Minnesota Academy of Family Physicians (MAFP) legislative rep Dave Renner, CAE, shares the latest health-care-related updates from the Minnesota Legislature, including:
- highlights from last week’s hearing on the House Health and Human Services omnibus bill
- the extension of the state’s reinsurance program
- movement to pass opioid legislation
- support for addressing health care worker mental health and well-being
Huntley Testified on Omnibus Bill
The Minnesota House Health Finance and Policy Committee took testimony on their health and human services omnibus budget bill on April 7, 2022.
MAFP CEO Maria Huntley, CAE, MAM, testified on behalf of the MAFP, stressing strong support for modifications to the All-Payer Claims Database (APCD) to authorize the collection of non-claims-based payment information from insurers and new funding for primary care rural residency grants to expand training in rural areas for future physicians. Watch Huntley’s testimony (begins 46 minutes and 50 seconds into the hearing).
The 456-page bill (HF4706; author: Representative Tina Liebling, DFL-Rochester) includes many provisions related to Minnesota’s health care programs. Key issues that the MAFP is watching:
- Authorization for the APCD to collect non-claims-based payment information to help gain a better understanding of how health care is being paid for in Minnesota.
- Grants for new primary care rural residency training sites.
- Expansion of eligibility for MinnesotaCare, allowing more Minnesotans to purchase coverage through a buy-in option.
- Limits to the abilities of insurers and pharmacy benefit managers from forcing patients to change medications in the middle of their enrollment year (because the insurer alters its drug formularies).
- Language directing the Commissioner of Health to study and develop a recommendation for a statewide registry for patients who have a Provider Order for Life-Sustaining Treatment (POLST) form.
- Coverage of tobacco cessation services in the state’s public programs.
- Expansion of student loan forgiveness funding for physicians and other health care workers.
The bill was referred to the Ways and Means Committee, where it will be combined with the human services bill before going to the floor. The bill will be significantly different from the Senate version; as a result, it will need to go through a conference committee that will work out differences prior to final passage.
Legislators Extend State Reinsurance Program
Legislation to extend Minnesota’s reinsurance program passed the Minnesota House and Senate on March 31, 2022.
The reinsurance program is designed to reduce the volatility of premiums for those purchasing coverage in the individual market. Under Minnesota’s program, the cost of high-cost claims is not borne exclusively by insurers. Rather, the state’s reinsurance fund covers 80 percent of an individual’s annual claims costs between $50,000 and $250,000.
The Senate bill (SF 3472; author: Senator Gary Dahms, R-Redwood Falls) proposed reauthorizing the program for five years, while the House bill (HF 3717; author: Representative Zack Stevenson, DFL-Coon Rapids) proposed a one-year extension and new insurance requirements. A 10-member conference committee agreed to a three-year extension.
Notably, the final bill includes two important coverage expansions:
- Requires insurers to offer an insurance product that allows enrollees to spread out high-deductible payments into smaller monthly installments over the entire year.
- Requires health plans to provide coverage for comprehensive postnatal care.
Legislators Move to Pass Opioid Legislation
Following a $26 billion national legal settlement last year, Minnesota lawmakers are reshaping previously passed legislation to help ensure Minnesotans receive maximum support for persons struggling with opioid addiction.
In July 2021, drug manufacturer Johnson & Johnson and drug wholesalers McKesson, AmerisourceBergen and Cardinal Health agreed to a legal settlement, following several lawsuits connected to claims, that their business actions contributed to the nationwide opioid epidemic.
SF 4025 (author: Senator Julie Rosen, R-Vernon Center) and HF 4265 (author: Representative Liz Olson, DFL-Duluth) would reshape Minnesota’s law to maximize settlement funds and ensure the money gets sent to Minnesota’s cities, counties and tribal governments, along with some set aside for the state’s Opioid Epidemic Response Advisory Council. Minnesota is set to receive about $300 million from the national settlement. If passed, advocates say the state could begin receiving funds as early as April 2022.
The bill amends the structure of legislation passed in 2019:
- 75% of the settlement funds goes to local governments.
- 25% goes to the state, specifically the Opioid Epidemic Response Advisory Council.
Senate Discussed Health Care Worker Mental Health
A bill appropriating funding for mental health programs, mostly through social service grants, was heard in the Minnesota Senate Health and Human Services Committee last week.
The bill (SF3249; author: Senator Rich Draheim, R-Madison Lake) primarily funds school-linked mental health and shelter-linked youth mental health grants. Minnesota entities providing social services would be the primary recipients. The bill also contains sustained funding for mental health provider loan forgiveness. In total, the bill allocates $22 million in 2022 and 2023 and $53.5 million in 2024 and 2025.
Senator Matt Klein, MD (DFL-Mendota Heights), offered an amendment to allocate $1 million from the state’s general fund to develop and implement an education and awareness initiative to address health care professional mental health and well-being. Klein noted that doctors are experiencing not only burnout, early retirement and workforce shortages, but increased violence, hostility and rates of suicide.
The amendment was withdrawn after the committee chair indicated that he would not support its inclusion in the bill. Instead, Senator Michelle Benson (R-Ham Lake) indicated that she has been working with Senator Erin Murphy (DFL-St. Paul) on SF3837, a bill to help retain medical staff, who have undergone increased stress, through peer-to-peer mental health support. She indicated her willingness to work with Klein to include his amendment in that legislation.
Timing of the Remaining 2022 Legislative Session
The Minnesota State Legislature is taking a one-week Easter/Passover break (beginning April 9, 2022) and will have just over five weeks left in the 2022 legislative session when they return.
The legislative deadline for committees to act on major appropriation and tax bills, which leads to what are called omnibus bulls (single large bills containing similar legislative initiatives), was April 8, 2022.
Once both bodies pass their budget bills, they will go to conference committees made up of an equal number of members from both chambers to work out differences between the bills. If the conference committees can reach final agreement on the various omnibus bills, they will go back for re-passage by both bodies before being sent to Governor Tim Walz for his signature.
Leaders of the Minnesota House and Senate, along with the governor, need to agree on provisions before the legislature adjourns on May 23, 2022.