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HF 9

1st Engrossment - 88th Legislature (2013 - 2014) Posted on 01/29/2013 11:33am

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to human services; expanding medical assistance eligibility; requiring
the use of modified adjusted gross income and a standard income disregard;
amending Minnesota Statutes 2012, sections 256B.02, by adding subdivisions;
256B.055, subdivision 15; 256B.056, subdivisions 1a, 3, 4, 7, by adding
subdivisions; 256B.057, subdivision 2.

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

Section 1.

Minnesota Statutes 2012, section 256B.02, is amended by adding a
subdivision to read:


new text begin Subd. 17. new text end

new text begin Affordable Care Act or ACA. new text end

new text begin "Affordable Care Act" or "ACA" means
Public Law 111-148, as amended by the federal Health Care and Education Reconciliation
Act of 2010 (Public Law 111-152), and any amendments to, or regulations or guidance
issued under, those acts.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 2.

Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision
to read:


new text begin Subd. 18. new text end

new text begin Modified adjusted gross income and household income. new text end

new text begin "Modified
adjusted gross income" and "household income" have the meaning provided in section
2002 of the Affordable Care Act.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 3.

Minnesota Statutes 2012, section 256B.055, subdivision 15, is amended to read:


Subd. 15.

Adults without children.

new text begin (a) new text end Medical assistance may be paid for a
person who is:

(1) at least age 21 and under age 65;

(2) not pregnant;

(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII
of the Social Security Act;

(4) not an adult in a family with children as defined in deleted text begin section 256L.01, subdivision
3a
deleted text end new text begin paragraph (b)new text end ; and

(5) not described in another subdivision of this section.

new text begin (b) "Family with children" means:
new text end

new text begin (1) parents and their dependent children as defined in subdivision 3a, residing in
the same household; or
new text end

new text begin (2) grandparents, foster parents, relative caretakers as defined in the medical
assistance program, or legal guardians; and their wards who are children residing in the
same household.
new text end

new text begin The term includes children who are temporarily absent from the household in settings such
as schools, camps, or parenting time with noncustodial parents.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 4.

Minnesota Statutes 2012, section 256B.056, subdivision 1a, is amended to read:


Subd. 1a.

Income and assets generally.

new text begin (a) new text end Unless specifically required by state
law or rule or federal law or regulation, the methodologies used in counting income and
assets to determine eligibility for medical assistance for persons whose eligibility category
is based on blindness, disability, or age of 65 or more years, the methodologies for the
supplemental security income program shall be used, except as provided under subdivision
3, paragraph (a), clause (6). Increases in benefits under title II of the Social Security Act
shall not be counted as income for purposes of this subdivision until July 1 of each year.

new text begin (b)new text end Effective upon federal approval, for children eligible under section 256B.055,
subdivision 12
, or for home and community-based waiver services whose eligibility
for medical assistance is determined without regard to parental income, child support
payments, including any payments made by an obligor in satisfaction of or in addition
to a temporary or permanent order for child support, and Social Security payments are
not counted as income. For families and childrendeleted text begin , which includesdeleted text end new text begin andnew text end all other eligibility
categoriesnew text begin exempt from the use of modified gross income and household income under
section 2002 of the Affordable Care Act
new text end , the methodologies under the state's AFDC
plan in effect as of July 16, 1996, as required by the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 104-193, shall be used,
except that effective October 1, 2003, the earned income disregards and deductions are
limited to those in subdivision 1c.

new text begin (c) Effective January 1, 2014, for families and children, adults without children, and
other individuals not otherwise exempt, the income and asset methodology required under
section 2002 of the Affordable Care Act shall be used.
new text end

new text begin (d)new text end For these purposes, a "methodology" does not include an asset or income
standard, or accounting method, or method of determining effective dates.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 5.

Minnesota Statutes 2012, section 256B.056, is amended by adding a
subdivision to read:


new text begin Subd. 1e. new text end

new text begin Families and children; income methodology effective January 1, 2014.
new text end

new text begin Effective January 1, 2014, the commissioner shall use modified adjusted gross income and
household income, and replace existing income disregards with a five percent standard
income disregard, when determining medical assistance income eligibility for applicants
and enrollees who are families and children and other individuals not exempt from these
requirements, as required under section 2002 of the Affordable Care Act.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 6.

Minnesota Statutes 2012, section 256B.056, is amended by adding a
subdivision to read:


new text begin Subd. 1f. new text end

new text begin Adults without children income methodology. new text end

new text begin Effective January 1,
2014, the commissioner shall use modified adjusted gross income and household income,
and replace existing income disregards with a five percent standard disregard, when
determining medical assistance income eligibility for applicants and enrollees who are
adults without children under section 256B.055, subdivision 15, as required under section
2002 of the Affordable Care Act.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 7.

Minnesota Statutes 2012, section 256B.056, subdivision 3, is amended to read:


Subd. 3.

Asset limitations for individuals and families.

