Bill Text: MN SF32 | 2011-2012 | 87th Legislature | Engrossed
Bill Title: Healthy Minnesota contribution program
Spectrum: Partisan Bill (Republican 2-0)
Status: (Introduced - Dead) 2011-05-03 - HF substituted on General Orders HF8 [SF32 Detail]
Download: Minnesota-2011-SF32-Engrossed.html
1.2relating to human services; establishing the healthy Minnesota contribution
1.3program; requiring plan to redesign service delivery for lower-income
1.4MinnesotaCare enrollees; amending Minnesota Statutes 2010, sections 62E.14,
1.5by adding a subdivision; 256B.04, subdivision 18; 256L.05, by adding a
1.6subdivision; proposing coding for new law in Minnesota Statutes, chapter 256L.
1.7BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.8 Section 1. Minnesota Statutes 2010, section 62E.14, is amended by adding a
1.9subdivision to read:
1.10 Subd. 4f. Waiver of preexisting conditions for persons covered by healthy
1.11Minnesota contribution program. A person may enroll in the comprehensive plan with
1.12a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for
1.13the healthy Minnesota contribution program, and has been denied coverage as described
1.14under section 256L.031, subdivision 6.
1.15 Sec. 2. Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:
1.16 Subd. 18. Applications for medical assistance. (a) The state agency may
1.17take applications for medical assistance and conduct eligibility determinations for
1.18MinnesotaCare enrollees.
1.19 (b) The commissioner of human services shall modify the Minnesota health care
1.20programs application form to add a question asking applicants: "Are you a U.S. military
1.21veteran?"
1.22 Sec. 3. [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
2.1 Subdivision 1. Defined contributions to enrollees. (a) Beginning January 1, 2012,
2.2the commissioner shall provide each MinnesotaCare enrollee eligible under section
2.3256L.04, subdivision 7, with gross family income equal to or greater than 133 percent
2.4of the federal poverty guidelines, with a monthly defined contribution to purchase health
2.5coverage under a health plan as defined in section 62A.011, subdivision 3. Beginning
2.6January 1, 2012, or upon federal approval, whichever is later, the commissioner shall
2.7provide each MinnesotaCare enrollee eligible under section 256L.04, subdivision 1, with
2.8gross family income equal to or greater than 133 percent of the federal poverty guidelines,
2.9with a monthly defined contribution to purchase health coverage under a health plan as
2.10defined in section 62A.011, subdivision 3, offered by a health plan company as defined
2.11in section 62Q.01, subdivision 4.
2.12(b) Enrollees eligible under paragraph (a) shall not be charged premiums under
2.13section 256L.15 and are exempt from the managed care enrollment requirement of section
2.14256L.12.
2.15(c) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to
2.16enrollees eligible under paragraph (a). Covered services, cost sharing, disenrollment
2.17for nonpayment of premium, enrollee appeal rights and complaint procedures, and the
2.18effective date of coverage for enrollees eligible under paragraph (a) shall be as provided
2.19under the terms of the health plan purchased by the enrollee.
2.20(d) Unless otherwise provided in this section, all MinnesotaCare requirements
2.21related to eligibility, income and asset methodology, income reporting, and program
2.22administration, continue to apply to enrollees obtaining coverage under this section.
2.23 Subd. 2. Use of defined contribution. An enrollee may use up to the monthly
2.24defined contribution to pay premiums for coverage under a health plan as defined in
2.25section 62A.011, subdivision 3.
2.26 Subd. 3. Determination of defined contribution amount. (a) The commissioner
2.27shall determine the defined contribution sliding scale using the base contribution specified
2.28in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
2.29for defined contributions that provides:
2.30(1) persons with household incomes equal to 133 percent of the federal poverty
2.31guidelines with a defined contribution of 150 percent of the base contribution;
2.32(2) persons with household incomes equal to 175 percent of the federal poverty
2.33guidelines with a defined contribution of 100 percent of the base contribution;
2.34(3) persons with household incomes equal to or greater than 250 percent of
2.35the federal poverty guidelines with a defined contribution of 80 percent of the base
2.36contribution; and
3.1(4) persons with household incomes in evenly spaced increments between the
3.2percentages of the federal poverty guidelines specified in clauses (1) to (3) with a base
3.3contribution that is a percentage interpolated from the defined contribution percentages
3.4specified in clauses (1) to (3).
