1.1 A bill for an act
1.2 relating to health; establishing a MinnesotaCare Plan; requiring the commissioner
1.3 of commerce to seek a section 1332 waiver; requiring the commissioner of human
1.4 services to request to suspend the MinnesotaCare program; amending Minnesota
1.5 Statutes 2024, sections 62V.02, by adding a subdivision; 62V.03, subdivisions 1,
1.6 3; 62V.05, subdivisions 3, 6, by adding a subdivision; 62V.051; 62V.13, subdivision
1.7 3; proposing coding for new law in Minnesota Statutes, chapter 62A.
1.8BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.9 Section 1. [62A.652] DEFINITIONS.
1.10 Subdivision 1.Applicability.For purposes of sections 62A.652 to 62A.656, the terms
1.11defined in this section have the meanings given.
1.12 Subd. 2.Commissioner."Commissioner" means the commissioner of commerce.
1.13 Subd. 3.Health carrier."Health carrier" has the meaning given in section 62A.011,
1.14subdivision 2.
1.15 Subd. 4.Income."Income" has the meaning given for modified adjusted gross income,
1.16as defined in Code of Federal Regulations, title 26, section 1.36B-1, and means a household's
1.17projected annual income for the applicable tax year.
1.18 Subd. 5.Individual health plan."Individual health plan" has the meaning given in
1.19section 62A.011, subdivision 4.
1.20 Subd. 6.MNsure."MNsure" has the meaning given in section 62V.02, subdivision 8.
1.21 Subd. 7.Qualified health plan."Qualified health plan" means a health plan that meets
1.22the definition in section 1301(a) of the Affordable Care Act, Public Law 111-148, and has
1Section 1.
REVISOR RSI/ES 25-0395503/26/25
State of Minnesota
This Document can be made available
in alternative formats upon request
HOUSE OF REPRESENTATIVES
H. F. No. 3139
NINETY-FOURTH SESSION
Authored by Nadeau04/07/2025
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
2.2be offered through MNsure.
2.3 Sec. 2. [62A.653] MINNESOTACARE PLAN.
2.4 Subdivision 1.Establishment.The commissioner, in consultation with the commissioners
2.5of health and human services, must establish the standards for a MinnesotaCare Plan in
2.6accordance with sections 62A.652 to 62A.656 and in a manner that allows a MinnesotaCare
2.7Plan to be certified as a qualified health plan.
2.8 Subd. 2.Issuance of policies required.(a) A health carrier must offer a MinnesotaCare
2.9Plan in every county in which the health carrier offers a qualified health plan in the individual
2.10market.
2.11 (b) A MinnesotaCare Plan must be:
2.12 (1) clearly labeled as a MinnesotaCare Plan;
2.13 (2) marketed by a health carrier in the same manner as other qualified health plans offered
2.14by the carrier; and
2.15 (3) offered for purchase to any eligible individual under section 62A.655 who resides
2.16in the applicable county.
2.17 Sec. 3. [62A.654] MINNESOTACARE PLAN STANDARDS.
2.18 Subdivision 1.Covered benefits.At a minimum, a MinnesotaCare Plan must include
2.19all health services reimbursed under section 256L.03.
2.20 Subd. 2.Cost-sharing.(a) A health carrier or county-based purchasing plan offering a
2.21MinnesotaCare Plan must adjust co-payments, coinsurance, and deductibles for covered
2.22services in a manner that maintains an actuarial value of 94 percent.
2.23 (b) Co-payments, cost-sharing, coinsurance, and deductibles under a MinnesotaCare
2.24Plan do not apply to:
2.25 (1) children under the age of 21; and
2.26 (2) American Indians, as defined in Code of Federal Regulations, title 42, section 600.5.
2.27 Subd. 3.Premiums.(a) Except as provided in paragraphs (c) to (e), a MinnesotaCare
2.28Plan enrollee with a household income that is less than or equal to 200 percent of the federal
2.29poverty guidelines must pay monthly premiums according to the following scale:
2Sec. 3.
