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Committee advances Foley funding amendment to bolster Maguera program and reduce premiums

Health Coverage, Insurance and Financial Services Committee · January 28, 2026

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Summary

Representative Foley proposed a combined funding approach — raise the existing $4 PM assessment to $5 PM and allocate the equivalent of a 1.5% premium assessment from the general fund — to generate an estimated $147.8M in revenue and a projected ~14% premium reduction; the committee adopted the amendment and asked bureaus to validate actuarial calculations.

During afternoon work sessions the committee considered LD 519, a bill addressing funding for the Maguera program (a rate-reduction mechanism for health insurance). Representative Foley presented an alternative funding package he calculated over the weekend designed to keep Maguera functioning and to meaningfully reduce premiums.

Foley proposed increasing the per-member-per-month assessment from $4 to $5 and using a general-fund appropriation equal to what a 1.5% premium assessment on the fully insured market would raise (rather than a direct new assessment on fully insured plans). Foley’s rough calculation suggested the package — combined with current assessments and federal pass-throughs — could raise approximately $147.8 million and might produce roughly a 14% reduction in premiums (based on a heuristic that $10.6 million equals a 1% premium reduction).

Representatives and stakeholders asked the bureau and actuaries to model Foley’s proposed mix precisely; committee staff and carriers noted the analysis should be verified because small calculation differences can change the projected premium impact. Anthem’s witness suggested as alternatives: (1) general fund support as other states do; (2) delay and study structural changes; or (3) maintain Maguera as-is while reviewing longer-term reforms.

The committee voted to adopt Foley’s amendment for further vetting and to forward the concept to appropriations for funding discussion and formal actuarial review. The roll call recorded 10 members in favor and 0 opposed on the amendment vote.