Public Option, Vaccine Exemptions, Loan Forgiveness & Climate Change

Dave Renner, CAE, our legislative rep, recaps recent activities at the State Capitol related to health care, including a hearing on MinnesotaCare expansion, the introduction of a new vaccine exemption bill, funding for physician loan forgiveness and a hearing on climate change and public health.

Public Option Bill—First to Receive Hearing in the House

Legislation to expand MinnesotaCare eligibility and allow small employers to purchase MinnesotaCare for their employees was heard by the House Health Finance and Policy Committee on January 26, 2021. This was the first bill to receive a hearing, this session. It passed and was referred to the House Commerce Committee for further action.

Representative Jennifer Schultz (DFL-Duluth) presented a “delete everything” amendment for HF 11 that expands eligibility for MinnesotaCare in stages:

  • Beginning January 1, 2022, families who have access to employer coverage that is deemed unaffordable, along with undocumented noncitizens, are eligible for MinnesotaCare.
  • Beginning January 1, 2023, eligibility is expanded for Minnesotans earning below 400 percent of the federal poverty level, from the current level of 200 percent with a subsidized, sliding-scale premium. Also, those earning over 400 percent but below 500 percent can purchase MinnesotaCare at full cost premium. Small employers with 50 or fewer employees are also eligible to purchase MinnesotaCare for their employees.

This legislation is supported by many patient advocacy groups that are looking for affordable options for families and individuals who cannot afford the high cost of premiums or deductibles. It is opposed by the Minnesota Council of Health Plans and the business communities that are worried it will lead to end the private small group and individual insurance market, resulting in more Minnesotans covered by public programs.

While Governor Walz has supported a public option in the past, it is interesting that he did not include it in his recent budget recommendations. It is unclear whether this proposal will receive a hearing in the Senate.

Vaccine Exemption Bill Introduced

Legislation to loosen the state’s childhood vaccine requirements was introduced by Senator Andrew Mathews (R-Princeton). The bill, SF 292, would add a new religious exemption to immunization requirements (which could be used by parents prior to enrolling children in a school or childcare facility). This exemption would be in addition to the current exemption based on the parent’s “conscientious objection” to a vaccine. The difference is this statement would not need to be notarized.

Minnesota already has one of the weakest childhood immunization laws in the country, and this additional exemption would further weaken the law. A Minnesota Academy of Family Physician’s (MAFP) legislative priority is to strengthen this law.

The bill does not yet have a House companion bill. Even if a companion is introduced, it is unclear whether this bill will receive a hearing this session.

In a related matter, legislation is being drafted by Representative Glenn Gruenhagen (R-Glencoe) that would prohibit an employer from firing or taking disciplinary action against an employee who refuses to get a vaccination. This bill is focused more on the COVID-19 and flu vaccines; but, it again would move Minnesota in the wrong direction.

Physician Loan Forgiveness Funding

Minnesota currently has loan forgiveness programs for physicians, midlevel providers, nurses, nursing home workers and others designed to encourage practitioners to practice in rural and urban underserved regions of the state. The Office of Rural Health and Primary Care within the Minnesota Department of Health administrates these programs.

MAFP Chief Operating Officer Jami Burbidge, MAM, and I met with Representative John Huot (DFL-Rosemount) to ask him to introduce legislation to increase funding for these programs by $1 million per year. Representative Huot, enthusiastically, said yes.

Last year, 35 physicians applied for six loan forgiveness spots and 54 midlevel practitioners applied for eight spots. The additional money will fund six additional physician spots and six additional midlevel spots.

Climate Change as a Public Health Issue

The House Preventive Health Division held a joint hearing with the Climate and Energy Finance and Policy Committee to hear about climate change and its impact on health.

A number of physicians testified on what they are seeing as the impact on their patients and the types of diseases they are treating because of the changing climate, including MAFP member Nyasha Spears, MD (Duluth). Many of those who testified are also active in the Health Professionals for a Healthy Climate organization.

This hearing was informational with no action taken.

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