HF 2359

as introduced - 91st Legislature (2019 - 2020) Posted on 03/11/2019 02:53pm

A bill for an act
relating to health coverage; making changes to the premium subsidy program;
appropriating money.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1. new text begin DEFINITIONS.
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new text begin Subdivision 1. new text end

new text begin Scope. new text end

new text begin For purposes of sections 1 to 5, the following terms have the
meanings given.
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new text begin Subd. 2. new text end

new text begin Board. new text end

new text begin "Board" means the board of directors of MNsure specified in section
62V.04.
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new text begin Subd. 3. new text end

new text begin Eligible individual. new text end

new text begin "Eligible individual" means a Minnesota resident who:
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new text begin (1) is determined not eligible to receive an advance credit payment under Code of Federal
Regulations, title 26, section 1.36B-1(j), of the premium tax credit under Code of Federal
Regulations, title 26, section 1.36B-2, for a given month of coverage;
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new text begin (2) is not enrolled in public program coverage under Minnesota Statutes, section 256B.055
or 256L.04; and
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new text begin (3) purchased a qualified health plan through MNsure.
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new text begin Subd. 4. new text end

new text begin Gross premium. new text end

new text begin "Gross premium" means the amount billed for a qualified
health plan purchased by an eligible individual prior to a premium subsidy or advanced
state-based tax credit being applied in a calendar year.
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new text begin Subd. 5. new text end

new text begin Health carrier. new text end

new text begin "Health carrier" has the meaning given in Minnesota Statutes,
section 62A.011, subdivision 2.
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new text begin Subd. 6. new text end

new text begin MNsure. new text end

new text begin "MNsure" means the state health benefit exchange as described in
section 1311 of the federal Patient Protection and Affordable Care Act, Public Law 111-148,
and Minnesota Statutes, chapter 62V.
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new text begin Subd. 7. new text end

new text begin Net premium. new text end

new text begin "Net premium" means the gross premium less the premium
subsidy.
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new text begin Subd. 8. new text end

new text begin Premium subsidy. new text end

new text begin "Premium subsidy":
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new text begin (1) is a rebate payment to discount the cost of insurance for the promotion of general
welfare, and is not compensation for any services;
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new text begin (2) is equal to 20 percent of the monthly gross premium otherwise paid by or on behalf
of the eligible individual for qualified health plan coverage purchased through MNsure that
covers the eligible individual and the eligible individual's covered spouse and covered
dependents; and
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new text begin (3) is excluded from any calculation used to determine eligibility within any of the
Department of Human Services programs.
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new text begin Subd. 9. new text end

new text begin Qualified health plan. new text end

new text begin "Qualified health plan" means a health plan that meets
the definition in section 1301(a) of the Affordable Care Act, Public Law 111-148, and has
been certified by the board in accordance with section 62V.05, subdivision 5, to be offered
through MNsure.
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Sec. 2. new text begin PAYMENT TO HEALTH CARRIERS ON BEHALF OF ELIGIBLE
INDIVIDUALS.
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new text begin Subdivision 1. new text end

new text begin Program established. new text end

new text begin The board shall establish and administer the
premium subsidy program authorized by this act to help eligible individuals pay for coverage
when purchasing qualified health plans through MNsure in plan year 2020 and in each
subsequent plan year for which an appropriation is approved.
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new text begin Subd. 2. new text end

new text begin Administration. new text end

new text begin MNsure shall determine if an individual applying for coverage
through MNsure is an eligible individual. If so, MNsure shall calculate the proper amount
of the eligible individual's premium subsidy. MNsure shall notify the relevant health carrier
of the premium subsidy amount and direct the health carrier to deduct the premium subsidy
amount from the eligible individual's gross premium as a discount to the eligible individual's
qualified health plan premium.
new text end

new text begin Subd. 3. new text end

new text begin Payments to health carriers. new text end

new text begin (a) The board shall make payments to health
carriers equal to the amount of the premium subsidy discounts provided to eligible individuals
effectuating coverage for the months in which the individual has paid the net premium
amount to the health carrier. Payments to health carriers shall be based on the premium
subsidy provided on behalf of eligible individuals, regardless of the cost of coverage
purchased.
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new text begin (b) Health carriers seeking reimbursement from the board must submit an invoice and
supporting information to the board using a format and method developed by the board in
order to be determined to be eligible for payment.
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new text begin (c) The board shall consider health carriers as vendors under Minnesota Statutes, section
16A.124, subdivision 3, and each monthly invoice shall represent the completed delivery
of the service.
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new text begin Subd. 4. new text end

new text begin Data practices. new text end

new text begin The data classifications in Minnesota Statutes, section 62V.06,
subdivision 3, apply to data on individuals applying for or receiving a premium subsidy
under this subdivision.
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new text begin Subd. 5. new text end

new text begin Data sharing. new text end

new text begin Notwithstanding any law to the contrary, the board is permitted
to share or disseminate the data in subdivision 4 as described in Minnesota Statutes, section
62V.06, subdivision 5.
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Sec. 3. new text begin APPEALS.
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new text begin MNsure appeals are available for Minnesota residents for initial determinations and
redeterminations made by MNsure of eligibility for and level of premium subsidy and should
follow the procedures enumerated in Minnesota Rules, chapter 7700.
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Sec. 4. new text begin APPLICABILITY OF GROSS PREMIUM.
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new text begin Notwithstanding premium subsidies provided under section 2, the premium base for
calculating the amount of any applicable premium taxes under Minnesota Statutes, chapter
297I, shall be the gross premium for a qualified health plan purchased by eligible individuals
through MNsure.
new text end

Sec. 5. new text begin APPROPRIATIONS.
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new text begin (a) Beginning in fiscal year 2020 and each fiscal year thereafter, an amount sufficient
to pay the premium subsidy for each plan is appropriated from the health care access fund
to the board for premium assistance under section 2.
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new text begin (b) An additional $8,052,000 in fiscal year 2020 is appropriated from the health care
access fund to the board for administration of the program. This appropriation is onetime.
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Sec. 6. new text begin TRANSFER.
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new text begin By August 30, 2020, the commissioner of commerce shall transfer $281,483,000 from
the premium security plan account to the health care access fund. This is a onetime transfer.
new text end