Minnesota 2025-2026 Regular Session

Minnesota House Bill HF3139 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1.1 A bill for an act
2	2	1.2 relating to health; establishing a MinnesotaCare Plan; requiring the commissioner
3	3	1.3 of commerce to seek a section 1332 waiver; requiring the commissioner of human
4	4	1.4 services to request to suspend the MinnesotaCare program; amending Minnesota
5	5	1.5 Statutes 2024, sections 62V.02, by adding a subdivision; 62V.03, subdivisions 1,
6	6	1.6 3; 62V.05, subdivisions 3, 6, by adding a subdivision; 62V.051; 62V.13, subdivision
7	7	1.7 3; proposing coding for new law in Minnesota Statutes, chapter 62A.
8	8	1.8BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
9	9	1.9 Section 1. [62A.652] DEFINITIONS.
10	10	1.10 Subdivision 1.Applicability.For purposes of sections 62A.652 to 62A.656, the terms
11	11	1.11defined in this section have the meanings given.
12	12	1.12 Subd. 2.Commissioner."Commissioner" means the commissioner of commerce.
13	13	1.13 Subd. 3.Health carrier."Health carrier" has the meaning given in section 62A.011,
14	14	1.14subdivision 2.
15	15	1.15 Subd. 4.Income."Income" has the meaning given for modified adjusted gross income,
16	16	1.16as defined in Code of Federal Regulations, title 26, section 1.36B-1, and means a household's
17	17	1.17projected annual income for the applicable tax year.
18	18	1.18 Subd. 5.Individual health plan."Individual health plan" has the meaning given in
19	19	1.19section 62A.011, subdivision 4.
20	20	1.20 Subd. 6.MNsure."MNsure" has the meaning given in section 62V.02, subdivision 8.
21	21	1.21 Subd. 7.Qualified health plan."Qualified health plan" means a health plan that meets
22	22	1.22the definition in section 1301(a) of the Affordable Care Act, Public Law 111-148, and has
23	23	1Section 1.
24	24	REVISOR RSI/ES 25-0395503/26/25
25	25	State of Minnesota
26	26	This Document can be made available
27	27	in alternative formats upon request
28	28	HOUSE OF REPRESENTATIVES
29	29	H. F. No. 3139
30	30	NINETY-FOURTH SESSION
31	31	Authored by Nadeau04/07/2025
32	32	The bill was read for the first time and referred to the Committee on Commerce Finance and Policy 2.1been certified by the MNsure board in accordance with section 62V.05, subdivision 5, to
33	33	2.2be offered through MNsure.
34	34	2.3 Sec. 2. [62A.653] MINNESOTACARE PLAN.
35	35	2.4 Subdivision 1.Establishment.The commissioner, in consultation with the commissioners
36	36	2.5of health and human services, must establish the standards for a MinnesotaCare Plan in
37	37	2.6accordance with sections 62A.652 to 62A.656 and in a manner that allows a MinnesotaCare
38	38	2.7Plan to be certified as a qualified health plan.
39	39	2.8 Subd. 2.Issuance of policies required.(a) A health carrier must offer a MinnesotaCare
40	40	2.9Plan in every county in which the health carrier offers a qualified health plan in the individual
41	41	2.10market.
42	42	2.11 (b) A MinnesotaCare Plan must be:
43	43	2.12 (1) clearly labeled as a MinnesotaCare Plan;
44	44	2.13 (2) marketed by a health carrier in the same manner as other qualified health plans offered
45	45	2.14by the carrier; and
46	46	2.15 (3) offered for purchase to any eligible individual under section 62A.655 who resides
47	47	2.16in the applicable county.
48	48	2.17 Sec. 3. [62A.654] MINNESOTACARE PLAN STANDARDS.
49	49	2.18 Subdivision 1.Covered benefits.At a minimum, a MinnesotaCare Plan must include
50	50	2.19all health services reimbursed under section 256L.03.
51	51	2.20 Subd. 2.Cost-sharing.(a) A health carrier or county-based purchasing plan offering a
52	52	2.21MinnesotaCare Plan must adjust co-payments, coinsurance, and deductibles for covered
53	53	2.22services in a manner that maintains an actuarial value of 94 percent.
