AN ACT TO CREATE ACCESS TO AFFORDABLE HEALTH INSURANCE THROUGH THE FEDERAL HEALTH BENEFITS EXCHANGE FOR INDIVIDUALS IN THE COVERAGE GAP.
States legislative intent to provide a refundable premium tax credit designed to help eligible individuals in the coverage gap to afford health insurance purchased through the federal Health Insurance Marketplace, or the Health Benefits Exchange, modeled after the federal refundable premium tax credit under the Affordable Care Act. Establishes eligibility requirements as: (1) that the individual has a modified adjusted gross income that is below 100% of the federal poverty level; (2) the individual is at least 19 and under 65 years of age; (3) the individual is not entitled to to or enrolled in Medicaid benefits under Parts A or B of Title XVIII of the Social Security Act; (4) the individual is not eligible for Medicaid coverage or NC Health Choice coverage under the State Plan providing minimum essential coverage; (5) the individual is not eligible for coverage under TRICARE; and (6) the individual is not able to obtain affordable coverage through an eligible employer-sponsored plan that provides minimum value and minimum essential coverage.
Directs the Department of Health and Human Services (DHHS) Secretary and the Department of Revenue Secretary to collaborate and design a program to implement the described State premium tax credit that (1) estimates the amount of credit that the individual will be eligible for in a given tax year, and (2) allows an individual to direct any amount of the estimated credit in advance directly to an insurance company offering health benefit plans in the State on the Health Benefits Exchange. Requires the Secretaries to submit a report by March 1, 2022, to the NCGA outlining the program, setting out recommendations, and providing any necessary legislative changes for implementation, as well as the costs associated with program administration. States legislative intent that program costs do not exceed $1 billion.
Appropriates $100,000 in nonrecurring funds from the General Fund to each DHHS and the Department of Revenue for the 2021-22 fiscal to design the program.