HF 2274

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

A bill for an act
relating to health care; removing the insurance barriers to MinnesotaCare
eligibility for children; amending Minnesota Statutes 2006, section 256L.07,
subdivisions 2, 3.

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

Section 1.

Minnesota Statutes 2006, section 256L.07, subdivision 2, is amended to read:

Subd. 2.

Must not have access to employer-subsidized coverage.

(a) To be
eligible, deleted text begin a family or individual deleted text end new text begin an adult new text end must not have access to subsidized health coverage
through an employer and must not have had access to employer-subsidized coverage
through a current employer for 18 months prior to application or reapplication. deleted text begin A family
or individual deleted text end new text begin An adult new text end whose employer-subsidized coverage is lost due to an employer
terminating health care coverage as an employee benefit during the previous 18 months
is not eligible.

(b) This subdivision does not apply to deleted text begin a family or individual deleted text end new text begin an adult new text end who was
enrolled in MinnesotaCare within six months or less of reapplication and who no longer
has employer-subsidized coverage due to the employer terminating health care coverage
as an employee benefit.

(c) For purposes of this requirement, subsidized health coverage means health
coverage for which the employer pays at least 50 percent of the cost of coverage for
the employee or dependent, or a higher percentage as specified by the commissioner.
deleted text begin Children are eligible for employer-subsidized coverage through either parent, including
the noncustodial parent. deleted text end The commissioner must treat employer contributions to Internal
Revenue Code Section 125 plans and any other employer benefits intended to pay
health care costs as qualified employer subsidies toward the cost of health coverage for
employees for purposes of this subdivision.

new text begin (d) This subdivision does not apply to children.
new text end

Sec. 2.

Minnesota Statutes 2006, section 256L.07, subdivision 3, is amended to read:

Subd. 3.

Other health coverage.

(a) deleted text begin Families and individuals deleted text end new text begin Adults new text end enrolled in the
MinnesotaCare program must have no health coverage while enrolled or for at least four
months prior to application and renewal. deleted text begin 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:
deleted text end

deleted text begin (1) lacks two or more of the following:
deleted text end

deleted text begin (i) basic hospital insurance;
deleted text end

deleted text begin (ii) medical-surgical insurance;
deleted text end

deleted text begin (iii) prescription drug coverage;
deleted text end

deleted text begin (iv) dental coverage; or
deleted text end

deleted text begin (v) vision coverage;
deleted text end

deleted text begin (2) requires a deductible of $100 or more per person per year; or
deleted text end

deleted text begin (3) lacks coverage because the child has exceeded the maximum coverage for a
particular diagnosis or the policy excludes a particular diagnosis.
deleted text end

The commissioner may change this eligibility criterion for sliding scale premiums in
order to remain within the limits of available appropriations. deleted text begin The requirement of no health
coverage deleted text end new text begin This paragraph new text end does not apply to deleted text begin newborns deleted text end new text begin children new text end .

(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.