SF 32

2nd Engrossment - 87th Legislature (2011 - 2012) Posted on 03/06/2012 01:08pm

A bill for an act
relating to human services; establishing the healthy Minnesota contribution
program; requiring plan to redesign service delivery for lower-income
MinnesotaCare enrollees; amending Minnesota Statutes 2010, sections 62E.14,
by adding a subdivision; 256B.04, subdivision 18; 256L.05, by adding a
subdivision; proposing coding for new law in Minnesota Statutes, chapter 256L.

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

Section 1.

Minnesota Statutes 2010, section 62E.14, is amended by adding a
subdivision to read:

new text begin Subd. 4f. new text end

new text begin Waiver of preexisting conditions for persons covered by healthy
Minnesota contribution program. new text end

new text begin A person may enroll in the comprehensive plan with
a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for
the healthy Minnesota contribution program, and has been denied coverage as described
under section 256L.031, subdivision 6.
new text end

Sec. 2.

Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:

Subd. 18.

Applications for medical assistance.

new text begin (a) new text end The state agency may
take applications for medical assistance and conduct eligibility determinations for
MinnesotaCare enrollees.

new text begin (b) The commissioner of human services shall modify the Minnesota health care
programs application form to add a question asking applicants: "Are you a U.S. military
veteran?"
new text end

Sec. 3.

new text begin [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Defined contributions to enrollees. new text end

new text begin (a) Beginning January 1, 2012,
the commissioner shall provide each MinnesotaCare enrollee eligible under section
256L.04, subdivision 7, with gross family income equal to or greater than 133 percent
of the federal poverty guidelines, with a monthly defined contribution to purchase health
coverage under a health plan as defined in section 62A.011, subdivision 3. Beginning
January 1, 2012, or upon federal approval, whichever is later, the commissioner shall
provide each MinnesotaCare enrollee eligible under section 256L.04, subdivision 1, with
gross family income equal to or greater than 133 percent of the federal poverty guidelines,
with a monthly defined contribution to purchase health coverage under a health plan as
defined in section 62A.011, subdivision 3, offered by a health plan company as defined
in section 62Q.01, subdivision 4.
new text end

new text begin (b) Enrollees eligible under paragraph (a) shall not be charged premiums under
section 256L.15 and are exempt from the managed care enrollment requirement of section
256L.12.
new text end

new text begin (c) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to
enrollees eligible under paragraph (a). Covered services, cost sharing, disenrollment
for nonpayment of premium, enrollee appeal rights and complaint procedures, and the
effective date of coverage for enrollees eligible under paragraph (a) shall be as provided
under the terms of the health plan purchased by the enrollee.
new text end

new text begin (d) Unless otherwise provided in this section, all MinnesotaCare requirements
related to eligibility, income and asset methodology, income reporting, and program
administration, continue to apply to enrollees obtaining coverage under this section.
new text end

new text begin Subd. 2. new text end

new text begin Use of defined contribution. new text end

new text begin An enrollee may use up to the monthly
defined contribution to pay premiums for coverage under a health plan as defined in
section 62A.011, subdivision 3.
new text end

new text begin Subd. 3. new text end

new text begin Determination of defined contribution amount. new text end

new text begin (a) The commissioner
shall determine the defined contribution sliding scale using the base contribution specified
in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
for defined contributions that provides:
new text end

new text begin (1) persons with household incomes equal to 133 percent of the federal poverty
guidelines with a defined contribution of 150 percent of the base contribution;
new text end

new text begin (2) persons with household incomes equal to 175 percent of the federal poverty
guidelines with a defined contribution of 100 percent of the base contribution;
new text end

new text begin (3) persons with household incomes equal to or greater than 250 percent of
the federal poverty guidelines with a defined contribution of 80 percent of the base
contribution; and
new text end

new text begin (4) persons with household incomes in evenly spaced increments between the
percentages of the federal poverty guidelines specified in clauses (1) to (3) with a base
contribution that is a percentage interpolated from the defined contribution percentages
specified in clauses (1) to (3).
new text end

new text begin Age new text end	new text begin Monthly Per-Person Base Contribution new text end
new text begin Under 21 new text end	new text begin $122.79 new text end
new text begin 21-29 new text end	new text begin 122.79 new text end
new text begin 30-31 new text end	new text begin 129.19 new text end
new text begin 32-33 new text end	new text begin 132.38 new text end
new text begin 34-35 new text end	new text begin 134.31 new text end
new text begin 36-37 new text end	new text begin 136.06 new text end
new text begin 38-39 new text end	new text begin 141.02 new text end
new text begin 40-41 new text end	new text begin 151.25 new text end
new text begin 42-43 new text end	new text begin 159.89 new text end
new text begin 44-45 new text end	new text begin 175.08 new text end
new text begin 46-47 new text end	new text begin 191.71 new text end
new text begin 48-49 new text end	new text begin 213.13 new text end
new text begin 50-51 new text end	new text begin 239.51 new text end
new text begin 52-53 new text end	new text begin 266.69 new text end
new text begin 54-55 new text end	new text begin 293.88 new text end
new text begin 56-57 new text end	new text begin 323.77 new text end
new text begin 58-59 new text end	new text begin 341.20 new text end
new text begin 60+ new text end	new text begin 357.19 new text end

