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SF 58

as introduced - 90th Legislature (2017 - 2018) Posted on 01/12/2017 08:51am

KEY: stricken = removed, old language. underscored = added, new language.

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Current Version - as introduced

A bill for an act
relating to health care; requiring the commissioner of human services to seek
federal waivers to permit individuals whose income is greater than the income
eligibility limit for MinnesotaCare to purchase coverage through MinnesotaCare
through a separate MinnesotaCare purchase option.

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

Section 1. MINNESOTACARE PURCHASE OPTION; FEDERAL WAIVER
REQUEST.

Subdivision 1.

Federal waiver request.

(a) The commissioner of human services shall
seek necessary federal waiver authority to establish a program that allows individuals with
income above the maximum income eligibility limit under Minnesota Statutes, section
256L.04, subdivision 1 or 7, and who otherwise meet the MinnesotaCare eligibility
requirements including, but not limited to, Minnesota Statutes, sections 256L.04, 256L.07,
and 256L.09, the option of purchasing coverage through MinnesotaCare instead of purchasing
a qualified health plan through MNsure as defined under Minnesota Statutes, section 62V.02,
or an individual health plan offered outside of MNsure.

(b) The commissioner shall also seek necessary federal waiver authority, for individuals
who qualify under paragraph (a) who choose to purchase the MinnesotaCare option, to use
advanced tax credits and cost-sharing credits, if eligible, to purchase this option.

(c) The commissioner shall also seek necessary federal waiver authority to permit the
MinnesotaCare purchase option to be offered through MNsure as a coverage option and to
be compared with qualified health plans offered through MNsure.

Subd. 2.

Program establishment and criteria.

(a) The MinnesotaCare purchase option
shall coordinate the administration of the purchase option with the MinnesotaCare program
to maximize efficiency and improve the continuity of care, consistent with the requirements
of Minnesota Statutes, sections 256L.06, 256L.10, 256L.11, 256L.12, and 256L.121. The
commissioner shall seek to implement mechanisms to ensure the long-term financial
sustainability of MinnesotaCare and mitigate any adverse financial impacts to MNsure.
These mechanisms must address issues related to minimizing adverse selection, the state
financial risk and contribution, and negative impacts to premiums in the individual and
group insurance market both inside and outside of MNsure.

(b) The purchase option shall include, at a minimum, the following:

(1) establishment of an annual per enrollee premium rate similar to the average rate paid
by the state to managed care plan contractors under Minnesota Statutes, section 256L.12;

(2) establishment of a benefit set equal to the benefits covered under MinnesotaCare
under Minnesota Statutes, section 256L.03;

(3) limiting annual enrollment to the same annual open enrollment periods established
for MNsure;

(4) ability of the commissioner to adjust the purchase option's actuarial value to a value
no lower than 87 percent;

(5) reimbursement mechanisms for addressing potential reductions in funding for MNsure
operations; and

(6) reimbursement mechanisms for addressing potential increased cost to the
MinnesotaCare program under Minnesota Statutes, chapter 256L.

Subd. 3.

Report.

The commissioner shall report to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance by March 1, 2018, on the progress of receiving a federal waiver and the
results from actuarial and economic analyses that are necessary for a waiver proposal. The
commissioner shall also make recommendations on any legislative changes necessary to
implement the program described in this section. Any implementation of this waiver that
requires a state financial contribution shall be contingent on further legislative action
approving the state's contribution.

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