3.24(b) The commissioner shall multiply the defined contribution amounts developed
3.25under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual
3.26health plan by a health plan company and who purchase coverage through the Minnesota
3.27Comprehensive Health Association.
3.28(c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall
3.29not exceed 90 percent of the monthly premium for the health plan purchased by the
3.30enrollee. If the enrollee purchases coverage under a health plan that does not include
3.31mental health services and chemical dependency treatment services, the monthly defined
3.32contribution amount determined under this subdivision shall be reduced by five percent.
3.33 Subd. 4. Administration by commissioner. The commissioner shall administer the
3.34defined contributions. The commissioner shall:
3.35 (1) calculate and process defined contributions for enrollees; and
3.36 (2) pay the defined contribution amount to health plan companies or the Minnesota
3.37Comprehensive Health Association, as applicable, for enrollee health plan coverage.
3.38 Subd. 5. Assistance to enrollees. The commissioner of human services, in
3.39consultation with the commissioner of commerce, shall develop an efficient and
4.1cost-effective method of referring eligible applicants to professional insurance agent
4.2associations.
4.3 Subd. 6. Minnesota Comprehensive Health Association (MCHA). Beginning
4.4January 1, 2012, MinnesotaCare enrollees who are denied coverage under an individual
4.5health plan by a health plan company are eligible for coverage through a health plan
4.6offered by the Minnesota Comprehensive Health Association and may enroll in MCHA
4.7in accordance with section 62E.14. Any difference between the revenue and covered
4.8losses to the MCHA related to implementation of this section shall be paid to the MCHA
4.9from the health care access fund.
4.10 Subd. 7. Federal approval. The commissioner shall seek all federal waivers
4.11and approvals necessary to implement coverage under this section for MinnesotaCare
4.12enrollees eligible under section 256L.04, subdivision 1, with gross family incomes equal
4.13to or greater than 133 percent of the federal poverty guidelines, while continuing to
4.14receive federal matching funds.
4.15 Subd. 8. Sunset. This section shall expire upon the full implementation of the
4.16Patient Protection and Affordable Care Act (ACA), Public Law 111-148. For purposes
4.17of this section, full implementation of the ACA means premium credits and cost-sharing
4.18subsidies are available for health plans offered in Minnesota through an insurance
4.19exchange established under sections 1311, 1321, 1401, and 1402 of the ACA, as amended
4.20by the Health Care Education Reconciliation Act of 2010, Public Law 111-152.
4.21 Sec. 4. Minnesota Statutes 2010, section 256L.05, is amended by adding a subdivision
4.22to read:
4.23 Subd. 6. Referral of veterans. The commissioner shall ensure that all applicants
4.24for MinnesotaCare with incomes less than 133 percent of the federal poverty guidelines
4.25who identify themselves as veterans are referred to a county veterans service officer for
4.26assistance in applying to the U.S. Department of Veterans Affairs for any veterans benefits
4.27for which they may be eligible.
4.28 Sec. 5. COVERAGE FOR LOWER-INCOME MINNESOTACARE
4.29ENROLLEES.
4.30The commissioner of human services shall develop and present to the legislature,
4.31by December 15, 2011, a plan to redesign service delivery for MinnesotaCare enrollees
4.32eligible under Minnesota Statutes, section 256L.04, subdivisions 1 and 7, with incomes
4.33less than 133 percent of the federal poverty guidelines. The plan must be designed to
4.34improve continuity and quality of care, reduce unnecessary emergency room visits, and
5.1reduce average per-enrollee costs. In developing the plan, the commissioner shall consider
5.2innovative methods of service delivery including, but not limited to, increasing the use
5.3and choice of private sector health plan coverage and encouraging the use of community
5.4health clinics, as defined in the federal Community Health Care Act of 1964, as health
5.5care homes.
5.6 Sec. 6. DIRECTION TO COMMISSIONER; FEDERAL WAIVER.
5.7The commissioner of human services shall apply to the Centers for Medicare and
5.8Medicaid Services for federal waivers to cover:
5.9(1) families with children eligible under Minnesota Statutes, section 256L.04,
5.10subdivision 1; and
5.11(2) adults eligible under Minnesota Statutes, section 256L.04, subdivision 1,
5.12under the MinnesotaCare healthy Minnesota contribution program established under
5.13Minnesota Statutes, section 256L.031, by July 1, 2011. The commissioner shall report to
5.14the legislative committees with jurisdiction over health and human services policy and
5.15finance whether or not the federal waiver application was accepted within ten working
5.16days of receipt of the decision.