REVISOR RSI/ES 25-0395503/26/25 Individual Premium
Amount
Less than3.1 Federal Poverty Guideline
3.2 Greater than or Equal to
$455%3.3 35%
$680%3.4 55%
$890%3.5 80%
$10100%3.6 90%
$12110%3.7 100%
$14120%3.8 110%
$15130%3.9 120%
$16140%3.10 130%
$25150%3.11 140%
$37160%3.12 150%
$44170%3.13 160%
$52180%3.14 170%
$61190%3.15 180%
$71200%3.16 190%
$803.17 200%
3.18 (b) Except as provided in paragraphs (c) to (e), a MinnesotaCare Plan enrollee with a
3.19household income that is greater than 200 percent of the federal poverty guidelines and less
3.20than or equal to 250 percent of the federal poverty guidelines must pay monthly premiums
3.21in the same manner as the enrollee would under United States Code, title 26, section
3.2236B(b)(3)(A)(i) and (ii).
3.23 (c) The following individuals are not required to pay premiums under a MinnesotaCare
3.24Plan:
3.25 (1) children under the age of 21; and
3.26 (2) an individual with a household income that is below 35 percent of the federal poverty
3.27guidelines.
3.28 (d) The commissioner must pay premiums for a member of the military and members
3.29of the military member's family who meet the eligibility criteria for a MinnesotaCare Plan
3.30upon eligibility approval made within 24 months following the end of the member's tour
3.31of active duty. The effective date of coverage for an individual or family who meets the
3.32criteria under this paragraph is the first day of the month following the month in which
3.33eligibility is approved. The exemption under this paragraph applies for 12 months.
3.34 (e) The commissioner must waive premiums for an American Indian and members of
3.35the American Indian's family who enroll in a MinnesotaCare Plan in accordance with section
3Sec. 3.
REVISOR RSI/ES 25-0395503/26/25 4.15006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5. An
4.2individual must indicate status as an American Indian, as defined under Code of Federal
4.3Regulations, title 42, section 447.50, to qualify for a premium waiver. The commissioner
4.4must accept attestation of an individual's status as an American Indian as verification until
4.5the United States Department of Health and Human Services approves an electronic data
4.6source to verify individual status.
4.7 Subd. 4.Application process and eligibility determination.An individual must apply
4.8for coverage in a MinnesotaCare Plan through MNsure. The Board of Directors of MNsure
4.9must process MinnesotaCare Plan applications and determine eligibility as provided under
4.10section 62V.05, subdivision 5a.
4.11 Sec. 4. [62A.655] ELIGIBILITY FOR A MINNESOTACARE PLAN.
4.12 Subdivision 1.General requirements.An individual must meet the requirements of
4.13this section to enroll in a MinnesotaCare Plan.
4.14 Subd. 2.Minnesota residency.To be eligible, an individual must meet the residency
4.15requirements in section 256L.09.
4.16 Subd. 3.Not eligible for other minimum essential coverage.(a) To be eligible, an
4.17individual must not have access to the following health insurance coverage:
4.18 (1) employer-sponsored coverage that is "affordable" and provides "minimum value,"
4.19as defined in Code of Federal Regulations, title 26, section 1.36B-2; or
4.20 (2) any other minimum essential coverage, as defined in section 5000A of the Internal
4.21Revenue Code.
4.22 (b) For purposes of this subdivision, an applicant or enrollee who is entitled to Medicare
4.23Part A or enrolled in Medicare Part B coverage under title XVII of the Social Security Act,
4.24United States Code, title 42, sections 1395c to 1395w-152, has access to minimum essential
4.25coverage. An applicant or enrollee who is entitled to premium-free Medicare Part A is
4.26prohibited from refusing to apply for or enroll in Medicare coverage to establish eligibility
4.27for a MinnesotaCare Plan.
4.28 (c) Notwithstanding paragraph (a), an eligible individual includes an individual who is
4.29ineligible for medical assistance, other than emergency medical assistance under section
4.30256B.06, subdivision 4, due to immigration status.
4Sec. 4.
REVISOR RSI/ES 25-0395503/26/25 5.1 Subd. 4.Citizenship requirements.To be eligible, an individual must be a citizen or
5.2national of the United States or a lawfully present noncitizen, as defined in Code of Federal
5.3Regulations, title 45, section 155.20.
5.4 Sec. 5. [62A.656] PAYMENTS TO HEALTH CARRIERS AND COUNTY-BASED
5.5PURCHASING PLANS.
5.6 Subdivision 1.Definitions.(a) For purposes of this section, the terms defined in this
5.7subdivision have the meanings given.