54	54	2.23 (b) Co-payments, cost-sharing, coinsurance, and deductibles under a MinnesotaCare
55	55	2.24Plan do not apply to:
56	56	2.25 (1) children under the age of 21; and
57	57	2.26 (2) American Indians, as defined in Code of Federal Regulations, title 42, section 600.5.
58	58	2.27 Subd. 3.Premiums.(a) Except as provided in paragraphs (c) to (e), a MinnesotaCare
59	59	2.28Plan enrollee with a household income that is less than or equal to 200 percent of the federal
60	60	2.29poverty guidelines must pay monthly premiums according to the following scale:
61	61	2Sec. 3.
62	62	REVISOR RSI/ES 25-0395503/26/25 Individual Premium
63	63	Amount
64	64	Less than3.1 Federal Poverty Guideline
65	65	3.2 Greater than or Equal to
66	66	$455%3.3 35%
67	67	$680%3.4 55%
68	68	$890%3.5 80%
69	69	$10100%3.6 90%
70	70	$12110%3.7 100%
71	71	$14120%3.8 110%
72	72	$15130%3.9 120%
73	73	$16140%3.10 130%
74	74	$25150%3.11 140%
75	75	$37160%3.12 150%
76	76	$44170%3.13 160%
77	77	$52180%3.14 170%
78	78	$61190%3.15 180%
79	79	$71200%3.16 190%
80	80	$803.17 200%
81	81	3.18 (b) Except as provided in paragraphs (c) to (e), a MinnesotaCare Plan enrollee with a
82	82	3.19household income that is greater than 200 percent of the federal poverty guidelines and less
83	83	3.20than or equal to 250 percent of the federal poverty guidelines must pay monthly premiums
84	84	3.21in the same manner as the enrollee would under United States Code, title 26, section
85	85	3.2236B(b)(3)(A)(i) and (ii).
86	86	3.23 (c) The following individuals are not required to pay premiums under a MinnesotaCare
87	87	3.24Plan:
88	88	3.25 (1) children under the age of 21; and
89	89	3.26 (2) an individual with a household income that is below 35 percent of the federal poverty
90	90	3.27guidelines.
91	91	3.28 (d) The commissioner must pay premiums for a member of the military and members
92	92	3.29of the military member's family who meet the eligibility criteria for a MinnesotaCare Plan
93	93	3.30upon eligibility approval made within 24 months following the end of the member's tour
94	94	3.31of active duty. The effective date of coverage for an individual or family who meets the
95	95	3.32criteria under this paragraph is the first day of the month following the month in which
96	96	3.33eligibility is approved. The exemption under this paragraph applies for 12 months.
97	97	3.34 (e) The commissioner must waive premiums for an American Indian and members of
98	98	3.35the American Indian's family who enroll in a MinnesotaCare Plan in accordance with section
99	99	3Sec. 3.
100	100	REVISOR RSI/ES 25-0395503/26/25 4.15006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5. An
101	101	4.2individual must indicate status as an American Indian, as defined under Code of Federal
102	102	4.3Regulations, title 42, section 447.50, to qualify for a premium waiver. The commissioner
103	103	4.4must accept attestation of an individual's status as an American Indian as verification until
104	104	4.5the United States Department of Health and Human Services approves an electronic data
105	105	4.6source to verify individual status.
106	106	4.7 Subd. 4.Application process and eligibility determination.An individual must apply
107	107	4.8for coverage in a MinnesotaCare Plan through MNsure. The Board of Directors of MNsure
108	108	4.9must process MinnesotaCare Plan applications and determine eligibility as provided under
109	109	4.10section 62V.05, subdivision 5a.
110	110	4.11 Sec. 4. [62A.655] ELIGIBILITY FOR A MINNESOTACARE PLAN.
111	111	4.12 Subdivision 1.General requirements.An individual must meet the requirements of
112	112	4.13this section to enroll in a MinnesotaCare Plan.
113	113	4.14 Subd. 2.Minnesota residency.To be eligible, an individual must meet the residency
114	114	4.15requirements in section 256L.09.
