MO SB464

No state-based health benefit exchange may be established, created, or operated in Missouri to implement Section 1311 of the federal health care act unless authorized by a bill, initiative petition, or referendum under the Missouri Constitution.

Authority for establishing, administering, or operating a state-based health benefit exchange cannot be based on an executive order issued by the governor.

State departments, agencies, and political subdivisions cannot establish programs, promulgate rules, or act as eligible entities to implement health benefit exchanges without statutory authority consistent with the bill's requirements.

State entities cannot apply for, accept, or expend federal funds related to state-based or federally-facilitated health benefit exchanges unless authorized by statute or appropriations bill.

Taxpayers and general assembly members have standing to sue for violations and may recover attorney's fees, court costs, and reasonable expenses from the violating entity's appropriated funds.

The act becomes effective only upon approval by a majority of votes cast at the November 2012 general election.