5.8 (b) "Eligible enrollee" means an individual who (1) is enrolled in a MinnesotaCare Plan,
5.9(2) has a household income that is less than or equal to 250 percent of the federal poverty
5.10guidelines, and (3) is required to pay a monthly premium under section 62A.654, subdivision
5.113, paragraph (a) or (b).
5.12 (c) "Premium-exempt enrollee" means an individual who is enrolled in a MinnesotaCare
5.13Plan and is not required to pay a monthly premium.
5.14 (d) "Gross premium" means the amount billed to an eligible enrollee or premium-exempt
5.15enrollee if the enrollee's premium was not capped, exempted, or waived under section
5.1662A.654, subdivision 3.
5.17 Subd. 2.Payments.(a) The commissioner must make payments to health carriers and
5.18county-based purchasing plans on behalf of:
5.19 (1) an eligible enrollee for the months in a calendar year for which the enrollee paid the
5.20required premium amount under section 62A.654, subdivision 3, paragraph (a) or (b), as
5.21applicable; and
5.22 (2) a premium-exempt enrollee for the months in a calendar year in which the enrollee
5.23received coverage under a MinnesotaCare Plan.
5.24 (b) A payment under this subdivision on behalf of an eligible enrollee must be equal to
5.25the enrollee's monthly gross premium, less the enrollee's monthly premium payment. A
5.26payment under this subdivision on behalf of a premium-exempt enrollee must be equal to
5.27the enrollee's monthly gross premium. A payment made under this subdivision:
5.28 (1) is to promote the general welfare and is not compensation for any services; and
5.29 (2) must be excluded from any calculation used to determine eligibility for programs
5.30administered by the Department of Human Services or the Department of Children, Youth,
5.31and Families.
5Sec. 5.
REVISOR RSI/ES 25-0395503/26/25 6.1 (c) To be eligible to receive a payment under this section, a health carrier and
6.2county-based purchasing plan must submit to the commissioner an invoice and other
6.3information required by the commissioner in the form and manner specified by the
6.4commissioner.
6.5 (d) The commissioner must consider health carriers and county-based purchasing plans
6.6as vendors under section 16A.124, subdivision 3. Each invoice submitted under this section
6.7represents the completed delivery of the service.
6.8 Subd. 3.Data practices.(a) The definitions in section 13.02 apply to this subdivision.
6.9 (b) Government data on an enrollee, health carrier, or county-based purchasing plan
6.10under this section are private data on individuals or nonpublic data, except that the total
6.11reimbursement requested by a health carrier and county-based purchasing plan and the total
6.12state payment to the health carrier and county-based purchasing plan are public data.
6.13 Sec. 6. Minnesota Statutes 2024, section 62V.02, is amended by adding a subdivision to
6.14read:
6.15 Subd. 7a.MinnesotaCare Plan."MinnesotaCare Plan" means a health plan offered in
6.16the individual market by a health carrier or county-based purchasing plan that meets the
6.17standards established by the commissioner of commerce under sections 62A.652 to 62A.656.
6.18 Sec. 7. Minnesota Statutes 2024, section 62V.03, subdivision 1, is amended to read:
6.19 Subdivision 1.Creation.MNsure is created as a board under section 15.012, paragraph
6.20(a), to:
6.21 (1) promote informed consumer choice, innovation, competition, quality, value, market
6.22participation, affordability, suitable and meaningful choices, health improvement, care
6.23management, reduction of health disparities, and portability of health plans;
6.24 (2) facilitate and simplify the comparison, choice, enrollment, and purchase of health
6.25plans for individuals purchasing in the individual market through MNsure and for employees
6.26and employers purchasing in the small group market through MNsure;
6.27 (3) assist small employers with access to small business health insurance tax credits and
6.28to assist individuals with access to public health care programs, premium assistance tax
6.29credits and cost-sharing reductions, and certificates of exemption from individual
6.30responsibility requirements;
6Sec. 7.
REVISOR RSI/ES 25-0395503/26/25 7.1 (4) facilitate the integration and transition of individuals between public health care
7.2programs, MinnesotaCare Plans, and other health plans in the individual or group market
7.3and develop processes that, to the maximum extent possible, provide for continuous coverage;
7.4and
7.5 (5) establish and modify as necessary a name and brand for MNsure based on market
7.6studies that show maximum effectiveness in attracting the uninsured and motivating them
7.7to take action.