5.17EFFECTIVE DATE.This section is effective the day following final enactment.
1.3program; requiring plan to redesign service delivery for lower-income
1.4MinnesotaCare enrollees; amending Minnesota Statutes 2010, sections 62E.14,
1.5by adding a subdivision; 256B.04, subdivision 18; 256L.05, by adding a
1.6subdivision; proposing coding for new law in Minnesota Statutes, chapter 256L.
1.7BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.8 Section 1. Minnesota Statutes 2010, section 62E.14, is amended by adding a
1.9subdivision to read:
1.10 Subd. 4f. Waiver of preexisting conditions for persons covered by healthy
1.11Minnesota contribution program. A person may enroll in the comprehensive plan with
1.12a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for
1.13the healthy Minnesota contribution program, and has been denied coverage as described
1.14under section 256L.031, subdivision 6.
1.15 Sec. 2. Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:
1.16 Subd. 18. Applications for medical assistance. (a) The state agency may
1.17take applications for medical assistance and conduct eligibility determinations for
1.18MinnesotaCare enrollees.
1.19 (b) The commissioner of human services shall modify the Minnesota health care
1.20programs application form to add a question asking applicants: "Are you a U.S. military
1.21veteran?"
1.22 Sec. 3. [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
2.1 Subdivision 1. Defined contributions to enrollees. (a) Beginning January 1, 2012,
2.2the commissioner shall provide each MinnesotaCare enrollee eligible under section
2.3256L.04, subdivision 7, with gross family income equal to or greater than 133 percent
2.4of the federal poverty guidelines, with a monthly defined contribution to purchase health
2.5coverage under a health plan as defined in section 62A.011, subdivision 3. Beginning
2.6January 1, 2012, or upon federal approval, whichever is later, the commissioner shall
2.7provide each MinnesotaCare enrollee eligible under section 256L.04, subdivision 1, with
2.8gross family income equal to or greater than 133 percent of the federal poverty guidelines,
2.9with a monthly defined contribution to purchase health coverage under a health plan as
2.10defined in section 62A.011, subdivision 3, offered by a health plan company as defined
2.11in section 62Q.01, subdivision 4.
2.12(b) Enrollees eligible under paragraph (a) shall not be charged premiums under
2.13section 256L.15 and are exempt from the managed care enrollment requirement of section
2.14256L.12.
2.15(c) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to
2.16enrollees eligible under paragraph (a). Covered services, cost sharing, disenrollment
2.17for nonpayment of premium, enrollee appeal rights and complaint procedures, and the
2.18effective date of coverage for enrollees eligible under paragraph (a) shall be as provided
2.19under the terms of the health plan purchased by the enrollee.
2.20(d) Unless otherwise provided in this section, all MinnesotaCare requirements
2.21related to eligibility, income and asset methodology, income reporting, and program
2.22administration, continue to apply to enrollees obtaining coverage under this section.
2.23 Subd. 2. Use of defined contribution. An enrollee may use up to the monthly
2.24defined contribution to pay premiums for coverage under a health plan as defined in
2.25section 62A.011, subdivision 3.
2.26 Subd. 3. Determination of defined contribution amount. (a) The commissioner
2.27shall determine the defined contribution sliding scale using the base contribution specified
2.28in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
2.29for defined contributions that provides:
2.30(1) persons with household incomes equal to 133 percent of the federal poverty
2.31guidelines with a defined contribution of 150 percent of the base contribution;
2.32(2) persons with household incomes equal to 175 percent of the federal poverty
2.33guidelines with a defined contribution of 100 percent of the base contribution;
2.34(3) persons with household incomes equal to or greater than 250 percent of
2.35the federal poverty guidelines with a defined contribution of 80 percent of the base
2.36contribution; and
3.1(4) persons with household incomes in evenly spaced increments between the
3.2percentages of the federal poverty guidelines specified in clauses (1) to (3) with a base
3.3contribution that is a percentage interpolated from the defined contribution percentages
3.4specified in clauses (1) to (3).
3.24(b) The commissioner shall multiply the defined contribution amounts developed
3.25under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual
3.26health plan by a health plan company and who purchase coverage through the Minnesota
3.27Comprehensive Health Association.