new text begin (b) The commissioner shall multiply the defined contribution amounts developed
under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual
health plan by a health plan company and who purchase coverage through the Minnesota
Comprehensive Health Association.
new text end

new text begin (c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall
not exceed 90 percent of the monthly premium for the health plan purchased by the
enrollee. If the enrollee purchases coverage under a health plan that does not include
mental health services and chemical dependency treatment services, the monthly defined
contribution amount determined under this subdivision shall be reduced by five percent.
new text end

new text begin Subd. 4. new text end

new text begin Administration by commissioner. new text end

new text begin The commissioner shall administer the
defined contributions. The commissioner shall:
new text end

new text begin (1) calculate and process defined contributions for enrollees; and
new text end

new text begin (2) pay the defined contribution amount to health plan companies or the Minnesota
Comprehensive Health Association, as applicable, for enrollee health plan coverage.
new text end

new text begin Subd. 5. new text end

new text begin Assistance to enrollees. new text end

new text begin The commissioner of human services, in
consultation with the commissioner of commerce, shall develop an efficient and
cost-effective method of referring eligible applicants to professional insurance agent
associations.
new text end

new text begin Subd. 6. new text end

new text begin Minnesota Comprehensive Health Association (MCHA). new text end

new text begin Beginning
January 1, 2012, MinnesotaCare enrollees who are denied coverage under an individual
health plan by a health plan company are eligible for coverage through a health plan
offered by the Minnesota Comprehensive Health Association and may enroll in MCHA
in accordance with section 62E.14. Any difference between the revenue and covered
losses to the MCHA related to implementation of this section shall be paid to the MCHA
from the health care access fund.
new text end

new text begin Subd. 7. new text end

new text begin Federal approval. new text end

new text begin The commissioner shall seek all federal waivers
and approvals necessary to implement coverage under this section for MinnesotaCare
enrollees eligible under section 256L.04, subdivision 1, with gross family incomes equal
to or greater than 133 percent of the federal poverty guidelines, while continuing to
receive federal matching funds.
new text end

new text begin Subd. 8. new text end

new text begin Sunset. new text end

new text begin This section shall expire upon the full implementation of the
Patient Protection and Affordable Care Act (ACA), Public Law 111-148. For purposes
of this section, full implementation of the ACA means premium credits and cost-sharing
subsidies are available for health plans offered in Minnesota through an insurance
exchange established under sections 1311, 1321, 1401, and 1402 of the ACA, as amended
by the Health Care Education Reconciliation Act of 2010, Public Law 111-152.
new text end

Sec. 4.

Minnesota Statutes 2010, section 256L.05, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Referral of veterans. new text end

new text begin The commissioner shall ensure that all applicants
for MinnesotaCare with incomes less than 133 percent of the federal poverty guidelines
who identify themselves as veterans are referred to a county veterans service officer for
assistance in applying to the U.S. Department of Veterans Affairs for any veterans benefits
for which they may be eligible.
new text end

Sec. 5. new text begin COVERAGE FOR LOWER-INCOME MINNESOTACARE
ENROLLEES.
new text end

new text begin The commissioner of human services shall develop and present to the legislature,
by December 15, 2011, a plan to redesign service delivery for MinnesotaCare enrollees
eligible under Minnesota Statutes, section 256L.04, subdivisions 1 and 7, with incomes
less than 133 percent of the federal poverty guidelines. The plan must be designed to
improve continuity and quality of care, reduce unnecessary emergency room visits, and
reduce average per-enrollee costs. In developing the plan, the commissioner shall consider
innovative methods of service delivery including, but not limited to, increasing the use
and choice of private sector health plan coverage and encouraging the use of community
health clinics, as defined in the federal Community Health Care Act of 1964, as health
care homes.
new text end

Sec. 6. new text begin DIRECTION TO COMMISSIONER; FEDERAL WAIVER.
new text end

new text begin The commissioner of human services shall apply to the Centers for Medicare and
Medicaid Services for federal waivers to cover:
new text end

new text begin (1) families with children eligible under Minnesota Statutes, section 256L.04,
subdivision 1; and
new text end

new text begin (2) adults eligible under Minnesota Statutes, section 256L.04, subdivision 1,
under the MinnesotaCare healthy Minnesota contribution program established under
Minnesota Statutes, section 256L.031, by July 1, 2011. The commissioner shall report to
the legislative committees with jurisdiction over health and human services policy and
finance whether or not the federal waiver application was accepted within ten working
days of receipt of the decision.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end