7.8 Sec. 8. Minnesota Statutes 2024, section 62V.03, subdivision 3, is amended to read:
7.9 Subd. 3.Continued operation of a private marketplace.(a) Nothing in this chapter
7.10shall be construed to prohibit: (1) a health carrier from offering outside of MNsure a health
7.11plan to a qualified individual or qualified employer; and (2) a qualified individual from
7.12enrolling in, or a qualified employer from selecting for its employees, a health plan offered
7.13outside of MNsure.
7.14 (b) Nothing in this chapter shall be construed to restrict the choice of a qualified individual
7.15to enroll or not enroll in a qualified health plan or a MinnesotaCare Plan, or to participate
7.16in MNsure. Nothing in this chapter shall be construed to compel an individual to enroll in
7.17a qualified health plan or a MinnesotaCare Plan, or to participate in MNsure.
7.18 (c) For purposes of this subdivision, "qualified individual" and "qualified employer"
7.19have the meanings given in section 1312 of the Affordable Care Act, Public Law 111-148,
7.20and further defined through amendments to the act and regulations issued under the act.
7.21 Sec. 9. Minnesota Statutes 2024, section 62V.05, subdivision 3, is amended to read:
7.22 Subd. 3.Insurance producers.(a) By April 30, 2013, The board, in consultation with
7.23the commissioner of commerce, shall establish certification requirements that must be met
7.24by insurance producers in order to assist individuals and small employers with purchasing
7.25coverage through MNsure. Prior to January 1, 2015, the board may amend the requirements,
7.26only if necessary, due to a change in federal rules.
7.27 (b) Certification requirements shall not exceed the requirements established under Code
7.28of Federal Regulations, title 45, part 155.220. Certification shall include training on health
7.29plans available through MNsure, available tax credits and cost-sharing arrangements,
7.30compliance with privacy and security standards, eligibility verification processes, online
7.31enrollment tools, and basic information on available public health care programs. Training
7.32required for certification under this subdivision shall qualify for continuing education
7Sec. 9.
REVISOR RSI/ES 25-0395503/26/25 8.1requirements for insurance producers required under chapter 60K, and must comply with
8.2course approval requirements under chapter 45.
8.3 (c) Producer compensation shall be established by health carriers that provide health
8.4plans through MNsure. The structure of compensation to insurance producers must be similar
8.5for health plans sold through MNsure and outside MNsure.
8.6 (d) Any insurance producer compensation structure established by a health carrier for
8.7the small group market must include compensation for defined contribution plans that
8.8involve multiple health carriers. The compensation offered must be commensurate with
8.9other small group market defined health plans.
8.10 (e) Any insurance producer assisting an individual or small employer with purchasing
8.11coverage through MNsure must disclose, orally and in writing, to the individual or small
8.12employer at the time of the first solicitation with the prospective purchaser the following:
8.13 (1) the health carriers and, qualified health plans, and MinnesotaCare Plans offered
8.14through MNsure that the producer is authorized to sell, and that the producer may not be
8.15authorized to sell all the qualified health plans or MinnesotaCare Plans offered through
8.16MNsure;
8.17 (2) that the producer may be receiving compensation from a health carrier for enrolling
8.18the individual or small employer into a particular health plan; and
8.19 (3) that information on all qualified health plans and MinnesotaCare Plans offered
8.20through MNsure is available through the MNsure website.
8.21For purposes of this paragraph, "solicitation" means any contact by a producer, or any person
8.22acting on behalf of a producer made for the purpose of selling or attempting to sell coverage
8.23through MNsure. If the first solicitation is made by telephone, the disclosures required under
8.24this paragraph need not be made in writing, but the fact that disclosure has been made must
8.25be acknowledged on the application.
8.26 (f) Beginning January 15, 2015, each health carrier that offers or sells qualified health
8.27plans or MinnesotaCare Plans through MNsure shall report in writing to the board and the
8.28commissioner of commerce the compensation and other incentives it offers or provides to
8.29insurance producers with regard to each type of health plan the health carrier offers or sells
8.30both inside and outside of MNsure. Each health carrier shall submit a report annually and
8.31upon any change to the compensation or other incentives offered or provided to insurance
8.32producers.
8Sec. 9.