115	115	4.16 Subd. 3.Not eligible for other minimum essential coverage.(a) To be eligible, an
116	116	4.17individual must not have access to the following health insurance coverage:
117	117	4.18 (1) employer-sponsored coverage that is "affordable" and provides "minimum value,"
118	118	4.19as defined in Code of Federal Regulations, title 26, section 1.36B-2; or
119	119	4.20 (2) any other minimum essential coverage, as defined in section 5000A of the Internal
120	120	4.21Revenue Code.
121	121	4.22 (b) For purposes of this subdivision, an applicant or enrollee who is entitled to Medicare
122	122	4.23Part A or enrolled in Medicare Part B coverage under title XVII of the Social Security Act,
123	123	4.24United States Code, title 42, sections 1395c to 1395w-152, has access to minimum essential
124	124	4.25coverage. An applicant or enrollee who is entitled to premium-free Medicare Part A is
125	125	4.26prohibited from refusing to apply for or enroll in Medicare coverage to establish eligibility
126	126	4.27for a MinnesotaCare Plan.
127	127	4.28 (c) Notwithstanding paragraph (a), an eligible individual includes an individual who is
128	128	4.29ineligible for medical assistance, other than emergency medical assistance under section
129	129	4.30256B.06, subdivision 4, due to immigration status.
130	130	4Sec. 4.
131	131	REVISOR RSI/ES 25-0395503/26/25 5.1 Subd. 4.Citizenship requirements.To be eligible, an individual must be a citizen or
132	132	5.2national of the United States or a lawfully present noncitizen, as defined in Code of Federal
133	133	5.3Regulations, title 45, section 155.20.
134	134	5.4 Sec. 5. [62A.656] PAYMENTS TO HEALTH CARRIERS AND COUNTY-BASED
135	135	5.5PURCHASING PLANS.
136	136	5.6 Subdivision 1.Definitions.(a) For purposes of this section, the terms defined in this
137	137	5.7subdivision have the meanings given.
138	138	5.8 (b) "Eligible enrollee" means an individual who (1) is enrolled in a MinnesotaCare Plan,
139	139	5.9(2) has a household income that is less than or equal to 250 percent of the federal poverty
140	140	5.10guidelines, and (3) is required to pay a monthly premium under section 62A.654, subdivision
141	141	5.113, paragraph (a) or (b).
142	142	5.12 (c) "Premium-exempt enrollee" means an individual who is enrolled in a MinnesotaCare
143	143	5.13Plan and is not required to pay a monthly premium.
144	144	5.14 (d) "Gross premium" means the amount billed to an eligible enrollee or premium-exempt
145	145	5.15enrollee if the enrollee's premium was not capped, exempted, or waived under section
146	146	5.1662A.654, subdivision 3.
147	147	5.17 Subd. 2.Payments.(a) The commissioner must make payments to health carriers and
148	148	5.18county-based purchasing plans on behalf of:
149	149	5.19 (1) an eligible enrollee for the months in a calendar year for which the enrollee paid the
150	150	5.20required premium amount under section 62A.654, subdivision 3, paragraph (a) or (b), as
151	151	5.21applicable; and
152	152	5.22 (2) a premium-exempt enrollee for the months in a calendar year in which the enrollee
153	153	5.23received coverage under a MinnesotaCare Plan.
154	154	5.24 (b) A payment under this subdivision on behalf of an eligible enrollee must be equal to
155	155	5.25the enrollee's monthly gross premium, less the enrollee's monthly premium payment. A
156	156	5.26payment under this subdivision on behalf of a premium-exempt enrollee must be equal to
157	157	5.27the enrollee's monthly gross premium. A payment made under this subdivision:
158	158	5.28 (1) is to promote the general welfare and is not compensation for any services; and
159	159	5.29 (2) must be excluded from any calculation used to determine eligibility for programs
160	160	5.30administered by the Department of Human Services or the Department of Children, Youth,
161	161	5.31and Families.
162	162	5Sec. 5.
