analysis and other administrative tasks related to applying for and implementing the 17-waiver. 18- Existing law creates the Board of Directors of the Exchange which consists of: 19-(1) five voting members appointed by the Governor; (2) one voting member 20-appointed by the Majority Leader of the Senate; (3) one voting member appointed 21-by the Speaker of the Assembly; and (4) three ex officio, nonvoting members. 22-(NRS 695I.300) Section 3 of this bill: (1) requires the Majority Leader of the 23-Senate and the Speaker of the Assembl y to each appoint one additional voting 24-member to the Board; and (2) makes a conforming change to the number of 25-members of the Board who must have certain expertise or experience to reflect the 26-increased number of members of the Board. Section 5 of this bill prescribes the 27-length of the initial terms of the new members added to the Board by section 3 to 28-ensure that the terms of the voting members of the Board are staggered. 29--THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN-SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:-- Section 1. Chapter 695I of NRS is hereby amended by adding 1-thereto a new section to read as follows: 2- 1. The Legislature hereby finds and declares that it is the 3-public policy of this State that each natural person who otherwise 4-qualifies to purchase a qualified health plan on the Exchange, 5-regardless of his or her immigration or citizenship status, is 6-eligible to receive the benefits of purchasing a qualified health 7-plan on the Exchange. 8- 2. The Executive Director, in collaboration with the Director 9-of the Department of Health and Human Services , the Director of 10-the Department of Business and Industry and the Commissioner, 11-shall: 12- (a) Conduct, or enter into a contract with an independent 13-actuary to conduct, an actuarial analysis to determine whether a 14-waiver described in paragraph (b) will meet the requirements of 42 15-U.S.C. § 18052(b); and 16- (b) If the actuarial analysis conducted pursuant to paragraph 17-(a) determines that the waiver will meet the requirements of 42 18-U.S.C. § 18052(b), apply to the Secretary of Health and Human 19-Services for a waiver pursuant to 42 U.S.C. § 18052 to authorize 20-any natural person to purchase a qualified health plan on the 21-Exchange, regardless of his or her immigration status, if the 22-natural person would otherwise be a qualified individual. 23- Sec. 2. NRS 695I.210 is hereby amended to read as follows: 24- 695I.210 1. The Exchange shall: 25- (a) Create and administer a health insurance exchange; 26- (b) Facilitate the purchase and sale of qualified health plans 27-consistent with established patterns of care within the State; 28- (c) Provide for the establishment of a program to assist qualified 29-small employers in Nevada in facilitating the enrollment of their 30-- – 3 –--- *SB97*-employees in qualified health plans offered in the small group 1-market; 2- (d) Except as otherwise authorized by a waiver obtained 3-pursuant to NRS 6 95I.505 [,] or section 1 of this act, make only 4-qualified health plans available to qualified individuals and qualified 5-small employers; and 6- (e) Unless the Federal Act is repealed or is held to be 7-unconstitutional or otherwise invalid or unlawful, perform all duties 8-that are required of the Exchange to implement the requirements of 9-the Federal Act. 10- 2. The Exchange may: 11- (a) Enter into contracts with any person, including, without 12-limitation, a local government, a political s ubdivision of a local 13-government and a governmental agency, to assist in carrying out the 14-duties and powers of the Exchange or the Board; and 15- (b) Apply for and accept any gift, donation, bequest, grant or 16-other source of money to carry out the duties and powers of the 17-Exchange or the Board. 18- 3. The Exchange is subject to the provisions of chapter 333 of 19-NRS. 20- Sec. 3. NRS 695I.300 is hereby amended to read as follows: 21- 695I.300 1. The governing authority of the Exchange is the 22-Board, consisting of [seven] nine voting members and three ex 23-officio nonvoting members. 24- 2. Subject to the provisions of subsections 3 to 6, inclusive: 25- (a) The Governor shall appoint five voting members of the 26-Board; 27- (b) The Senate Majority Leader shall appoint [one] two voting 28-[member] members of the Board; and 29- (c) The Speaker of the Assembly shall appoint [one] two voting 30-[member] members of the Board. 31- 3. Each voting member of the Board must have: 32- (a) Expertise in the sale or marketing of individual or small 33-employer health insurance; 34- (b) Expertise in health care administration, health care 35-financing, health information technology or health insurance; 36- (c) Expertise in the administration of health care delivery 37-systems; 38- (d) Experience as a consumer who would benefit from services 39-provided by the Exchange; or 40- (e) Experience as a consumer advocate, including, without 41-limitation, experience in consumer outreach and education for those 42-who would benefit from services provided by the Exchange. 