REVISOR RSI/ES 25-0395503/26/25 9.1 (g) Nothing in this chapter shall prohibit an insurance producer from offering professional
9.2advice and recommendations to a small group purchaser based upon information provided
9.3to the producer.
9.4 (h) An insurance producer that offers health plans in the small group market shall notify
9.5each small group purchaser of which group health plans qualify for Internal Revenue Service
9.6approved section 125 tax benefits. The insurance producer shall also notify small group
9.7purchasers of state law provisions that benefit small group plans when the employer agrees
9.8to pay 50 percent or more of its employees' premium. Individuals who are eligible for
9.9cost-effective medical assistance will count toward the 75 percent participation requirement
9.10in section 62L.03, subdivision 3.
9.11 (i) Nothing in this subdivision shall be construed to limit the licensure requirements or
9.12regulatory functions of the commissioner of commerce under chapter 60K.
9.13 Sec. 10. Minnesota Statutes 2024, section 62V.05, is amended by adding a subdivision to
9.14read:
9.15 Subd. 5a.Administration of MinnesotaCare Plans.(a) An individual must be able to
9.16apply for and, if eligible, enroll in a MinnesotaCare Plan by completing the application for
9.17a qualified health plan with premium tax credits or cost-sharing reductions.
9.18 (b) MNsure must ensure that individuals interested in applying for a qualified health
9.19plan or a MinnesotaCare Plan are able to compare coverage options in a simple, convenient,
9.20and understandable manner on the MNsure website.
9.21 (c) MNsure must process MinnesotaCare Plan applications and make eligibility
9.22determinations for MinnesotaCare Plans in accordance with section 62A.655.
9.23 (d) MNsure must identify MinnesotaCare Plan enrollees who are premium-exempt or
9.24subject to the premium caps under section 62A.654, subdivision 3, and provide the
9.25information to the health carrier offering the MinnesotaCare Plan in which the individual
9.26enrolls. MNsure must identify MinnesotaCare enrollees who may be eligible for premium
9.27tax credits or cost-sharing reductions and assist the enrollees with accessing the subsidies.
9.28 (e) MNsure may utilize existing resources, personnel, and operations to carry out the
9.29duties under this subdivision.
9.30 Sec. 11. Minnesota Statutes 2024, section 62V.05, subdivision 6, is amended to read:
9.31 Subd. 6.Appeals.(a) The board may conduct hearings, appoint hearing officers, and
9.32recommend final orders related to appeals of any MNsure determinations, except for those
9Sec. 11.
REVISOR RSI/ES 25-0395503/26/25 10.1determinations identified in paragraph (d). An appeal by a health carrier regarding a specific
10.2certification or selection determination made by MNsure under subdivision 5 must be
10.3conducted as a contested case proceeding under chapter 14, with the report or order of the
10.4administrative law judge constituting the final decision in the case, subject to judicial review
10.5under sections 14.63 to 14.69. For other appeals, the board shall establish hearing processes
10.6which provide for a reasonable opportunity to be heard and timely resolution of the appeal
10.7and which are consistent with the requirements of federal law and guidance. An appealing
10.8party may be represented by legal counsel at these hearings, but this is not a requirement.
10.9 (b) MNsure may establish service-level agreements with state agencies to conduct
10.10hearings for appeals. Notwithstanding section 471.59, subdivision 1, a state agency is
10.11authorized to enter into service-level agreements for this purpose with MNsure.
10.12 (c) For proceedings under this subdivision, MNsure may be represented by an attorney
10.13who is an employee of MNsure.
10.14 (d) This subdivision does not apply to appeals of determinations where a state agency
10.15hearing is available under section 256.045.
10.16 (e) An appellant aggrieved by an order of MNsure issued in an eligibility appeal, as
10.17defined in Minnesota Rules, part 7700.0101, may appeal the order to the district court of
10.18the appellant's county of residence by serving a written copy of a notice of appeal upon
10.19MNsure and any other adverse party of record within 30 days after the date MNsure issued
10.20the order, the amended order, or order affirming the original order, and by filing the original
10.21notice and proof of service with the court administrator of the district court. Service may
10.22be made personally or by mail; service by mail is complete upon mailing; no filing fee shall
10.23be required by the court administrator in appeals taken pursuant to this subdivision. MNsure
10.24shall furnish all parties to the proceedings with a copy of the decision and a transcript of
10.25any testimony, evidence, or other supporting papers from the hearing held before the appeals
10.26examiner within 45 days after service of the notice of appeal.
