Bill Text: MN SF2094 | 2011-2012 | 87th Legislature | Introduced
Bill Title: Healthy Minnesota contribution program modifications
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2012-02-27 - Referred to Health and Human Services [SF2094 Detail]
Download: Minnesota-2011-SF2094-Introduced.html
1.2relating to human services; modifying eligibility for the healthy Minnesota
1.3contribution program; amending Minnesota Statutes 2010, section 256L.07,
1.4subdivision 3; Minnesota Statutes 2011 Supplement, sections 62E.14, subdivision
1.54g; 256L.031, subdivisions 1, 2, 3, 6.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2011 Supplement, section 62E.14, subdivision 4g, is
1.8amended to read:
1.9 Subd. 4g. Waiver of preexisting conditions for persons covered by healthy
1.10Minnesota contribution program. A person may enroll in the comprehensive plan with
1.11a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for
1.12the healthy Minnesota contribution program, and has been denied coverage as described
1.13under section256L.031, subdivision 6 . The six-month durational residency requirement
1.14specified in section 62E.02, subdivision 13, does not apply to individuals enrolled in the
1.15healthy Minnesota contribution program.
1.16 Sec. 2. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 1, is
1.17amended to read:
1.18 Subdivision 1. Defined contributions to enrollees. (a) Beginning July 1, 2012, the
1.19commissioner shall provide each MinnesotaCare enrollee eligible under section256L.04 ,
1.20subdivision 7, with family income equal to or greater than200 150 percent of the federal
1.21poverty guidelines with a monthly defined contribution to purchase health coverage under
1.22a health plan as defined in section62A.011, subdivision 3 .
2.1(b) Enrollees eligible under this section shall not be charged premiums under
2.2section256L.15 and are exempt from the managed care enrollment requirement of section
2.3256L.12
.
2.4(c) Sections256L.03 ;
256L.05, subdivision 3 ; and
256L.11 do not apply to enrollees
2.5eligible under this section unless otherwise provided in this section. Covered services, cost
2.6sharing, disenrollment for nonpayment of premium, enrollee appeal rights and complaint
2.7procedures, and the effective date of coverage for enrollees eligible under this section shall
2.8be as provided under the terms of the health plan purchased by the enrollee.
2.9(d) Unless otherwise provided in this section, all MinnesotaCare requirements
2.10related to eligibility, income and asset methodology, income reporting, and program
2.11administration, continue to apply to enrollees obtaining coverage under this section.
2.12 Sec. 3. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 2, is
2.13amended to read:
2.14 Subd. 2. Use of defined contribution; health plan requirements. (a) An enrollee
2.15may use up to the monthly defined contribution to pay premiums for coverage under
2.16a health plan as defined in section62A.011, subdivision 3 , or as provided in section
2.17256L.031, subdivision 6.
2.18(b) An enrollee must select a health plan withinthree four calendar months of
2.19approval of MinnesotaCare eligibility. If a health plan is not selected and purchased
2.20within this time period, the enrollee must reapply and must meet all eligibility criteria.
2.21The commissioner may determine criteria under which an enrollee has more than four
2.22calendar months to select a health plan.
2.23(c)A health plan Coverage purchased under this section must:
2.24(1)provide coverage for include mental health and chemical dependency treatment
2.25services; and
2.26(2) comply with the coverage limitations specified in section256L.03, subdivision
2.271, the second paragraph.
2.28 Sec. 4. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 3, is
2.29amended to read:
2.30 Subd. 3. Determination of defined contribution amount. (a) The commissioner
2.31shall determine the defined contribution sliding scale using the base contribution specified
2.32in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
2.33for defined contributions that provides:
3.1(1) persons with household incomes equal to 150 percent of the federal poverty
3.2guidelines with a defined contribution equal to 106 percent of the base contribution;
3.3(1) (2) persons with household incomes equal to 200 percent of the federal poverty
3.4guidelines with a defined contribution of 93 percent of the base contribution;
3.5(2) (3) persons with household incomes equal to 250 percent of the federal poverty
3.6guidelines with a defined contribution of 80 percent of the base contribution; and
3.7(3) (4) persons with household incomes in evenly spaced increments between the
3.8percentages of the federal poverty guideline or income level specified in clauses (1)
3.9and (2) to (3) with a base contribution that is a percentage interpolated from the defined
3.10contribution percentages specified in clauses (1)and (2) to (3).
3.19(b) The commissioner shall multiply the defined contribution amounts developed
3.20under paragraph (a) by1.20 for enrollees who are denied coverage under an individual
3.21health plan by a health plan company and who purchase coverage through the Minnesota
3.22Comprehensive Health Association.
