HF 650

as introduced - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:40am

A bill for an act
relating to health care access; establishing the MinnesotaCare CMF program;
providing coverage through medical benefit accounts and high-deductible health
plans; proposing coding for new law in Minnesota Statutes, chapter 256L.

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

Section 1.

new text begin [256L.30] MINNESOTACARE CARE FOR MORE FAMILIES
PROGRAM.
new text end

new text begin The commissioner shall establish the MinnesotaCare Care for More Families (CMF)
program. The commissioner shall implement the program on January 1, 2010, or upon
federal approval, whichever is later.
new text end

Sec. 2.

new text begin [256L.31] ELIGIBILITY.
new text end

new text begin Subdivision 1. new text end

new text begin General requirements. new text end

new text begin Families and children meeting the eligibility
requirements of this section are eligible for the MinnesotaCare CMF program. Enrollment
in the program is voluntary. For purposes of the program, a child is an individual under
age 19.
new text end

new text begin Subd. 2. new text end

new text begin Income limit. new text end

new text begin Families and children with family income equal to or less
than 300 percent of the federal poverty guidelines for the applicable family size are
eligible for the MinnesotaCare CMF program.
new text end

new text begin Subd. 3. new text end

new text begin No other health coverage. new text end

new text begin (a) Families and children must have no other
health coverage at the time of application, except that families and children that contribute
15 percent or more of their gross income toward the cost of employer-sponsored coverage
are eligible for the program.
new text end

new text begin (b) Families and children eligible to enroll in the medical assistance program are not
eligible for the MinnesotaCare CMF program.
new text end

new text begin (c) Families and children enrolled in the MinnesotaCare program under section
256L.04, subdivision 1, may voluntarily enroll in the MinnesotaCare CMF program.
new text end

new text begin Subd. 4. new text end

new text begin Other MinnesotaCare eligibility requirements. new text end

new text begin (a) To be eligible for
MinnesotaCare CMF, families and children must comply with the citizenship requirement
in section 256L.04, subdivision 10, and the residency requirement in section 256L.09.
new text end

new text begin (b) Section 256L.07, subdivisions 2 and 3, do not apply to enrollment under the
MinnesotaCare CMF program.
new text end

Sec. 3.

new text begin [256L.33] PROGRAM ADMINISTRATION.
new text end

new text begin Unless otherwise specified, the commissioner shall administer the MinnesotaCare
CMF program using the procedures and methods used to administer the MinnesotaCare
program for persons enrolled under section 256L.04, subdivision 1.
new text end

Sec. 4.

new text begin [256L.35] COVERED SERVICES.
new text end

new text begin Covered services under the MinnesotaCare CMF program consist of all
comprehensive health maintenance services covered under a standard HMO contract, as
defined under section 62D.02, subdivision 7, and Minnesota Rules, chapter 4685, or
their actuarial equivalent.
new text end

Sec. 5.

new text begin [256L.37] HIGH-DEDUCTIBLE HEALTH PLAN.
new text end

new text begin Subdivision 1. new text end

new text begin Purchase required. new text end

new text begin Enrollees shall purchase a high-deductible
health plan through a health insurance exchange established under section 62U.02. For
purposes of this requirement, a high-deductible health plan is a health plan with an
annual deductible equal to $1,000 for individuals and $2,000 for families, indexed by the
Consumer Price Index (CPI-urban). The health plan purchased may be either a family or
individual policy, at the option of the enrollee. Enrollees who receive premium subsidies
must select the least costly high-deductible health plan available to the enrollee.
new text end

new text begin Subd. 2. new text end

new text begin Plan coverage. new text end

new text begin High-deductible health plans must provide coverage for
all services required to be covered under section 256L.35.
new text end

new text begin Subd. 3. new text end

new text begin Cost-sharing. new text end

new text begin High-deductible plans shall have no enrollee cost-sharing
beyond the deductible.
new text end

Sec. 6.

