HB518 Summary

• Creates a nonprofit Alabama Health Insurance Exchange to facilitate the purchase and sale of qualified health plans in the individual and small business markets, maintaining state sovereignty over health insurance regulation.

• Establishes a 13-member Board of Directors appointed by the Governor, Lieutenant Governor, Senate President Pro Tempore, and Speaker of the House (2 each), plus the Insurance Commissioner, State Health Officer, and Medicaid Agency Commissioner, with staggered terms and expertise requirements.

• Board must hire an executive director, adopt bylaws, maintain financial records, submit annual fiscal and operational reports beginning December 31, 2024, and obtain independent audits.

• Exchange must educate consumers, assist with income-based assistance including premium tax credits and cost-sharing reductions, and enable individuals to enroll in qualified health plans through carriers, brokers, and agents.

• By January 1, 2025, the board and commissioner shall review and recommend whether to submit a Section 1332 State Innovation Waiver to the federal government to modify ACA provisions; act becomes effective the first day of the third month after passage.