Health & Human Services Budget Update

Our legislative rep Dave Renner, CAE, shares a recap on the recent passage of Health and Human Services Budget bills in both the Minnesota House and Senate health committees.

On Friday, April 9, 2021, both the Minnesota House and Senate health committees passed their versions of the Health and Human Services omnibus budget bills. While both bills include some items that are the same, the bills differ significantly in size and spending.

MN House Budget Bill

Representative Tina Liebling (DFL-Rochester) introduced the delete everything amendment to HF 2128 that is 373 pages and allocates an increase in General Fund spending of $155.9 million over the next biennium for health and human services programs.

Included in the House bill are two MAFP priorities:

SUPPORT FOR TELEHEALTH: The House bill includes language to expand coverage for telehealth services based on the expansions that were implemented during the COVID-19 public health emergency. The language allows telehealth to be provided to patients in their home, expands the definition to include audio-only coverage and includes coverage for telemonitoring services. It maintains the current law that says that payment for telehealth services must be at the same rate as in-person services.

To address the future costs to the state, referred to as “budget tails,” the bill sunsets coverage for telehealth for all public programs on July 1, 2023. Prior to the sunset, the Department of Human Services is required to study how telehealth is working, including how it is addressing access and health disparities, and the impact it is having on health care costs and innovative payment models. Representative Liebling said when proposing the sunset that no one wants telehealth coverage to stop, but the sunset will force the Legislature to review the telehealth expansions in the future and take action to continue the program if it is shown to be improving care. This sunset creates uncertainty and work will continue to limit or eliminate it in the coming weeks to ensure continued coverage for all Minnesotans.

LIMITING INSURERS & PHARMACY BENEFIT MANAGERS FROM CHANGING MEDICATIONS DURING AN ENROLLMENT YEAR: The bill limits insurers and pharmacy benefit managers (PBMs) from forcing an enrollee who is currently using a medication to change that drug to one that the PBM says is cheaper (during an enrollment year). Under current law, an enrollee cannot change health plans during the year, but the insurer can change coverages whenever it wants, even if it may not be in the best interest of the enrollee.

Also included in the House bill:

  • Language directing the Department of Human Services to perform actuarial and financial analysis in developing a public option program, including through expanded enrollment in MinnesotaCare, and reporting findings back to the Legislature by December 15, 2021.
  • Expanding Medical Assistance coverage for pregnant women to six months postpartum. Current law only covers 60 days postpartum.
  • Adding raw, smokable cannabis as part of Minnesota’s Medical Cannabis program.

MN Senate Budget Bill

Senator Michelle Benson (R-Ham Lake) introduced the delete everything amendment to SF 2360 that is 121 pages and reduces health and human service General Fund spending by $74.8 million over the biennium.

This bill includes:

  • Increased Medical Assistance coverage for postpartum care to six months.
  • More grant funding for local public health agencies (up by $15 million each year). Some of that increase is paid for by reducing the appropriation to the Statewide Health Improvement Program (SHIP) funding by $10 million each year.
  • New requirements for health plans to act on provider credentialling decisions within 45 days of receiving a clean credentialling application (similar language is also in the House bill).
  • Language requiring clinics and hospitals to post the price they are willing to accept as payment in full as a percent of the Medicare payment for procedures. This proposal has many challenges—not all procedures are covered by Medicare and providing this information may be confusing to patients, as it does not help them understand their out-of-pocket costs.

While the Senate bill does not include the telehealth language, Senator Benson said the Senate plans to pass that bill as a stand-alone bill and that it may be added later.

Next Steps

Both bills passed on party-line votes and will be heard on their respective floors within the next two weeks.

Once both bills pass their respective floors, the differences between the two bills will need to be reconciled in a conference committee comprised of five House members and five Senate members. Before they can meet there will need to be an agreement between House and Senate leadership and Governor Walz on what the total appropriations will be for each area of the budget.

They must finish their work before May 17, 2021, if they hope to avoid a Special Session.

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