163	163	REVISOR RSI/ES 25-0395503/26/25 6.1 (c) To be eligible to receive a payment under this section, a health carrier and
164	164	6.2county-based purchasing plan must submit to the commissioner an invoice and other
165	165	6.3information required by the commissioner in the form and manner specified by the
166	166	6.4commissioner.
167	167	6.5 (d) The commissioner must consider health carriers and county-based purchasing plans
168	168	6.6as vendors under section 16A.124, subdivision 3. Each invoice submitted under this section
169	169	6.7represents the completed delivery of the service.
170	170	6.8 Subd. 3.Data practices.(a) The definitions in section 13.02 apply to this subdivision.
171	171	6.9 (b) Government data on an enrollee, health carrier, or county-based purchasing plan
172	172	6.10under this section are private data on individuals or nonpublic data, except that the total
173	173	6.11reimbursement requested by a health carrier and county-based purchasing plan and the total
174	174	6.12state payment to the health carrier and county-based purchasing plan are public data.
175	175	6.13 Sec. 6. Minnesota Statutes 2024, section 62V.02, is amended by adding a subdivision to
176	176	6.14read:
177	177	6.15 Subd. 7a.MinnesotaCare Plan."MinnesotaCare Plan" means a health plan offered in
178	178	6.16the individual market by a health carrier or county-based purchasing plan that meets the
179	179	6.17standards established by the commissioner of commerce under sections 62A.652 to 62A.656.
180	180	6.18 Sec. 7. Minnesota Statutes 2024, section 62V.03, subdivision 1, is amended to read:
181	181	6.19 Subdivision 1.Creation.MNsure is created as a board under section 15.012, paragraph
182	182	6.20(a), to:
183	183	6.21 (1) promote informed consumer choice, innovation, competition, quality, value, market
184	184	6.22participation, affordability, suitable and meaningful choices, health improvement, care
185	185	6.23management, reduction of health disparities, and portability of health plans;
186	186	6.24 (2) facilitate and simplify the comparison, choice, enrollment, and purchase of health
187	187	6.25plans for individuals purchasing in the individual market through MNsure and for employees
188	188	6.26and employers purchasing in the small group market through MNsure;
189	189	6.27 (3) assist small employers with access to small business health insurance tax credits and
190	190	6.28to assist individuals with access to public health care programs, premium assistance tax
191	191	6.29credits and cost-sharing reductions, and certificates of exemption from individual
192	192	6.30responsibility requirements;
193	193	6Sec. 7.
194	194	REVISOR RSI/ES 25-0395503/26/25 7.1 (4) facilitate the integration and transition of individuals between public health care
195	195	7.2programs, MinnesotaCare Plans, and other health plans in the individual or group market
196	196	7.3and develop processes that, to the maximum extent possible, provide for continuous coverage;
197	197	7.4and
198	198	7.5 (5) establish and modify as necessary a name and brand for MNsure based on market
199	199	7.6studies that show maximum effectiveness in attracting the uninsured and motivating them
200	200	7.7to take action.
201	201	7.8 Sec. 8. Minnesota Statutes 2024, section 62V.03, subdivision 3, is amended to read:
202	202	7.9 Subd. 3.Continued operation of a private marketplace.(a) Nothing in this chapter
203	203	7.10shall be construed to prohibit: (1) a health carrier from offering outside of MNsure a health
204	204	7.11plan to a qualified individual or qualified employer; and (2) a qualified individual from
205	205	7.12enrolling in, or a qualified employer from selecting for its employees, a health plan offered
206	206	7.13outside of MNsure.
207	207	7.14 (b) Nothing in this chapter shall be construed to restrict the choice of a qualified individual
208	208	7.15to enroll or not enroll in a qualified health plan or a MinnesotaCare Plan, or to participate
209	209	7.16in MNsure. Nothing in this chapter shall be construed to compel an individual to enroll in
210	210	7.17a qualified health plan or a MinnesotaCare Plan, or to participate in MNsure.
211	211	7.18 (c) For purposes of this subdivision, "qualified individual" and "qualified employer"
212	212	7.19have the meanings given in section 1312 of the Affordable Care Act, Public Law 111-148,
213	213	7.20and further defined through amendments to the act and regulations issued under the act.
