An Act To
Maine Legislature, Session 128, LD 0659
Committee Amendment CA_A_S123 (Senate)
Amends: 24-A MRSA §3953

COMMITTEE AMENDMENT "A" to S.P. 221, L.D. 659, Bill, "An Act To 
Amend the Maine Guaranteed Access Reinsurance Association Act" 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inse1iing the following: 
'Sec. 1. 24-A MRSA §3953, sub-§1, · as amended by PL 2015, c. 404, §1, is 
further amended to read: 
1. 
Guaranteed access reinsurance mechanism established. 
The Maine 
Guaranteed Access Reinsurance Association is established as a nonprofit legal entity. As 
a condition of doing business in the State, an insurer that has issued or administered 
medical insurance within the previous 12 months or is actively marketing a medical 
insurance policy or medical insurance administrative services in this State must 
patiicipate in the association. The Dirigo Health Program established in chapter 87 and 
any other state-sponsored health benefit program shall also participate in the association. 
Except as provided in section 3962 Unless an earlier resumption of operations is ordered 
by the superintendent in accordance with paragraph A, operations of the association are 
suspended until December 31, 2023 except to the extent provided in section 3962 and the 
association may not collect assessments as provided in section 3957, provide reinsurance 
for member insurers under section 3958 or provide reimbursement for member insurers 
under section 3961 as of the date on which a transitional reinsurance program established 
under the authority of Section 1341 of the federal Affordable Care Act commences 
operations in this State until December 31, 2017. 
A. If the board proposes a revised plan of operation that calls for the resumption of 
operations earlier than December 31, 2023 and the superintendent dete1mines that the 
revised plan is likely to provide significant benefit to the State's health insurance 
market, the superintendent may order the association to resume operations in 
accordance with the revised plan. This paragraph applies only if: 
(1) An innovation waiver under Section 1332 of the federal Affordable Care Act 
as contemplated by paragraphs B and C is granted; or 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT "A "to S.P. 221, L.D. 659 
(2) The federal Affordable Care Act is repealed or amended in a manner that 
makes the granting of an innovation waiver unnecessary or inapplicable. 
B. After consulting with the board and receiving public comment, the superintendent 
may develop a proposal for an innovation waiver under Section 1332 of the federal 
Affordable Care Act that facilitates the resumption of operations of the association in 
a manner that prevents or minimizes the loss of federal funding to support the 
affordability of health insurance in the State. 
C. With the approval of the Governor, the superintendent may submit an application 
on behalf of the State in accordance with the proposal developed under paragraph B 
for the purposes of resuming operations of the association to the United States 
Department of Health and Human Services and to the United States Secretaty of the 
Treasmy to waive certain provisions of the federal Affordable Care Act as provided 
in Section 1332. The superintendent may implement any federally approved waiver.' 
SUMMARY 
This amendment replaces the bill. The amendment extends the suspension of the 
operations of the Maine Guaranteed Access Reinsurance Association until December 31, 
2023. The amendment also authorizes the Superintendent of Insurance to develop a 
proposal for an innovation waiver under Section .1332 of the federal Patient Protection 
and Affordable Care Act to facilitate the resumption of operations of the association and, 
if approved by the Governor, to apply for and implement a Section 1332 waiver. The 
suspension of the operations is continued until 2023 to reflect that innovation waivers are 
granted for5-year tenns. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 05/17/17 .feac 
LD 659 
LR 1412(02) 
An Act To Amend the Maine Guaranteed Access Reinsurance Association Act 
Fiscal Detaii and Notes 
Fiscal Note for Bill as Amended by Committee Amendment ''A' ( S ~ \'L...~ 
Committee: Insurance and Financial Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - Other Special Revenue Funds 
Any additional costs to the Department of Professional and Financial Regulation from the provisions of this bill are 
expected to be minor and can be absorbed within existing budgeted resources. 
LR1412(02) - Fiscal Note - Page 1 of 1