Connecticut HB 5041: AN ACT CONCERNING A STUDY OF A CONNECTICUT OPTION FOR AFFORDABLE HEALTH CARE, HEALTH INSURER REQUIREMENTS FOR CERTAIN GENERIC DRUGS, TAX CREDITS FOR SMALL BUSINESS HEALTH CARE ARRANGEMENTS AND WORKER PORTABLE BENEFIT ACCOUNTS.

Bill Text

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General Assembly  
Substitute Bill No. 5041  
February Session, 2026 
 
 
 
 
AN ACT CONCERNING A STUDY OF A CONNECTICUT OPTION FOR 
AFFORDABLE HEALTH CARE, HEALTH INSURER REQUIREMENTS 
FOR CERTAIN GENERIC DRUGS, TAX CREDITS FOR SMALL 
BUSINESS HEALTH CARE ARRANGEMENTS AND WORKER 
PORTABLE BENEFIT ACCOUNTS.  
Be  it  enacted  by  the  Senate  and  House  of  Representatives  in  General 
Assembly convened: 
 
Section 1. (Effective from passage) (a) As used in this section: 1 
(1)   "Affordable   Care   Act"   means   the   Patient   Protection   and 2 
Affordable Care Act, P.L. 111-148, as amended by the Health Care and 3 
Education  Reconciliation  Act,  P.L.  111-152,  as  both  may  be  amended 4 
from time to time, and regulations adopted pursuant to said acts; 5 
(2)  "Connecticut  Option  program"  means  a  standardized  health 6 
benefit plan designed by the state to reduce health care coverage costs 7 
and made available through private or commercial insurance carriers to 8 
individuals in the state; 9 
(3)  "Exchange"  means  the  Connecticut  Health  Insurance  Exchange 10 
established under section 38a-1081 of the general statutes; 11 
(4) "Health benefit plan" has the same meaning as provided in section 12 
38a-1080 of the general statutes; 13 
(5)  "State  innovation  waiver"  means  a  waiver  of  one  or  more 14 
requirements of the Affordable Care Act authorized under section 1332 15 

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of said act; and 16 
(6)  "Secretary"  means  the  Secretary  of  the  Office  of  Policy  and 17 
Management. 18 
(b)  The Secretary  of  the Office  of  Policy  and  Management  shall, 19 
within  available  resources,  study  the  feasibility  of  establishing  the 20 
Connecticut Option program with the goal of reducing health insurance 21 
premiums.    The    study    shall    include    analyses,    conclusions    and 22 
recommendations  sufficient  for  the  secretary,  in  consultation  with  the 23 
Insurance  Commissioner,  to  evaluate  and  compare  design  models for 24 
the program. The study shall include, but need not be limited to: 25 
(1) A review of the efficacy, impact and reasonableness of proposed 26 
program  design  elements,  including,  but  not  limited  to:  (A)  Provider 27 
reimbursement  methodologies;  (B)  value-based  or  performance-based 28 
contracting   arrangements;   (C)   enrollee   cost-sharing   and   premium 29 
affordability targets; (D) incentives or rewards for the delivery of high-30 
quality,  cost-effective  health  care;  and  (E)  any  state-specific  premium 31 
assistance  programs  or  risk  stabilization  programs,  including,  but  not 32 
limited  to,  a  state-operated  reinsurance  program  that  may  maximize 33 
available federal funding pursuant to a state innovation waiver; 34 
(2)  Identification  of  any  necessary  statutory  or  regulatory  changes 35 
required for implementation of the Connecticut Option program; 36 
(3) Determination of staffing needs across state agencies to effectively 37 
implement the Connecticut Option program; 38 
(4)  Analysis  of  the  state  insurance  market  and  projected  impacts  of 39 
the  Connecticut  Option  program  on  persons  who  receive  health  care 40 
coverage through the exchange; and 41 
(5)  Required  state  action  or  design  elements  needed  to  achieve 42 
multiple premium savings targets. 43 
(c) Not later than January 15, 2027, the secretary shall file an interim 44 
report, in accordance with the provisions of section 11-4a of the general 45 

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statutes,  on  the  study  conducted  pursuant  to  subsection  (b)  of  this 46 
section  with  the  joint  standing  committees  of  the  General  Assembly 47 
having cognizance of matters relating to appropriations and the budgets 48 
of state agencies, human services and insurance and real estate. Not later 49 
than January 31, 2028, the secretary shall file a final report, in accordance 50 
with  the  provisions  of  section  11-4a  of  the  general  statutes,  on  the 51 
feasibility of the Connecticut Option program and any 52 
recommendations on implementing the program with the joint standing 53 
committees  of  the  General  Assembly  having  cognizance  of  matters 54 
relating  to  appropriations  and  the  budgets  of  state  agencies,  human 55 
services and insurance and real estate. 56 
(d) If the secretary, in consultation with the Insurance Commissioner, 57 
determines  a  Connecticut  Option  program  is  feasible  after  completion 58 
of the study or related reports pursuant to subsections (b) and (c) of this 59 
section,  the  secretary  may  direct  the  relevant  state  agency  to  develop 60 
and implement a state innovation waiver or any applicable waiver from 61 
federal  law  that  may  be  required  to  maximize  federal  funding  for  the 62 
program  or  any  component  part  of  a  program  design