214	214	7.21 Sec. 9. Minnesota Statutes 2024, section 62V.05, subdivision 3, is amended to read:
215	215	7.22 Subd. 3.Insurance producers.(a) By April 30, 2013, The board, in consultation with
216	216	7.23the commissioner of commerce, shall establish certification requirements that must be met
217	217	7.24by insurance producers in order to assist individuals and small employers with purchasing
218	218	7.25coverage through MNsure. Prior to January 1, 2015, the board may amend the requirements,
219	219	7.26only if necessary, due to a change in federal rules.
220	220	7.27 (b) Certification requirements shall not exceed the requirements established under Code
221	221	7.28of Federal Regulations, title 45, part 155.220. Certification shall include training on health
222	222	7.29plans available through MNsure, available tax credits and cost-sharing arrangements,
223	223	7.30compliance with privacy and security standards, eligibility verification processes, online
224	224	7.31enrollment tools, and basic information on available public health care programs. Training
225	225	7.32required for certification under this subdivision shall qualify for continuing education
226	226	7Sec. 9.
227	227	REVISOR RSI/ES 25-0395503/26/25 8.1requirements for insurance producers required under chapter 60K, and must comply with
228	228	8.2course approval requirements under chapter 45.
229	229	8.3 (c) Producer compensation shall be established by health carriers that provide health
230	230	8.4plans through MNsure. The structure of compensation to insurance producers must be similar
231	231	8.5for health plans sold through MNsure and outside MNsure.
232	232	8.6 (d) Any insurance producer compensation structure established by a health carrier for
233	233	8.7the small group market must include compensation for defined contribution plans that
234	234	8.8involve multiple health carriers. The compensation offered must be commensurate with
235	235	8.9other small group market defined health plans.
236	236	8.10 (e) Any insurance producer assisting an individual or small employer with purchasing
237	237	8.11coverage through MNsure must disclose, orally and in writing, to the individual or small
238	238	8.12employer at the time of the first solicitation with the prospective purchaser the following:
239	239	8.13 (1) the health carriers and, qualified health plans, and MinnesotaCare Plans offered
240	240	8.14through MNsure that the producer is authorized to sell, and that the producer may not be
241	241	8.15authorized to sell all the qualified health plans or MinnesotaCare Plans offered through
242	242	8.16MNsure;
243	243	8.17 (2) that the producer may be receiving compensation from a health carrier for enrolling
244	244	8.18the individual or small employer into a particular health plan; and
245	245	8.19 (3) that information on all qualified health plans and MinnesotaCare Plans offered
246	246	8.20through MNsure is available through the MNsure website.
247	247	8.21For purposes of this paragraph, "solicitation" means any contact by a producer, or any person
248	248	8.22acting on behalf of a producer made for the purpose of selling or attempting to sell coverage
249	249	8.23through MNsure. If the first solicitation is made by telephone, the disclosures required under
250	250	8.24this paragraph need not be made in writing, but the fact that disclosure has been made must
251	251	8.25be acknowledged on the application.
252	252	8.26 (f) Beginning January 15, 2015, each health carrier that offers or sells qualified health
253	253	8.27plans or MinnesotaCare Plans through MNsure shall report in writing to the board and the
254	254	8.28commissioner of commerce the compensation and other incentives it offers or provides to
255	255	8.29insurance producers with regard to each type of health plan the health carrier offers or sells
256	256	8.30both inside and outside of MNsure. Each health carrier shall submit a report annually and
257	257	8.31upon any change to the compensation or other incentives offered or provided to insurance
258	258	8.32producers.
259	259	8Sec. 9.
260	260	REVISOR RSI/ES 25-0395503/26/25 9.1 (g) Nothing in this chapter shall prohibit an insurance producer from offering professional
261	261	9.2advice and recommendations to a small group purchaser based upon information provided
262	262	9.3to the producer.
