MS HB590

Creates the Health Care Affordability Fund as a special fund in the Mississippi State Treasury, administered by the Commissioner of Insurance, to reduce premiums and cost sharing for residents purchasing health insurance on the federal marketplace.

Imposes an additional 3% annual tax on gross premium receipts for both foreign and domestic health insurance companies doing business in Mississippi, with revenue deposited into the new fund.

Authorizes the fund to maintain marketplace coverage for residents with incomes below 200% of the federal poverty level if the Affordable Care Act is repealed or invalidated by Congress or the Supreme Court.

Requires the Commissioner of Insurance to submit a coverage plan by October 1, 2026, for implementation by January 1, 2027, and provide annual reports on enrollment numbers and cost reductions by county and income level.

Reduces the additional 3% tax rate (to a minimum of 1%) if Congress reimposed the ACA's annual fee on health insurance providers under Section 9010.