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SB 418

AN ACT RELATING TO TAXATION -- SALES AND USE TAXES -- LIABILITY AND COMPUTATION

2025 Regular Session Introduced by Sam Bell and 7 co-sponsors

Would authorize NC Insurance Commissioner to create a state-run Health Benefits Exchange under the ACA, with GA oversight and a $100,000 recurring appropriation; withdrawn.

03/04/2025 Committee recommended measure be held for further study
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Bill Summary · SB 418

Summary — SB 418 (NC): NC Health Benefits Exchange Implementation

Status: Introduced Feb 18, 2025; withdrawn from committee April 1, 2025 (not enacted)

Main purpose

SB 418 would authorize the North Carolina Commissioner of Insurance to establish and operate a State‑run Health Benefits Exchange (a state insurance marketplace) under the federal Affordable Care Act (ACA) or other applicable federal law. The bill also reserves the General Assembly’s authority over any State–federal Exchange agreements and restricts state agencies from entering into Partnership or other Exchange arrangements without legislative authorization.

Key provisions

  • Adds a new subsection to G.S. 58‑2‑40 giving the Commissioner of Insurance explicit authority to:

    • Establish and operate a State‑run Health Benefits Exchange under the ACA (P.L. 111‑148) or applicable federal regulations.
    • Adopt or modify programs, rules, policies, guidelines, or plans needed to create/operate the Exchange (rulemaking under Chapter 150B).
    • Apply for and accept federal funds related to Exchange creation, implementation, or operation.
    • Create advisory boards or committees to advise on Exchange creation, implementation, or operations.

  • Amends G.S. 143B‑24 to clarify the General Assembly’s reserved authority over the State’s degree of interaction with a federally facilitated Health Benefit Exchange and to prohibit any State department, agency, or institution from:

    • Entering contracts or committing resources to provide services to a federally facilitated Exchange under a “Partnership” model, except when expressly authorized by the General Assembly; or
    • Taking actions (without the General Assembly’s authorization) that would pursue the formation of a State‑run Exchange.

  • Appropriation: directs a recurring appropriation of $100,000 from the General Fund to the Department of Insurance for FY 2025–26 (effective July 1, 2025) to support establishment/operation activities.

  • Effective date: generally upon enactment; appropriation effective July 1, 2025.

Who would be affected

  • North Carolina Department of Insurance and the Insurance Commissioner (primary implementers).
  • State agencies (restricted from pursuing Exchange partnerships absent legislative authorization).
  • Insurers, brokers, and health plan consumers who would participate in a state Exchange.
  • Potential recipients of federal Exchange implementation grants if the state pursues federal funds.

Fiscal and implementation notes

  • Direct, explicit appropriation: $100,000 recurring for 2025–26 to begin Exchange implementation work. The bill does not estimate longer‑term operating costs; establishing and running a statewide Exchange typically requires significantly more funding and staff if fully implemented.
  • The Commissioner may seek federal implementation funds — which could offset state costs but are subject to federal program rules and timing.

Procedural / timeline aspects

  • Introduced Feb 18, 2025.
  • Contained immediate‑effect / rulemaking authorizations for the Commissioner to proceed with design and federal grant applications.
  • Withdrawn from committee on April 1, 2025 and therefore did not advance to enactment in this session.

If you want, I can:
- Compare SB 418 to other NC Exchange policy proposals or to how Exchanges were set up in other states; or
- Produce a brief on likely next‑step costs and administrative tasks required to implement a state Exchange.

Compiled from official sources — confirm details with the bill’s official record.

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