263	263	9.4 (h) An insurance producer that offers health plans in the small group market shall notify
264	264	9.5each small group purchaser of which group health plans qualify for Internal Revenue Service
265	265	9.6approved section 125 tax benefits. The insurance producer shall also notify small group
266	266	9.7purchasers of state law provisions that benefit small group plans when the employer agrees
267	267	9.8to pay 50 percent or more of its employees' premium. Individuals who are eligible for
268	268	9.9cost-effective medical assistance will count toward the 75 percent participation requirement
269	269	9.10in section 62L.03, subdivision 3.
270	270	9.11 (i) Nothing in this subdivision shall be construed to limit the licensure requirements or
271	271	9.12regulatory functions of the commissioner of commerce under chapter 60K.
272	272	9.13 Sec. 10. Minnesota Statutes 2024, section 62V.05, is amended by adding a subdivision to
273	273	9.14read:
274	274	9.15 Subd. 5a.Administration of MinnesotaCare Plans.(a) An individual must be able to
275	275	9.16apply for and, if eligible, enroll in a MinnesotaCare Plan by completing the application for
276	276	9.17a qualified health plan with premium tax credits or cost-sharing reductions.
277	277	9.18 (b) MNsure must ensure that individuals interested in applying for a qualified health
278	278	9.19plan or a MinnesotaCare Plan are able to compare coverage options in a simple, convenient,
279	279	9.20and understandable manner on the MNsure website.
280	280	9.21 (c) MNsure must process MinnesotaCare Plan applications and make eligibility
281	281	9.22determinations for MinnesotaCare Plans in accordance with section 62A.655.
282	282	9.23 (d) MNsure must identify MinnesotaCare Plan enrollees who are premium-exempt or
283	283	9.24subject to the premium caps under section 62A.654, subdivision 3, and provide the
284	284	9.25information to the health carrier offering the MinnesotaCare Plan in which the individual
285	285	9.26enrolls. MNsure must identify MinnesotaCare enrollees who may be eligible for premium
286	286	9.27tax credits or cost-sharing reductions and assist the enrollees with accessing the subsidies.
287	287	9.28 (e) MNsure may utilize existing resources, personnel, and operations to carry out the
288	288	9.29duties under this subdivision.
289	289	9.30 Sec. 11. Minnesota Statutes 2024, section 62V.05, subdivision 6, is amended to read:
290	290	9.31 Subd. 6.Appeals.(a) The board may conduct hearings, appoint hearing officers, and
291	291	9.32recommend final orders related to appeals of any MNsure determinations, except for those
292	292	9Sec. 11.
293	293	REVISOR RSI/ES 25-0395503/26/25 10.1determinations identified in paragraph (d). An appeal by a health carrier regarding a specific
294	294	10.2certification or selection determination made by MNsure under subdivision 5 must be
295	295	10.3conducted as a contested case proceeding under chapter 14, with the report or order of the
296	296	10.4administrative law judge constituting the final decision in the case, subject to judicial review
297	297	10.5under sections 14.63 to 14.69. For other appeals, the board shall establish hearing processes
298	298	10.6which provide for a reasonable opportunity to be heard and timely resolution of the appeal
299	299	10.7and which are consistent with the requirements of federal law and guidance. An appealing
300	300	10.8party may be represented by legal counsel at these hearings, but this is not a requirement.
301	301	10.9 (b) MNsure may establish service-level agreements with state agencies to conduct
302	302	10.10hearings for appeals. Notwithstanding section 471.59, subdivision 1, a state agency is
303	303	10.11authorized to enter into service-level agreements for this purpose with MNsure.
304	304	10.12 (c) For proceedings under this subdivision, MNsure may be represented by an attorney
305	305	10.13who is an employee of MNsure.
306	306	10.14 (d) This subdivision does not apply to appeals of determinations where a state agency
307	307	10.15hearing is available under section 256.045.
308	308	10.16 (e) An appellant aggrieved by an order of MNsure issued in an eligibility appeal, as
309	309	10.17defined in Minnesota Rules, part 7700.0101, may appeal the order to the district court of
310	310	10.18the appellant's county of residence by serving a written copy of a notice of appeal upon
311	311	10.19MNsure and any other adverse party of record within 30 days after the date MNsure issued
312	312	10.20the order, the amended order, or order affirming the original order, and by filing the original
313	313	10.21notice and proof of service with the court administrator of the district court. Service may
314	314	10.22be made personally or by mail; service by mail is complete upon mailing; no filing fee shall
315	315	10.23be required by the court administrator in appeals taken pursuant to this subdivision. MNsure
316	316	10.24shall furnish all parties to the proceedings with a copy of the decision and a transcript of
317	317	10.25any testimony, evidence, or other supporting papers from the hearing held before the appeals
318	318	10.26examiner within 45 days after service of the notice of appeal.
