Enacts the Northeast Regional Health Insurance Compact Act directing the governor to 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, to 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.
STATE OF NEW YORK
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9254
2025-2026 Regular Sessions
IN ASSEMBLY
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:
1 Section 1. This act shall be known and may be cited as the "northeast
2 regional health insurance compact act".
3 § 2. (a) The Legislature finds that:
4 (i) The rising cost of health insurance coverage has created chal-
5 lenges for New York residents and businesses.
6 (ii) A regional, market-based approach could increase competition,
7 choice, and affordability by allowing residents to select qualified
8 health insurance products offered in any participating northeast state.
9 (iii) Collaborative action is necessary to seek federal waivers and
10 create a health insurance market that reflects the principles of feder-
11 alism and state innovation.
12 (iv) It is in the best interest of New Yorkers to pursue multi-state
13 solutions rather than unilateral, government-run programs that may
14 impose significant fiscal and policy impacts.
15 (b) The purpose of this act is to authorize and direct the governor of
16 New York to convene a summit of northeast states to explore and develop
17 a regional health insurance collaborative for offering multi-state
18 health insurance options.
19 § 3. (a) Within ninety days of the effective date of this act, the
20 governor shall invite the governors of Connecticut, Massachusetts, New
21 Hampshire, Rhode Island, Vermont, Maine, New Jersey, and Pennsylvania to
22 participate in a northeast regional health insurance compact summit
23 along with their respective health and insurance regulators.
24 (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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1 (i) Discuss the feasibility of creating a regional health insurance
2 collaborative that allows residents of participating states to purchase
3 qualified health insurance plans offered in any member state;
4 (ii) Explore mechanisms for seeking federal waivers under section 1332
5 of the Affordable Care Act or other applicable federal law to facilitate
6 interstate health insurance offerings;
7 (iii) Identify regulatory, legal, and administrative barriers to
8 multi-state health insurance markets;
9 (iv) Develop a framework for state cooperation, including governance
10 structures, data sharing, consumer protections, and dispute resolution;
11 and
12 (v) Assess potential impacts on insurance markets, consumer choice,
13 affordability, and state revenues.
14 (c) The governor may designate the commissioner of health, the super-
15 intendent of financial services, or other appropriate officials to
16 represent New York at the summit.
17 (d) The summit shall produce a report of findings and recommendations
18 to be submitted to the legislature within one hundred eighty days of the
19 first convening.
20 § 4. (a) Subject to further legislative approval, New York may enter
21 into an interstate compact or cooperative agreement with participating
22 northeast states to establish a regional health insurance collaborative.
23 (b) The collaborative may:
24 (i) Facilitate the offering of qualified health insurance plans across
25 state lines;
26 (ii) Establish uniform standards for plan certification, rates, cost-
27 sharing requirements, consumer protections, and regulatory oversight;
28 (iii) Coordinate with federal agencies to obtain necessary waivers or
29 approvals;
30 (iv) Create a governance structure with representation from each
31 participating state;
32 (v) Develop mechanisms for revenue sharing, risk adjustment, and rein-
33 surance as appropriate; and
34 (vi) Promote transparency, competition, and consumer choice in health
35 insurance markets.
36 (c) Participation in the collaborative shall be voluntary for states
37 and shall not require New York to adopt policies inconsistent with state
38 law or the interests of New York residents.
39 § 5. The governor shall submit an annual report to the legislature
40 detailing:
41 (a) Progress in developing the regional health insurance collabora-
42 tive;
43 (b) Any agreements, compacts, or memoranda of understanding entered
44 into with other states;
45 (c) Federal waiver applications and approvals;
46 (d) Impacts on New York's health insurance market, including enroll-
47 ment, premiums, and consumer satisfaction; and
48 (e) Recommendations for further legislative action.
49 § 6. (a) The governor is authorized to:
50 (i) Convene the northeast regional health insurance compact summit as
51 described in section three of this act;
52 (ii) Participate in discussions and planning activities with other
53 states;
54 (iii) Designate state officials to represent New York in collaborative
55 efforts; and
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1 (iv) Submit any required applications or waiver requests to federal
2 agencies as developed by the collaborative.
3 (b) Implementation of regional health insurance operations, and mate-
4 rial financial or statutory commitments by the state of New York, shall
5 require further specific authorization by the legislature.
6 § 7. If any clause, sentence, paragraph, subdivision, section or part
7 of this act shall be adjudged by any court of competent jurisdiction to
8 be invalid, such judgment shall not affect, impair, or invalidate the
9 remainder thereof, but shall be confined in its operation to the clause,
10 sentence, paragraph, subdivision, section or part thereof directly
11 involved in the controversy in which such judgment shall have been
12 rendered. It is hereby declared to be the intent of the legislature that
13 this act would have been enacted even if such invalid provisions had not
14 been included herein.
15 § 8. This act shall take effect immediately.