3.28(c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall
3.29not exceed 90 percent of the monthly premium for the health plan purchased by the
3.30enrollee. If the enrollee purchases coverage under a health plan that does not include
3.31mental health services and chemical dependency treatment services, the monthly defined
3.32contribution amount determined under this subdivision shall be reduced by five percent.
3.33 Subd. 4. Administration by commissioner. The commissioner shall administer the
3.34defined contributions. The commissioner shall:
3.35 (1) calculate and process defined contributions for enrollees; and
3.36 (2) pay the defined contribution amount to health plan companies or the Minnesota
3.37Comprehensive Health Association, as applicable, for enrollee health plan coverage.
3.38 Subd. 5. Assistance to enrollees. The commissioner of human services, in
3.39consultation with the commissioner of commerce, shall develop an efficient and
4.1cost-effective method of referring eligible applicants to professional insurance agent
4.2associations.
4.3 Subd. 6. Minnesota Comprehensive Health Association (MCHA). Beginning
4.4January 1, 2012, MinnesotaCare enrollees who are denied coverage under an individual
4.5health plan by a health plan company are eligible for coverage through a health plan
4.6offered by the Minnesota Comprehensive Health Association and may enroll in MCHA
4.7in accordance with section 62E.14. Any difference between the revenue and covered
4.8losses to the MCHA related to implementation of this section shall be paid to the MCHA
4.9from the health care access fund.
4.10 Subd. 7. Federal approval. The commissioner shall seek all federal waivers
4.11and approvals necessary to implement coverage under this section for MinnesotaCare
4.12enrollees eligible under section 256L.04, subdivision 1, with gross family incomes equal
4.13to or greater than 133 percent of the federal poverty guidelines, while continuing to
4.14receive federal matching funds.
4.15 Subd. 8. Sunset. This section shall expire upon the full implementation of the
4.16Patient Protection and Affordable Care Act (ACA), Public Law 111-148. For purposes
4.17of this section, full implementation of the ACA means premium credits and cost-sharing
4.18subsidies are available for health plans offered in Minnesota through an insurance
4.19exchange established under sections 1311, 1321, 1401, and 1402 of the ACA, as amended
4.20by the Health Care Education Reconciliation Act of 2010, Public Law 111-152.
4.21 Sec. 4. Minnesota Statutes 2010, section 256L.05, is amended by adding a subdivision
4.22to read:
4.23 Subd. 6. Referral of veterans. The commissioner shall ensure that all applicants
4.24for MinnesotaCare with incomes less than 133 percent of the federal poverty guidelines
4.25who identify themselves as veterans are referred to a county veterans service officer for
4.26assistance in applying to the U.S. Department of Veterans Affairs for any veterans benefits
4.27for which they may be eligible.
4.28 Sec. 5. COVERAGE FOR LOWER-INCOME MINNESOTACARE
4.29ENROLLEES.
4.30The commissioner of human services shall develop and present to the legislature,
4.31by December 15, 2011, a plan to redesign service delivery for MinnesotaCare enrollees
4.32eligible under Minnesota Statutes, section 256L.04, subdivisions 1 and 7, with incomes
4.33less than 133 percent of the federal poverty guidelines. The plan must be designed to
4.34improve continuity and quality of care, reduce unnecessary emergency room visits, and
5.1reduce average per-enrollee costs. In developing the plan, the commissioner shall consider
5.2innovative methods of service delivery including, but not limited to, increasing the use
5.3and choice of private sector health plan coverage and encouraging the use of community
5.4health clinics, as defined in the federal Community Health Care Act of 1964, as health
5.5care homes.
5.6 Sec. 6. DIRECTION TO COMMISSIONER; FEDERAL WAIVER.
5.7The commissioner of human services shall apply to the Centers for Medicare and
5.8Medicaid Services for federal waivers to cover:
5.9(1) families with children eligible under Minnesota Statutes, section 256L.04,
5.10subdivision 1; and
5.11(2) adults eligible under Minnesota Statutes, section 256L.04, subdivision 1,
5.12under the MinnesotaCare healthy Minnesota contribution program established under
5.13Minnesota Statutes, section 256L.031, by July 1, 2011. The commissioner shall report to
5.14the legislative committees with jurisdiction over health and human services policy and
5.15finance whether or not the federal waiver application was accepted within ten working
5.16days of receipt of the decision.
5.17EFFECTIVE DATE.This section is effective the day following final enactment.