319	319	10.27 (f) Any party aggrieved by the failure of an adverse party to obey an order issued by
320	320	10.28MNsure may compel performance according to the order in the manner prescribed in sections
321	321	10.29586.01 to 586.12.
322	322	10.30 (g) Any party may obtain a hearing at a special term of the district court by serving a
323	323	10.31written notice of the time and place of the hearing at least ten days prior to the date of the
324	324	10.32hearing. The court may consider the matter in or out of chambers, and shall take no new or
325	325	10.33additional evidence unless it determines that such evidence is necessary for a more equitable
326	326	10.34disposition of the appeal.
327	327	10Sec. 11.
328	328	REVISOR RSI/ES 25-0395503/26/25 11.1 (h) Any party aggrieved by the order of the district court may appeal the order as in
329	329	11.2other civil cases. No costs or disbursements shall be taxed against any party nor shall any
330	330	11.3filing fee or bond be required of any party.
331	331	11.4 (i) If MNsure or a district court orders eligibility for qualified health plan coverage or
332	332	11.5MinnesotaCare Plan coverage through MNsure, or eligibility for federal advance payment
333	333	11.6of premium tax credits or cost-sharing reductions contingent upon full payment of respective
334	334	11.7premiums, the premiums must be paid or provided pending appeal to the district court, court
335	335	11.8of appeals, or supreme court. Provision of eligibility by MNsure pending appeal does not
336	336	11.9render moot MNsure's position in a court of law.
337	337	11.10Sec. 12. Minnesota Statutes 2024, section 62V.051, is amended to read:
338	338	11.11 62V.051 MNSURE; CONSUMER RETROACTIVE APPOINTMENT OF A
339	339	11.12NAVIGATOR OR PRODUCER PERMITTED.
340	340	11.13 Notwithstanding any other law or rule to the contrary, for up to six months after the
341	341	11.14effective date of the qualified health plan or MinnesotaCare Plan, MNsure must permit a
342	342	11.15qualified health plan or MinnesotaCare Plan policyholder, who has not designated a navigator
343	343	11.16or an insurance producer, to retroactively appoint a navigator or insurance producer. MNsure
344	344	11.17must provide notice of the retroactive appointment to the health carrier. The health carrier
345	345	11.18must retroactively pay commissions to the insurance producer if the producer can demonstrate
346	346	11.19that they were certified by MNsure at the time of the original enrollment, were appointed
347	347	11.20by the selected health carrier at the time of the enrollment, and that an agent of record
348	348	11.21agreement was executed prior to or at the time of the effective date of the policy. MNsure
349	349	11.22must adopt a standard form of agent of record agreement for purposes of this section.
350	350	11.23Sec. 13. Minnesota Statutes 2024, section 62V.13, subdivision 3, is amended to read:
351	351	11.24 Subd. 3.Outreach letter and special enrollment period.(a) MNsure must provide a
352	352	11.25written letter of the projected assessment under subdivision 2 to a taxpayer who indicates
353	353	11.26to the commissioner of revenue that the taxpayer is interested in obtaining information on
354	354	11.27access to health insurance.
355	355	11.28 (b) MNsure must allow a special enrollment period for taxpayers who receive the outreach
356	356	11.29letter in paragraph (a) and are determined eligible to enroll in a qualified health plan or
357	357	11.30MinnesotaCare Plan through MNsure. The triggering event for the special enrollment period
358	358	11.31is the day the outreach letter under this subdivision is mailed to the taxpayer. An eligible
359	359	11.32individual, and their dependents, have 65 days from the triggering event to select a qualifying
360	360	11Sec. 13.
