HF 1181

as introduced - 89th Legislature (2015 - 2016) Posted on 02/23/2015 02:32pm

A bill for an act
relating to health; preparing for a Minnesota innovation waiver under section
1332 of the Affordable Care Act; developing a health care system that best serves
Minnesotans; requiring a cost analysis; appropriating money.

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

Section 1.

new text begin INVESTIGATING OPPORTUNITIES FOR HEALTH CARE
INNOVATION.
new text end

new text begin Subdivision 1. new text end

new text begin Purpose. new text end

new text begin Section 1332 of title 1 of the Affordable Care Act offers
states the opportunity to use new, innovative ways of delivering health care. States can
apply for an innovation waiver starting in 2017, as long as the proposal provides better,
more comprehensive coverage to at least as many people and is more affordable than the
Affordable Care Act. Minnesota has a long tradition of health care innovation and it has
long been a state goal to cover all Minnesotans with high-quality health care as efficiently
and effectively as possible. Consequently, the state should investigate different approaches
to see whether there is a better health care delivery system Minnesota could implement
which would increase access, affordability, and quality of care.
new text end

new text begin Subd. 2. new text end

new text begin Values. new text end

new text begin All Minnesotans deserve access to high-quality, affordable health
care for all of their medical needs. Furthermore, decisions about appropriate care should
be made by patients and their providers.
new text end

Sec. 2. new text begin SECTION 1332 WAIVER COST AND BENEFIT ANALYSIS.
new text end

new text begin Subdivision 1. new text end

new text begin Contract for analysis of proposals. new text end

new text begin In preparation for a section
1332 waiver request, the commissioner of management and budget shall contract with the
University of Minnesota School of Public Health and the Carlson School of Management,
to conduct an analysis of the costs and benefits of up to three specific proposals that
seek to create a better health care system which would increase access, affordability, and
quality of care in comparison to the current system.
new text end

new text begin Subd. 2. new text end

new text begin Plans. new text end

new text begin After consulting with interested legislators, the commissioner of
health shall submit to the University of Minnesota the following proposals:
new text end

new text begin (1) a free-market insurance-based competition approach;
new text end

new text begin (2) a universal health care plan designed to meet the following principles:
new text end

new text begin (i) ensure all Minnesotans receive quality health care;
new text end

new text begin (ii) not restrict, delay, or deny care or reduce the quality of care to hold down costs,
but instead reduce costs through prevention, efficiency, and reduction of bureaucracy;
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new text begin (iii) cover all necessary care, including all coverage currently required by law,
complete mental health services, chemical dependency treatment, prescription drugs,
medical equipment and supplies, dental care, long-term care, and home care services;
new text end

new text begin (iv) allow patients to choose their own providers;
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new text begin (v) be funded through premiums based on ability to pay and other revenue sources;
new text end

new text begin (vi) focus on preventive care and early intervention to improve the health of all
Minnesota residents and reduce costs from untreated illnesses and diseases;
new text end

new text begin (vii) ensure an adequate number of qualified health care professionals and facilities
to guarantee availability of and timely access to quality care throughout the state;
new text end

new text begin (viii) continue Minnesota's leadership in medical education, training, research,
and technology;
new text end

new text begin (ix) provide adequate and timely payments to providers; and
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new text begin (x) reduce the costly bureaucratic complexity of the health care system; and
new text end

new text begin (3) a third alternative may be submitted by the commissioner that offers a different
approach.
new text end

new text begin Subd. 3. new text end

new text begin Proposal analysis. new text end

new text begin (a) The analysis of each proposal must measure the
impact on total public and private health care spending in Minnesota that would result
from each proposal. "Total public and private health care spending" means spending on all
medical care, including dental care, prescription drugs, medical equipment and supplies,
complete mental health services, chemical dependency treatment, long-term care, and
home care services as well as all of the costs for administering, delivering, and paying for
the care. The analysis of total health care spending shall include whether there are savings
or additional costs compared to the existing system due to:
new text end

new text begin (1) increased or reduced insurance, billing, underwriting, marketing, and other
administrative functions;
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new text begin (2) timely and appropriate use of medical care;
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new text begin (3) market-driven or negotiated prices on medical services and products, including
pharmaceuticals;
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new text begin (4) shortages or excess capacity of medical facilities and equipment;
new text end

new text begin (5) increased or decreased utilization, better health outcomes, increased wellness
due to prevention, early intervention, and health-promoting activities;
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new text begin (6) payment reforms;
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new text begin (7) coordination of care; and
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new text begin (8) non-health care impacts on state and local expenditures such as reduced
out-of-home placement or crime costs due to mental health or chemical dependency
coverage.
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new text begin (b) The analysis must also estimate for each proposal job losses or gains in health
care and elsewhere in the economy due to implementation of the reforms.
new text end

new text begin (c) The analysts shall work with the authors of each proposal to gain understanding
or clarification of the specifics of each proposal. The analysis shall assume that the
provisions in each proposal are not preempted by federal law or that the federal
government gives a waiver to the preemption.
new text end

new text begin (d) The proposals must be submitted to the University of Minnesota analysts
within 30 days after final enactment of this legislation. The analysis shall be completed
by August 1, 2016.
new text end

Sec. 3. new text begin APPROPRIATION.
new text end

new text begin $....... is appropriated in fiscal year 2015 from the general fund to the commissioner
of management and budget to contract with the University of Minnesota to conduct
an economic analysis of costs and benefits of section 1332 waiver health care system
proposals specified in section 2.
new text end

Sec. 4. new text begin EFFECTIVE DATE.
new text end

new text begin Sections 1 to 3 are effective the day following final enactment.
new text end