3.23 Sec. 5. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 6, is
3.24amended to read:
3.25 Subd. 6. Minnesota Comprehensive Health Association (MCHA). Beginning
3.26July 1, 2012, MinnesotaCare enrolleeswho are denied coverage in the individual
3.27health market by a health plan company in accordance with section
62A.65 are eligible
3.28for coverage through a health plan offered by the Minnesota Comprehensive Health
3.29Associationand may enroll in MCHA in accordance with section
62E.14 . Any difference
3.30between the revenue and actual covered losses to MCHA related to the implementation of
3.31this section are appropriated annually to the commissioner of human services from the
3.32health care access fund and shall be paid to MCHA.
3.33 Sec. 6. Minnesota Statutes 2010, section 256L.07, subdivision 3, is amended to read:
3.34 Subd. 3. Other health coverage. (a) Families and individuals enrolled in the
3.35MinnesotaCare program must have no health coverage while enrolled or for at least four
4.1months prior to application and renewal. Children enrolled in the original children's health
4.2plan and children in families with income equal to or less than 150 percent of the federal
4.3poverty guidelines, who have other health insurance, are eligible if the coverage:
4.4(1) lacks two or more of the following:
4.5(i) basic hospital insurance;
4.6(ii) medical-surgical insurance;
4.7(iii) prescription drug coverage;
4.8(iv) dental coverage; or
4.9(v) vision coverage;
4.10(2) requires a deductible of $100 or more per person per year; or
4.11(3) lacks coverage because the child has exceeded the maximum coverage for a
4.12particular diagnosis or the policy excludes a particular diagnosis.
4.13The commissioner may change this eligibility criterion for sliding scale premiums
4.14in order to remain within the limits of available appropriations. The requirement of no
4.15health coverage does not apply to newborns.
4.16(b) Coverage purchased as provided under section 256L.031, subdivision 2, medical
4.17assistance,general assistance medical care, and the Civilian Health and Medical Program
4.18of the Uniformed Service, CHAMPUS, or other coverage provided under United States
4.19Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or health
4.20coverage for purposes of the four-month requirement described in this subdivision.
4.21(c) For purposes of this subdivision, an applicant or enrollee who is entitled to
4.22Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
4.23Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to
4.24have health coverage. An applicant or enrollee who is entitled to premium-free Medicare
4.25Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility
4.26for MinnesotaCare.
4.27(d) Applicants who were recipients of medical assistanceor general assistance
4.28medical care within one month of application must meet the provisions of this subdivision
4.29and subdivision 2.
4.30(e) Cost-effective health insurance that was paid for by medical assistance is not
4.31considered health coverage for purposes of the four-month requirement under this
4.32section, except if the insurance continued after medical assistance no longer considered it
4.33cost-effective or after medical assistance closed.
1.3contribution program; amending Minnesota Statutes 2010, section 256L.07,
1.4subdivision 3; Minnesota Statutes 2011 Supplement, sections 62E.14, subdivision
1.54g; 256L.031, subdivisions 1, 2, 3, 6.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2011 Supplement, section 62E.14, subdivision 4g, is
1.8amended to read:
1.9 Subd. 4g. Waiver of preexisting conditions for persons covered by healthy
1.10Minnesota contribution program. A person may enroll in the comprehensive plan with
1.11a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for
1.12the healthy Minnesota contribution program, and has been denied coverage as described
1.13under section
1.14specified in section 62E.02, subdivision 13, does not apply to individuals enrolled in the
1.15healthy Minnesota contribution program.
1.16 Sec. 2. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 1, is
1.17amended to read:
1.18 Subdivision 1. Defined contributions to enrollees. (a) Beginning July 1, 2012, the
1.19commissioner shall provide each MinnesotaCare enrollee eligible under section
1.20subdivision 7, with family income equal to or greater than
1.21poverty guidelines with a monthly defined contribution to purchase health coverage under
1.22a health plan as defined in section
2.1(b) Enrollees eligible under this section shall not be charged premiums under
2.2section
2.4(c) Sections
2.5eligible under this section unless otherwise provided in this section. Covered services, cost
2.6sharing, disenrollment for nonpayment of premium, enrollee appeal rights and complaint
2.7procedures, and the effective date of coverage for enrollees eligible under this section shall
2.8be as provided under the terms of the health plan purchased by the enrollee.
2.9(d) Unless otherwise provided in this section, all MinnesotaCare requirements
2.10related to eligibility, income and asset methodology, income reporting, and program
2.11administration, continue to apply to enrollees obtaining coverage under this section.