43- 4. When making an appointment pursuant to subsection 2, the 44-Governor, the Majority Leader and the Speaker of the Assembly 45-- – 4 –--- *SB97*-shall consider the collective expertise and experience of the voting 1-members of the Board and shall attempt to make each appointment 2-so that: 3- (a) The areas of expertise and experience described in 4-subsection 3 are collectively represented by the voting members of 5-the Board; and 6- (b) The voting members of the Board represent a range and 7-diversity of skills, knowledge, experience and geographic and 8-stakeholder perspectives. 9- 5. When making an appointment pursuant to subsection 2, the 10-Governor, the Majority Leader and the Speaker of the Assembly 11-shall, as vacancies on the Board occur, ensure that not more than 12-[two] three voting members of the Board represent any particular 13-area of expertise or experience described in paragraph (a), (b), (c), 14-(d) or (e) of subsection 3. 15- 6. A voting member of the Board may not be a Legislator or 16-hold any elective office in State Government. 17- 7. The following are ex officio nonvoting members of th e 18-Board who shall assist the voting members of the Board by 19-providing advice and expertise: 20- (a) The Director of the Department of Health and Human 21-Services, or his or her designee; 22- (b) The Director of the Department of Business and Industry, or 23-his or her designee; and 24- (c) The Director of the Office of Finance, or his or her designee. 25- Sec. 4. 1. There is hereby appropriated from the State 26-General Fund to the Silver State Health Insurance Exchange the sum 27-of $1,000,000 to pay the costs of: 28- (a) The actuarial analysis required by paragraph (a) of 29-subsection 2 of section 1 of this act; and 30- (b) Any other administrative activiti es related to the application 31-for and implementation of the waiver described in paragraph (b) of 32-subsection 2 of section 1 of this act. 33- 2. Any remaining b alance of the appropriation made by 34-subsection 1 must not be committed for expenditure after June 30, 35-2027, by the entity to which the appropriation is made or any entity 36-to which money from the appropriation is granted or otherwise 37-transferred in any mann er, and any portion of the appropriated 38-money remaining must not be spent for any purpose after 39-September 17, 2027, by either the entity to which the money was 40-appropriated or the entity to which the money was subsequently 41-granted or transferred, and must be reverted to the State General 42-Fund on or before September 17, 2027. 43- Sec. 5. 1. The Speaker of the Assembly shall appoint the 44-additional voting member of the Board of Directors of the Silver 45-- – 5 –--- *SB97*-State Health Insurance Excha nge pursuant to paragraph (c) of 1-subsection 2 of NRS 695I.300, as amended by section 3 of this 2-act, to an initial term commencing on July 1, 2025 , and expiring on 3-June 30, 2027. 4- 2. The Senate Majority Leader shall appoint the additional 5-voting member of the Board of Directors of the Silver State Health 6-Insurance Exchange pursuant to paragraph (b) of subsection 2 of 7-NRS 695I.300, as amended by section 3 of this act, to an initial term 8-commencing on July 1, 2025, and expiring on June 30, 2028. 9- Sec. 6. 1. This section and se ctions 4 and 5 of this act 10-become effective upon passage and approval. 11- 2. Section 3 of this act becomes effective on July 1, 2025. 12- 3. Sections 1 and 2 of this act become effective: 13- (a) Upon passage and approval for the purpose of conducting the 14-actuarial analysis required by paragraph (a) of subsection 2 of 15-section 1 of this act, preparing and submitting the application for the 16-federal waiver described in paragraph (b) of subsection 2 of section 17-1 of this act and performing any other prepar atory administrative 18-tasks that are necessary to carry out the provisions of this act; and 19- (b) On January 1, 2028, for all other purposes. 20--H+1+B+rett Scolari representing the Reno-Sparks Indian Colony+(775) 240-9007+PROPOSED AMENDMENT TO SB 97+P+roposed conceptual Amendment to SB 97 to delete bill language in its+entirety and Amend NRS Section 695I.300(2)(a) to make one of the five+Governor appointments to the Silver State Health Insurance Exchange a+Member of a Nevada Tribe with experience in tribal health care+administration.+Delete Sections 1 and 2 of the bill.+Delete changes in Section 3, subsection 1.+Amend Section 3, subsection 2(a) as follows:+2. Subject to the provisions of subsections 3 to 6, inclusive:+(a) The Governor shall appoint five voting members of the+Board, one of which shall be a member of a Nevada Indian Tribe with+expertise in health care administration amongst a Nevada Indian+Tribe;+Delete changes in Section 3, subsection 2(b).+Delete changes in Section 3, subsection 5.+Delete Sections 4 and 5.+Make conforming changes to Section 6 and rest of bill.+2
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