Minnesota Legislature
SF 2094
as introduced - 87th Legislature (2011 - 2012) Posted on 02/28/2012 08:34am
Current Version - as introduced
1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15
1.16 1.17 1.18 1.19 1.20 1.21 1.22 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11
2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27
2.28 2.29 2.30 2.31 2.32 2.33 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22
3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32
3.33 3.34 3.35 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33
A bill for an act
relating to human services; modifying eligibility for the healthy Minnesota
contribution program; amending Minnesota Statutes 2010, section 256L.07,
subdivision 3; Minnesota Statutes 2011 Supplement, sections 62E.14, subdivision
4g; 256L.031, subdivisions 1, 2, 3, 6.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2011 Supplement, section 62E.14, subdivision 4g, is
amended to read:
Subd. 4g.
Waiver of preexisting conditions for persons covered by healthy
Minnesota contribution program.
A person may enroll in the comprehensive plan with
a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for
the healthy Minnesota contribution program, and has been denied coverage as described
under section 256L.031, subdivision 6.new text begin The six-month durational residency requirement
specified in section 62E.02, subdivision 13, does not apply to individuals enrolled in the
healthy Minnesota contribution program.
new text end
Sec. 2.
Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 1, is
amended to read:
Subdivision 1.
Defined contributions to enrollees.
(a) Beginning July 1, 2012, the
commissioner shall provide each MinnesotaCare enrollee eligible under section 256L.04,
subdivision 7, with family income equal to or greater than deleted text begin 200deleted text end new text begin 150new text end percent of the federal
poverty guidelines with a monthly defined contribution to purchase health coverage under
a health plan as defined in section 62A.011, subdivision 3.
(b) Enrollees eligible under this section shall not be charged premiums under
section 256L.15 and are exempt from the managed care enrollment requirement of section
256L.12.
(c) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to enrollees
eligible under this section unless otherwise provided in this section. Covered services, cost
sharing, disenrollment for nonpayment of premium, enrollee appeal rights and complaint
procedures, and the effective date of coverage for enrollees eligible under this section shall
be as provided under the terms of the health plan purchased by the enrollee.
(d) Unless otherwise provided in this section, all MinnesotaCare requirements
related to eligibility, income and asset methodology, income reporting, and program
administration, continue to apply to enrollees obtaining coverage under this section.
Sec. 3.
Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 2, is
amended to read:
Subd. 2.
Use of defined contribution; health plan requirements.
(a) An enrollee
may use up to the monthly defined contribution to pay premiums for coverage under
a health plan as defined in section 62A.011, subdivision 3new text begin , or as provided in section
256L.031, subdivision 6new text end .
(b) An enrollee must select a health plan within deleted text begin threedeleted text end new text begin fournew text end calendar months of
approval of MinnesotaCare eligibility. If a health plan is not selected and purchased
within this time period, the enrollee must reapply and must meet all eligibility criteria.new text begin
The commissioner may determine criteria under which an enrollee has more than four
calendar months to select a health plan.
new text end
(c) deleted text begin A health plandeleted text end new text begin Coveragenew text end purchased under this section must:
(1) deleted text begin provide coverage fordeleted text end new text begin includenew text end mental health and chemical dependency treatment
services; and
(2) comply with the coverage limitations specified in section 256L.03, subdivision
1, the second paragraph.
Sec. 4.
Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 3, is
amended to read:
Subd. 3.
Determination of defined contribution amount.
(a) The commissioner
shall determine the defined contribution sliding scale using the base contribution specified
in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
for defined contributions that provides:
new text begin
(1) persons with household incomes equal to 150 percent of the federal poverty
guidelines with a defined contribution equal to 106 percent of the base contribution;
new text end
deleted text begin (1)deleted text end new text begin (2)new text end persons with household incomes equal to 200 percent of the federal poverty
guidelines with a defined contribution of 93 percent of the base contribution;
deleted text begin (2)deleted text end new text begin (3)new text end persons with household incomes equal to 250 percent of the federal poverty
guidelines with a defined contribution of 80 percent of the base contribution; and
deleted text begin (3)deleted text end new text begin (4)new text end persons with household incomes in evenly spaced increments between the
percentages of the federal poverty guideline or income level specified in clauses (1)
deleted text begin and (2)deleted text end new text begin to (3)new text end with a base contribution that is a percentage interpolated from the defined
contribution percentages specified in clauses (1) deleted text begin and (2)deleted text end new text begin to (3)new text end .
| 19-29 |
$125 |
|
| 30-34 |
$135 |
|
| 35-39 |
$140 |
|
| 40-44 |
$175 |
|
| 45-49 |
$215 |
|
| 50-54 |
$295 |
|
| 55-59 |
$345 |
|
| 60+ |
$360 |
(b) The commissioner shall multiply the defined contribution amounts developed
under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual
health plan by a health plan company and who purchase coverage through the Minnesota
Comprehensive Health Association.
Sec. 5.
Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 6, is
amended to read:
Subd. 6.
Minnesota Comprehensive Health Association (MCHA).
Beginning
July 1, 2012, MinnesotaCare enrollees deleted text begin who are denied coverage in the individual
health market by a health plan company in accordance with section 62A.65 aredeleted text end eligible
for coverage through a health plan offered by the Minnesota Comprehensive Health
Association deleted text begin anddeleted text end may enroll in MCHA in accordance with section 62E.14. Any difference
between the revenue and actual covered losses to MCHA related to the implementation of
this section are appropriated annually to the commissioner of human services from the
health care access fund and shall be paid to MCHA.
Sec. 6.
Minnesota Statutes 2010, section 256L.07, subdivision 3, is amended to read:
Subd. 3.
Other health coverage.
(a) Families and individuals enrolled in the
MinnesotaCare program must have no health coverage while enrolled or for at least four
months prior to application and renewal. Children enrolled in the original children's health
plan and children in families with income equal to or less than 150 percent of the federal
poverty guidelines, who have other health insurance, are eligible if the coverage:
(1) lacks two or more of the following:
(i) basic hospital insurance;
(ii) medical-surgical insurance;
(iii) prescription drug coverage;
(iv) dental coverage; or
(v) vision coverage;
(2) requires a deductible of $100 or more per person per year; or
(3) lacks coverage because the child has exceeded the maximum coverage for a
particular diagnosis or the policy excludes a particular diagnosis.
The commissioner may change this eligibility criterion for sliding scale premiums
in order to remain within the limits of available appropriations. The requirement of no
health coverage does not apply to newborns.
(b) new text begin Coverage purchased as provided under section 256L.031, subdivision 2, new text end medical
assistance, deleted text begin general assistance medical care,deleted text end and the Civilian Health and Medical Program
of the Uniformed Service, CHAMPUS, or other coverage provided under United States
Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or health
coverage for purposes of the four-month requirement described in this subdivision.
(c) For purposes of this subdivision, an applicant or enrollee who is entitled to
Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to
have health coverage. An applicant or enrollee who is entitled to premium-free Medicare
Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility
for MinnesotaCare.
(d) Applicants who were recipients of medical assistance deleted text begin or general assistance
medical caredeleted text end within one month of application must meet the provisions of this subdivision
and subdivision 2.
(e) Cost-effective health insurance that was paid for by medical assistance is not
considered health coverage for purposes of the four-month requirement under this
section, except if the insurance continued after medical assistance no longer considered it
cost-effective or after medical assistance closed.