(a) To be eligible for
medical assistance, a person must not individually own more than $3,000 in assets, or if a
member of a household with two family members, husband and wife, or parent and child,
the household must not own more than $6,000 in assets, plus $200 for each additional
legal dependent. In addition to these maximum amounts, an eligible individual or family
may accrue interest on these amounts, but they must be reduced to the maximum at the
time of an eligibility redetermination. The accumulation of the clothing and personal
needs allowance according to section 256B.35 must also be reduced to the maximum at
the time of the eligibility redetermination. The value of assets that are not considered in
determining eligibility for medical assistance is the value of those assets excluded under
the supplemental security income program for aged, blind, and disabled persons, with
the following exceptions:

(1) household goods and personal effects are not considered;

(2) capital and operating assets of a trade or business that the local agency determines
are necessary to the person's ability to earn an income are not considered;

(3) motor vehicles are excluded to the same extent excluded by the supplemental
security income program;

(4) assets designated as burial expenses are excluded to the same extent excluded by
the supplemental security income program. Burial expenses funded by annuity contracts
or life insurance policies must irrevocably designate the individual's estate as contingent
beneficiary to the extent proceeds are not used for payment of selected burial expenses;

(5) for a person who no longer qualifies as an employed person with a disability due
to loss of earnings, assets allowed while eligible for medical assistance under section
256B.057, subdivision 9, are not considered for 12 months, beginning with the first month
of ineligibility as an employed person with a disability, to the extent that the person's total
assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph (d);

(6) when a person enrolled in medical assistance under section 256B.057, subdivision
9
, is age 65 or older and has been enrolled during each of the 24 consecutive months
before the person's 65th birthday, the assets owned by the person and the person's spouse
must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d),
when determining eligibility for medical assistance under section 256B.055, subdivision
7
. The income of a spouse of a person enrolled in medical assistance under section
256B.057, subdivision 9, during each of the 24 consecutive months before the person's
65th birthday must be disregarded when determining eligibility for medical assistance
under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to
the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013
is required to have qualified for medical assistance under section 256B.057, subdivision 9,
prior to age 65 for at least 20 months in the 24 months prior to reaching age 65; and

(7) effective July 1, 2009, certain assets owned by American Indians are excluded as
required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
Law 111-5. For purposes of this clause, an American Indian is any person who meets the
definition of Indian according to Code of Federal Regulations, title 42, section 447.50.

(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
15.

new text begin (c) No asset limit shall apply to families and children and other individuals for whom
asset tests are prohibited under section 2002 of the Affordable Care Act.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 8.

Minnesota Statutes 2012, section 256B.056, subdivision 4, is amended to read:


Subd. 4.

Income.

(a) To be eligible for medical assistance, a person eligible under
section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
the federal poverty guidelines. Effective January 1, 2000, and each successive January,
recipients of supplemental security income may have an income up to the supplemental
security income standard in effect on that date.

(b) To be eligible for medical assistance, families and children may have an income
up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
1996, shall be increased by three percent.

(c) Effective deleted text begin July 1, 2002deleted text end new text begin January 1, 2014new text end , to be eligible for medical assistance,
deleted text begin familiesdeleted text end new text begin parents and relative caretakers may have an income up to 133 percent of the
federal poverty guidelines for family size
new text end and children may have an income up to deleted text begin 100deleted text end new text begin 275
new text end percent of the federal poverty guidelines for the family size.

(d) To be eligible for medical assistance under section 256B.055, subdivision 15,
a person may have an income up to deleted text begin 75deleted text end new text begin 133new text end percent of federal poverty guidelines for
the family size.

(e) In computing income to determine eligibility of persons under paragraphs (a) to
(d) who are not residents of long-term care facilities, the commissioner shall disregard
increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509.
Veterans aid and attendance benefits and Veterans Administration unusual medical
expense payments are considered income to the recipient.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 9.

Minnesota Statutes 2012, section 256B.056, subdivision 7, is amended to read:


Subd. 7.

Period of eligibility.

Eligibility is available for the month of application
and for three months prior to application if the person was eligible in those prior months. A
redetermination of eligibility must occur every 12 months.new text begin For persons subject to eligibility
determinations using modified adjusted gross income and household income as required
under section 2002 of the Affordable Care Act, six-month renewals shall not be required.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 10.

Minnesota Statutes 2012, section 256B.057, subdivision 2, is amended to read:


Subd. 2.

Children.

(a) deleted text begin Except as specified in subdivision 1b,deleted text end Effective deleted text begin October 1,
2003
deleted text end new text begin January 1, 2014new text end , a child deleted text begin onedeleted text end new text begin twonew text end through deleted text begin 18deleted text end new text begin 20new text end years of age in a family whose
countable income is no greater than deleted text begin 150deleted text end new text begin 275new text end percent of the federal poverty guidelines for
the same family size, is eligible for medical assistance.

(b) For applications processed within one calendar month prior to the effective date,
eligibility shall be determined by applying the income standards and methodologies in
effect prior to the effective date for any months in the deleted text begin six-monthdeleted text end budget period before
that date and the income standards and methodologies in effect on the effective date for
any months in the deleted text begin six-monthdeleted text end budget period on or after that date. The income standards
for each month shall be added together and compared to the applicant's total countable
income for the deleted text begin six-monthdeleted text end budget period to determine eligibility.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end

Sec. 11. new text begin TRANSFER; SHIFT OF PREGNANT WOMEN AND CHILDREN
TO MEDICAL ASSISTANCE.
new text end

new text begin $....... is transferred from the health care access fund to the general fund for the
biennium ending June 30, 2015, to pay for health care services provided under the medical
assistance program to former MinnesotaCare enrollees who are pregnant women and
children.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end