Bill > AB1216

Introduced Session

This bill directs the Office of the Commissioner of Insurance to establish and operate a state-based health insurance exchange. Under current law, the federal Affordable Care Act (ACA) requires that an exchange be established in each state to facilitate the purchase of qualified health insurance coverage by individuals and small employers. Under the ACA, a state must operate its own state-based exchange, use the federally facilitated exchange operated by the federal Department of Health and Human Services, or adopt a hybrid approach under which the state operates a state-based exchange but uses the federal platform, known as HealthCare.gov, to handle eligibility and enrollment functions. Wisconsin currently uses the federally facilitated exchange. The bill directs OCI to establish and operate a state-based exchange, first by using the federal platform and then transitioning to a fully state-run exchange. The bill authorizes OCI to enter into any agreement with the federal government necessary to implement those provisions. The bill also requires that OCI impose a user fee on insurers offering plans through the state-based exchange. Under current law, the ACA imposes user fees on insurers offering plans through federally facilitated exchanges and state-based exchanges using the federal platform, which are currently 1.5 percent and 1.2 percent of total monthly premiums, respectively. The bill authorizes OCI to impose a user fee at the following rates: 1. For any plan year that OCI operates the state-based exchange using the federal platform, the rate is 0.5 percent. 2. For the first two plan years that OCI operates the fully state-run exchange, the rate is equal to the user fee for the federally facilitated exchanges. For later plan years, the rate is set by OCI by rule. For further information see the state fiscal estimate, which will be printed as an appendix to this bill.

AI Summary

Committee Categories

Mike Bare (D)*,  Russell Goodwin (D)*,  Tara Johnson (D)*,  Karen Kirsch (D)*,  Ann Roe (D)*,  Christine Sinicki (D)*,  Lisa Subeck (D)*,  Sequanna Taylor (D)*,  Dora Drake (D),  Dianne Hesselbein (D),  Chris Larson (D),  Melissa Ratcliff (D),  Kelda Roys (D),  Mark Spreitzer (D), 

Read first time and referred to Committee on Insurance (on 03/19/2026)

Official Document