2.12 Sec. 3. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 2, is
2.13amended to read:
2.14 Subd. 2. Use of defined contribution; health plan requirements. (a) An enrollee
2.15may use up to the monthly defined contribution to pay premiums for coverage under
2.16a health plan as defined in section
2.17256L.031, subdivision 6.
2.18(b) An enrollee must select a health plan within
2.19approval of MinnesotaCare eligibility. If a health plan is not selected and purchased
2.20within this time period, the enrollee must reapply and must meet all eligibility criteria.
2.21The commissioner may determine criteria under which an enrollee has more than four
2.22calendar months to select a health plan.
2.23(c)
2.24(1)
2.25services; and
2.26(2) comply with the coverage limitations specified in section
2.28 Sec. 4. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 3, is
2.29amended to read:
2.30 Subd. 3. Determination of defined contribution amount. (a) The commissioner
2.31shall determine the defined contribution sliding scale using the base contribution specified
2.32in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
2.33for defined contributions that provides:
3.1(1) persons with household incomes equal to 150 percent of the federal poverty
3.2guidelines with a defined contribution equal to 106 percent of the base contribution;
3.3
3.4guidelines with a defined contribution of 93 percent of the base contribution;
3.5
3.6guidelines with a defined contribution of 80 percent of the base contribution; and
3.7
3.8percentages of the federal poverty guideline or income level specified in clauses (1)
3.9
3.10contribution percentages specified in clauses (1)
| 3.11 |
19-29 |
$125 |
|
| 3.12 |
30-34 |
$135 |
|
| 3.13 |
35-39 |
$140 |
|
| 3.14 |
40-44 |
$175 |
|
| 3.15 |
45-49 |
$215 |
|
| 3.16 |
50-54 |
$295 |
|
| 3.17 |
55-59 |
$345 |
|
| 3.18 |
60+ |
$360 |
3.20under paragraph (a) by
3.21health plan by a health plan company and who purchase coverage through the Minnesota
3.22Comprehensive Health Association.
3.23 Sec. 5. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 6, is
3.24amended to read:
3.25 Subd. 6. Minnesota Comprehensive Health Association (MCHA). Beginning
3.26July 1, 2012, MinnesotaCare enrollees
3.27
3.28for coverage through a health plan offered by the Minnesota Comprehensive Health
3.29Association
3.30between the revenue and actual covered losses to MCHA related to the implementation of
3.31this section are appropriated annually to the commissioner of human services from the
3.32health care access fund and shall be paid to MCHA.
3.33 Sec. 6. Minnesota Statutes 2010, section 256L.07, subdivision 3, is amended to read:
3.34 Subd. 3. Other health coverage. (a) Families and individuals enrolled in the
3.35MinnesotaCare program must have no health coverage while enrolled or for at least four
4.1months prior to application and renewal. Children enrolled in the original children's health
4.2plan and children in families with income equal to or less than 150 percent of the federal
4.3poverty guidelines, who have other health insurance, are eligible if the coverage:
4.4(1) lacks two or more of the following:
4.5(i) basic hospital insurance;
4.6(ii) medical-surgical insurance;
4.7(iii) prescription drug coverage;
4.8(iv) dental coverage; or
4.9(v) vision coverage;
4.10(2) requires a deductible of $100 or more per person per year; or
4.11(3) lacks coverage because the child has exceeded the maximum coverage for a
4.12particular diagnosis or the policy excludes a particular diagnosis.
4.13The commissioner may change this eligibility criterion for sliding scale premiums
4.14in order to remain within the limits of available appropriations. The requirement of no
4.15health coverage does not apply to newborns.
4.16(b) Coverage purchased as provided under section 256L.031, subdivision 2, medical
4.17assistance,
4.18of the Uniformed Service, CHAMPUS, or other coverage provided under United States
4.19Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or health
4.20coverage for purposes of the four-month requirement described in this subdivision.
4.21(c) For purposes of this subdivision, an applicant or enrollee who is entitled to
4.22Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
4.23Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to
4.24have health coverage. An applicant or enrollee who is entitled to premium-free Medicare
4.25Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility
4.26for MinnesotaCare.
4.27(d) Applicants who were recipients of medical assistance
4.28
4.29and subdivision 2.
4.30(e) Cost-effective health insurance that was paid for by medical assistance is not
4.31considered health coverage for purposes of the four-month requirement under this
4.32section, except if the insurance continued after medical assistance no longer considered it
4.33cost-effective or after medical assistance closed.