new text begin [256L.39] MEDICAL BENEFIT ACCOUNT.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment of account. new text end

new text begin Each enrollee shall manage a medical
benefit account. A medical benefit account is a trust established and owned by the state of
Minnesota for the sole benefit of the MinnesotaCare CMF enrollee, that may be used to
pay for health care services subject to a deductible, other qualified medical expenses, and
qualified educational expenses of the enrollee. The medical benefit account shall consist
of a deductible account and a freedom account.
new text end

new text begin Subd. 2. new text end

new text begin Deductible account. new text end

new text begin The deductible account shall be funded by the
enrollee and the state, to the value of the annual deductible of the high-deductible health
plan. Expenditures from the deductible account are limited to medical expenses that count
toward the deductible, according to the terms of the high-deductible health plan.
new text end

new text begin Subd. 3. new text end

new text begin Freedom account. new text end

new text begin The freedom account shall be funded with money
rolled over from the enrollee's previous year's unspent deductible account dollars,
investment gains, and any additional private contributions. Money in the freedom account
may be spent on:
new text end

new text begin (1) all qualified medical expenses, as defined in section 213(d) of the Internal
Revenue Code;
new text end

new text begin (2) qualified education expenses; and
new text end

new text begin (3) private sector health plan premiums, for persons who lose eligibility for or are no
longer enrolled in MinnesotaCare CMF.
new text end

new text begin For purposes of this subdivision, "qualified educational expenses" means tuition and fees
at postsecondary educational institutions. Money in the freedom account may be invested
by the enrollee, using the procedures that apply to individual retirement accounts.
new text end

new text begin Subd. 4. new text end

new text begin Administration. new text end

new text begin Any organization qualified to administer individual
retirement accounts may administer the medical benefit account, subject to any restrictions
specified in the trust documents. Funds in the medical benefits account must be accessible
through a debit card. Charges on the debit card must be limited to allowed expenditures.
new text end

new text begin Subd. 5. new text end

new text begin Additional contributions. new text end

new text begin Enrollees, and employers and other third
parties, may contribute additional funds to the medical benefit account. These funds are
subject to the same spending restrictions as contributions by the enrollee and the state.
new text end

new text begin Subd. 6. new text end

new text begin Continued access to account. new text end

new text begin Individuals who become ineligible for or
leave the MinnesotaCare CMF program shall continue to have access to money in the
medical benefit account, if they had been enrolled in the MinnesotaCare CMF program for
at least 12 consecutive months. Medical benefit account funds for persons enrolled in the
MinnesotaCare CMF program for less than 12 consecutive months shall be forfeited by
the person and deposited into the general fund.
new text end

Sec. 7.

new text begin [256L.41] PREMIUMS.
new text end

new text begin Subdivision 1. new text end

new text begin Requirement. new text end

new text begin Families and children shall pay a premium based on
the sliding scale specified in section 256L.15. All other provisions of section 256L.15
shall apply to premium administration and collection under the MinnesotaCare CMF
program, unless otherwise specified in this section. Families and children with incomes
that exceed the income limit for the MinnesotaCare CMF program may remain on the
program, but must pay the full cost of the high-deductible premium and must fully fund
the deductible account without any state subsidy.
new text end

new text begin Subd. 2. new text end

new text begin Premiums applied first to deductible account. new text end

new text begin The commissioner
shall fully fund each enrollee's deductible account at the time of initial enrollment and
at the start of each plan year, and shall use the required premium contributions from the
enrollee to pay back the cost of fully funding the deductible. The commissioner shall
apply the premiums collected under this section to the cost of premium payments for the
high-deductible health plan policy only if the enrollee still has a premium obligation
after fully funding the deductible account.
new text end

new text begin Subd. 3. new text end

new text begin Payment to exchange. new text end

new text begin The commissioner shall require families and
children to pay sliding scale premiums to the health insurance exchange from which the
MinnesotaCare CMF high-deductible health plan is purchased.
new text end

Sec. 8.

new text begin [256L.43] WAIVERS AND FEDERAL APPROVAL.
new text end

new text begin The commissioner shall seek all necessary federal waivers and approvals to
implement the MinnesotaCare CMF program and to use federal medical assistance and
state children's health insurance program dollars to pay for health care services covered
under the MinnesotaCare CMF program.
new text end