361	361	REVISOR RSI/ES 25-0395503/26/25 12.1health plan or MinnesotaCare Plan, and coverage for the qualifying health plan or
362	362	12.2MinnesotaCare Plan is effective the first day of the month after plan selection.
363	363	12.3 (c) Taxpayers who have a member of the taxpayer's household currently enrolled in a
364	364	12.4qualified health plan or MinnesotaCare Plan through MNsure are not eligible for the special
365	365	12.5enrollment under paragraph (b).
366	366	12.6 (d) MNsure must provide information to the general public about the easy enrollment
367	367	12.7health insurance outreach program and the special enrollment period described in this
368	368	12.8subdivision.
369	369	12.9 Sec. 14. DIRECTION TO THE COMMISSIONER; ESTABLISHING A
370	370	12.10MINNESOTACARE PLAN.
371	371	12.11 Subdivision 1.Request for federal section 1332 waiver.(a) The commissioner of
372	372	12.12commerce, in cooperation with the commissioner of human services and the Board of
373	373	12.13Directors of MNsure, must submit a section 1332 waiver pursuant to United States Code,
374	374	12.14title 42, section 18052, to the United States Secretary of Health and Human Services for
375	375	12.15federal approval to implement this act consistent with this section.
376	376	12.16 (b) The 1332 waiver must request that the state receive 100 percent of the value of
377	377	12.17premium tax credits and cost-sharing reductions that MinnesotaCare Plan enrollees with
378	378	12.18household incomes less than or equal to 250 percent of the federal poverty guidelines would
379	379	12.19receive if the MinnesotaCare Plan enrollees enrolled in a qualified health plan through
380	380	12.20MNsure, rather than the 95 percent of the value of premium tax credits and cost-sharing
381	381	12.21reductions the state receives for enrollees in a basic health program. The waiver must require
382	382	12.22that additional federal funding must be dedicated to supporting lower costs for MinnesotaCare
383	383	12.23Plan enrollees.
384	384	12.24 Subd. 2.Request to suspend basic health program.(a) Given the administrative burden
385	385	12.25on both the federal government and the state to conduct a basic health program blueprint,
386	386	12.26the commissioner of human services, in coordination with the commissioner of commerce
387	387	12.27and the Board of Directors of MNsure, must submit an application to suspend the state's
388	388	12.28basic health program, MinnesotaCare, pursuant to Code of Federal Regulations, title 42,
389	389	12.29section 600.140, to the United States Secretary of Health and Human Services.
390	390	12.30 (b) The application must request to suspend the basic health program prior to
391	391	12.31implementation of the 1332 waiver requested under this section and for the duration of the
392	392	12.32waiver, and to maintain the state's current basic health program trust fund for allowable
393	393	12.33uses.
394	394	12Sec. 14.
395	395	REVISOR RSI/ES 25-0395503/26/25 13.1 Subd. 3.Current MinnesotaCare enrollees.(a) The 1332 waiver requested under this
396	396	13.2section must not impact the experience of current MinnesotaCare enrollees. Upon federal
397	397	13.3approval of the 1332 waiver, current MinnesotaCare enrollees who are eligible to enroll in
398	398	13.4a MinnesotaCare Plan must be automatically enrolled in a MinnesotaCare Plan offered by
399	399	13.5the enrollee's current health carrier or county-based purchasing plan, unless the enrollee
400	400	13.6selects a different plan. When an enrollee transitions from MinnesotaCare to a MinnesotaCare
401	401	13.7Plan, the eligibility and enrollment processes must not change and the premiums, cost-sharing
402	402	13.8requirements, and covered benefits must remain the same for current MinnesotaCare
403	403	13.9enrollees.
404	404	13.10 (b) Pursuant to Minnesota Statutes, chapter 256L, suspension of the state's basic health
405	405	13.11program does not prohibit the commissioner of human services from continuing to administer
406	406	13.12MinnesotaCare for individuals who meet the eligibility requirements for MinnesotaCare
407	407	13.13but do not qualify to enroll in a MinnesotaCare Plan established under a 1332 waiver
408	408	13.14requested under this section.
409	409	13Sec. 14.
410	410	REVISOR RSI/ES 25-0395503/26/25