HF 27

as introduced - 91st Legislature (2019 - 2020) Posted on 02/14/2019 05:05pm

A bill for an act
relating to health care; requiring the commissioners of human services and
commerce to seek federal waivers to permit individuals whose income is greater
than the income eligibility limit for MinnesotaCare to purchase coverage through
MinnesotaCare through a MinnesotaCare purchase option; requiring a proposal
to the legislature.

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

Section 1. new text begin MINNESOTACARE PURCHASE OPTION; FEDERAL WAIVER
REQUEST.
new text end

new text begin Subdivision 1. new text end

new text begin Purpose. new text end

new text begin The legislature finds that the staggering growth in health care
costs is having a devastating effect on the health and cost of living of Minnesota residents.
The legislature further finds that the number of uninsured and underinsured residents is
growing each year and that the cost of health care coverage for our insured residents often
far exceeds their ability to pay.
new text end

new text begin The legislature further finds that it must enact immediate and intensive cost containment
measures to limit the growth of health care expenditures, reform insurance practices, and
finance a plan that offers access to affordable health care for our residents by capturing
dollars now lost to inefficiencies in Minnesota's health care system.
new text end

new text begin The legislature further finds that providing affordable access to health care is essential
to quality of life in Minnesota.
new text end

new text begin It is, therefore, the intent of the legislature to establish an optional buy-in for the delivery
and financing of health care in Minnesota and to call this new optional buy-in the Minnesota
Comprehensive Health Act.
new text end

new text begin Subd. 2. new text end

new text begin Program establishment and criteria. new text end

new text begin (a) The commissioners of human services
and commerce shall coordinate the administration of the purchase option with the
MinnesotaCare program to maximize efficiency and improve the continuity of care, consistent
with the requirements of Minnesota Statutes, sections 256L.06, 256L.10, 256L.11, 256L.12,
and 256L.121.
new text end

new text begin (b) The purchase option shall include, at a minimum, the following:
new text end

new text begin (1) establishment of an annual per enrollee premium sufficient to maintain fiscal stability
of the program;
new text end

new text begin (2) establishment of a benefit set equivalent to the benefit set covered under
MinnesotaCare under Minnesota Statutes, section 256L.03;
new text end

new text begin (3) limiting annual enrollment to the same annual open enrollment periods established
for the individual and small group market;
new text end

new text begin (4) ability of the commissioners to adjust the purchase options to set a sliding scale for
enrollees to decrease out-of-pocket costs so enrollees are not deterred from accessing care;
new text end

new text begin (5) reimbursement mechanisms for addressing potential increased cost to the
MinnesotaCare program under Minnesota Statutes, chapter 256L;
new text end

new text begin (6) establish reimbursement rates to providers which are adequate to ensure essential
provider viability; and
new text end

new text begin (7) establishment of direct contracting with health care providers to contain costs.
new text end

new text begin (c) The commissioners shall seek to implement mechanisms to ensure the long-term
financial sustainability of MinnesotaCare and mitigate any adverse financial impacts to the
individual and group insurance market. These mechanisms must address issues related to
minimizing adverse selection, the state financial risk and contribution, and negative impacts
to premiums in the individual and group insurance market.
new text end

new text begin Subd. 3. new text end

new text begin Proposal. new text end

new text begin The commissioners of human services and commerce shall submit
to the chairs and ranking minority members of the legislative committees with jurisdiction
over health and human services policy and finance by March 1, 2020, a proposal for the
purchase option and the results from actuarial and economic analyses that are necessary for
a waiver proposal. In preparing the proposal, the commissioners shall consult with the
legislature and incorporate legislative recommendations when feasible. The commissioners
shall also make recommendations on any legislative changes necessary to implement the
program described in this section.
new text end

new text begin Subd. 4. new text end

new text begin Federal waiver request. new text end

new text begin (a) The commissioners of human services and
commerce shall seek necessary federal waiver authority to establish a program that allows
individuals with income above the maximum income eligibility limit under Minnesota
Statutes, section 256L.04, subdivision 1 or 7, and who otherwise meet the MinnesotaCare
eligibility requirements including, but not limited to, Minnesota Statutes, sections 256L.04,
256L.07, and 256L.09, the option of purchasing coverage through MinnesotaCare instead
of purchasing a qualified health plan through the state health insurance exchange or an
individual health plan offered outside of the state health insurance exchange.
new text end

new text begin (b) The commissioners shall also seek necessary federal waiver authority, for individuals
who qualify under paragraph (a) who choose to purchase the MinnesotaCare option, to use
advanced tax credits and cost-sharing reductions, if eligible, to purchase this option.
new text end

new text begin (c) The commissioners shall also seek necessary federal waiver authority to permit the
MinnesotaCare purchase option to be offered through the state health insurance exchange
as a coverage option and to be compared with qualified health plans offered through the
state health insurance exchange.
new text end