HF 914

as introduced - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to health; eliminating the MinnesotaCare four-month uninsured
requirement for children; amending Minnesota Statutes 2006, section 256L.07,
subdivisions 1, 3.

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

Section 1.

Minnesota Statutes 2006, section 256L.07, subdivision 1, is amended to read:

Subdivision 1.

General requirements.

(a) Children enrolled in the original
children's health plan as of September 30, 1992, children who enrolled in the
MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
article 4, section 17, and children who have family gross incomes that are equal to or
less than 150 percent of the federal poverty guidelines are eligible without meeting
the requirements of subdivision 2 deleted text begin and the four-month requirement in subdivision 3 deleted text end , as
long as they maintain continuous coverage in the MinnesotaCare program or medical
assistance. Children who apply for MinnesotaCare on or after the implementation date
of the employer-subsidized health coverage program as described in Laws 1998, chapter
407, article 5, section 45, who have family gross incomes that are equal to or less than 150
percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to
be eligible for MinnesotaCare.

(b) Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, whose
income increases above 275 percent of the federal poverty guidelines, are no longer
eligible for the program and shall be disenrolled by the commissioner. Individuals enrolled
in MinnesotaCare under section 256L.04, subdivision 7, whose income increases above
175 percent of the federal poverty guidelines are no longer eligible for the program and
shall be disenrolled by the commissioner. For persons disenrolled under this subdivision,
MinnesotaCare coverage terminates the last day of the calendar month following the
month in which the commissioner determines that the income of a family or individual
exceeds program income limits.

(c) Notwithstanding paragraph (b), children may remain enrolled in MinnesotaCare
if ten percent of their gross individual or gross family income as defined in section
256L.01, subdivision 4, is less than the premium for a six-month policy with a $500
deductible available through the Minnesota Comprehensive Health Association. Children
who are no longer eligible for MinnesotaCare under this clause shall be given a 12-month
notice period from the date that ineligibility is determined before disenrollment. The
premium for children remaining eligible under this clause shall be the maximum premium
determined under section 256L.15, subdivision 2, paragraph (b).

(d) Notwithstanding paragraphs (b) and (c), parents are not eligible for
MinnesotaCare if gross household income exceeds $25,000 for the six-month period
of eligibility.

Sec. 2.

Minnesota Statutes 2006, 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 deleted text begin or deleted text end new text begin and adults must
have no health coverage new text end 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) Medical assistance, general assistance medical care, 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 or general assistance
medical care 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.