Pennsylvania HR 585: A Resolution directing the Legislative Budget and Finance Committee to conduct a study and issue a report on the cost to the Commonwealth associated with the defrayal of health insurance benefit mandates under the Affordable Care Act.

Bill Text

PRINTER'S NO. 3763
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE RESOLUTION
No. 585
Session of
2026
INTRODUCED BY KEPHART, STENDER, GAYDOS, KRUPA, BARGER, HAMM,
MARCELL AND ZIMMERMAN, JULY 10, 2026
REFERRED TO COMMITTEE ON INSURANCE, JULY 11, 2026
A RESOLUTION
Directing the Legislative Budget and Finance Committee to
conduct a study and issue a report on the cost to the
Commonwealth associated with the defrayal of health insurance
benefit mandates under the Affordable Care Act.
WHEREAS, The Affordable Care Act, enacted in March 2010,
expanded the scope of mandated health care services covered
under health insurance policies; and
WHEREAS, The Affordable Care Act includes requirements
relating to the defrayal of state-required health insurance
benefit mandates that exceed Federal essential health benefits
requirements; and
WHEREAS, Under prior Federal policy, states are permitted in
certain circumstances to avoid defrayal costs by including new
state-required benefits as part of the state benchmark plan for
essential health benefits; and
WHEREAS, On February 9, 2026, the Centers for Medicare and
Medicaid Services proposed reversing that policy and requiring
states to bear the cost of defrayal for mandates that are not
exempted from or otherwise covered under Federal law; and
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WHEREAS, As a result, the Commonwealth may be required to
defray the cost of certain State-required health insurance
benefit mandates that are in addition to essential health
benefits contained in the benchmark plan filed by the
Commonwealth with the Centers for Medicare and Medicaid
Services; and
WHEREAS, The Commonwealth currently faces a significant
budget deficit; therefore be it
RESOLVED, That the House of Representatives direct the
Legislative Budget and Finance Committee to conduct a study and
issue a report on the cost to the Commonwealth associated with
the defrayal of health insurance benefit mandates under the
Affordable Care Act; and be it further
RESOLVED, That the study include all of the following:
(1) A comprehensive list of each health insurance
benefit mandate adopted by the General Assembly since
December 31, 2011.
(2) An analysis of whether each mandate meets the
defrayal requirements under the Affordable Care Act.
(3) The cost to the Commonwealth if a mandate is subject
to defrayal under the Affordable Care Act.
(4) The impact of each mandate since December 31, 2011,
including specific cost changes in the small group and
individual health insurance markets in this Commonwealth;
and be it further
RESOLVED, That the Insurance Department provide to the
Legislative Budget and Finance Committee any paper, book, file,
record, account, document, data or other information, in de-
identified form, that the Executive Director of the Legislative
Budget and Finance Committee deems necessary to carry out the
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objectives of this resolution; and be it further
RESOLVED, That the Legislative Budget and Finance Committee
submit a report of its findings and recommendations to the
General Assembly no later than one year after the adoption of
this resolution.
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