Assembly Bill A9254

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9254
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             November 21, 2025
                                ___________
 
 Introduced by M. of A. SLATER -- read once and referred to the Committee
   on Insurance
 
 AN  ACT  relating  to  enacting the "northeast regional health insurance
   compact act"
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section  1. This act shall be known and may be cited as the "northeast
 regional health insurance compact act".
   § 2. (a) The Legislature finds that:
   (i) The rising cost of health insurance  coverage  has  created  chal-
 lenges for New York residents and businesses.
   (ii)  A  regional,  market-based  approach could increase competition,
 choice, and affordability by  allowing  residents  to  select  qualified
 health insurance products offered in any participating northeast state.
   (iii)  Collaborative  action  is necessary to seek federal waivers and
 create a health insurance market that reflects the principles of  feder-
 alism and state innovation.
   (iv)  It  is in the best interest of New Yorkers to pursue multi-state
 solutions rather  than  unilateral,  government-run  programs  that  may
 impose significant fiscal and policy impacts.
   (b) The purpose of this act is to authorize and direct the governor of
 New  York to convene a summit of northeast states to explore and develop
 a regional  health  insurance  collaborative  for  offering  multi-state
 health insurance options.
   §  3.  (a)  Within  ninety days of the effective date of this act, the
 governor shall invite the governors of Connecticut,  Massachusetts,  New
 Hampshire, Rhode Island, Vermont, Maine, New Jersey, and Pennsylvania to
 participate  in  a  northeast  regional  health insurance compact summit
 along with their respective health and insurance regulators.
   (b) The purpose of the summit shall be to:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD14038-01-5
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   (i) Discuss the feasibility of creating a  regional  health  insurance
 collaborative  that allows residents of participating states to purchase
 qualified health insurance plans offered in any member state;
   (ii) Explore mechanisms for seeking federal waivers under section 1332
 of the Affordable Care Act or other applicable federal law to facilitate
 interstate health insurance offerings;
   (iii)  Identify  regulatory,  legal,  and  administrative  barriers to
 multi-state health insurance markets;
   (iv) Develop a framework for state cooperation,  including  governance
 structures,  data sharing, consumer protections, and dispute resolution;
 and
   (v) Assess potential impacts on insurance  markets,  consumer  choice,
 affordability, and state revenues.
   (c)  The governor may designate the commissioner of health, the super-
 intendent of financial  services,  or  other  appropriate  officials  to
 represent New York at the summit.
   (d)  The summit shall produce a report of findings and recommendations
 to be submitted to the legislature within one hundred eighty days of the
 first convening.
   § 4. (a) Subject to further legislative approval, New York  may  enter
 into  an  interstate compact or cooperative agreement with participating
 northeast states to establish a regional health insurance collaborative.
   (b) The collaborative may:
   (i) Facilitate the offering of qualified health insurance plans across
 state lines;
   (ii) Establish uniform standards for plan certification, rates,  cost-
 sharing requirements, consumer protections, and regulatory oversight;
   (iii)  Coordinate with federal agencies to obtain necessary waivers or
 approvals;
   (iv) Create a  governance  structure  with  representation  from  each
 participating state;
   (v) Develop mechanisms for revenue sharing, risk adjustment, and rein-
 surance as appropriate; and
   (vi)  Promote transparency, competition, and consumer choice in health
 insurance markets.
   (c) Participation in the collaborative shall be voluntary  for  states
 and shall not require New York to adopt policies inconsistent with state
 law or the interests of New York residents.
   §  5.  The  governor  shall submit an annual report to the legislature
 detailing:
   (a) Progress in developing the regional  health  insurance  collabora-
 tive;
   (b)  Any  agreements,  compacts, or memoranda of understanding entered
 into with other states;
   (c) Federal waiver applications and approvals;
   (d) Impacts on New York's health insurance market,  including  enroll-
 ment, premiums, and consumer satisfaction; and
   (e) Recommendations for further legislative action.
   § 6. (a) The governor is authorized to:
   (i)  Convene the northeast regional health insurance compact summit as
 described in section three of this act;
   (ii) Participate in discussions and  planning  activities  with  other
 states;
   (iii) Designate state officials to represent New York in collaborative
 efforts; and
 A. 9254                             3
 
   (iv)  Submit  any  required applications or waiver requests to federal
 agencies as developed by the collaborative.
   (b)  Implementation of regional health insurance operations, and mate-
 rial financial or statutory commitments by the state of New York,  shall
 require further specific authorization by the legislature.
   §  7. If any clause, sentence, paragraph, subdivision, section or part
 of this act shall be adjudged by any court of competent jurisdiction  to
 be  invalid,  such  judgment shall not affect, impair, or invalidate the
 remainder thereof, but shall be confined in its operation to the clause,
 sentence, paragraph,  subdivision,  section  or  part  thereof  directly
 involved  in  the  controversy  in  which  such judgment shall have been
 rendered. It is hereby declared to be the intent of the legislature that
 this act would have been enacted even if such invalid provisions had not
 been included herein.
   § 8. This act shall take effect immediately.