10.27 (f) Any party aggrieved by the failure of an adverse party to obey an order issued by
10.28MNsure may compel performance according to the order in the manner prescribed in sections
10.29586.01 to 586.12.
10.30 (g) Any party may obtain a hearing at a special term of the district court by serving a
10.31written notice of the time and place of the hearing at least ten days prior to the date of the
10.32hearing. The court may consider the matter in or out of chambers, and shall take no new or
10.33additional evidence unless it determines that such evidence is necessary for a more equitable
10.34disposition of the appeal.
10Sec. 11.
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
11.2other civil cases. No costs or disbursements shall be taxed against any party nor shall any
11.3filing fee or bond be required of any party.
11.4 (i) If MNsure or a district court orders eligibility for qualified health plan coverage or
11.5MinnesotaCare Plan coverage through MNsure, or eligibility for federal advance payment
11.6of premium tax credits or cost-sharing reductions contingent upon full payment of respective
11.7premiums, the premiums must be paid or provided pending appeal to the district court, court
11.8of appeals, or supreme court. Provision of eligibility by MNsure pending appeal does not
11.9render moot MNsure's position in a court of law.
11.10Sec. 12. Minnesota Statutes 2024, section 62V.051, is amended to read:
11.11 62V.051 MNSURE; CONSUMER RETROACTIVE APPOINTMENT OF A
11.12NAVIGATOR OR PRODUCER PERMITTED.
11.13 Notwithstanding any other law or rule to the contrary, for up to six months after the
11.14effective date of the qualified health plan or MinnesotaCare Plan, MNsure must permit a
11.15qualified health plan or MinnesotaCare Plan policyholder, who has not designated a navigator
11.16or an insurance producer, to retroactively appoint a navigator or insurance producer. MNsure
11.17must provide notice of the retroactive appointment to the health carrier. The health carrier
11.18must retroactively pay commissions to the insurance producer if the producer can demonstrate
11.19that they were certified by MNsure at the time of the original enrollment, were appointed
11.20by the selected health carrier at the time of the enrollment, and that an agent of record
11.21agreement was executed prior to or at the time of the effective date of the policy. MNsure
11.22must adopt a standard form of agent of record agreement for purposes of this section.
11.23Sec. 13. Minnesota Statutes 2024, section 62V.13, subdivision 3, is amended to read:
11.24 Subd. 3.Outreach letter and special enrollment period.(a) MNsure must provide a
11.25written letter of the projected assessment under subdivision 2 to a taxpayer who indicates
11.26to the commissioner of revenue that the taxpayer is interested in obtaining information on
11.27access to health insurance.
11.28 (b) MNsure must allow a special enrollment period for taxpayers who receive the outreach
11.29letter in paragraph (a) and are determined eligible to enroll in a qualified health plan or
11.30MinnesotaCare Plan through MNsure. The triggering event for the special enrollment period
11.31is the day the outreach letter under this subdivision is mailed to the taxpayer. An eligible
11.32individual, and their dependents, have 65 days from the triggering event to select a qualifying
11Sec. 13.
REVISOR RSI/ES 25-0395503/26/25 12.1health plan or MinnesotaCare Plan, and coverage for the qualifying health plan or
12.2MinnesotaCare Plan is effective the first day of the month after plan selection.
12.3 (c) Taxpayers who have a member of the taxpayer's household currently enrolled in a
12.4qualified health plan or MinnesotaCare Plan through MNsure are not eligible for the special
12.5enrollment under paragraph (b).
12.6 (d) MNsure must provide information to the general public about the easy enrollment
12.7health insurance outreach program and the special enrollment period described in this
12.8subdivision.
12.9 Sec. 14. DIRECTION TO THE COMMISSIONER; ESTABLISHING A
12.10MINNESOTACARE PLAN.
12.11 Subdivision 1.Request for federal section 1332 waiver.(a) The commissioner of
12.12commerce, in cooperation with the commissioner of human services and the Board of
12.13Directors of MNsure, must submit a section 1332 waiver pursuant to United States Code,
12.14title 42, section 18052, to the United States Secretary of Health and Human Services for
12.15federal approval to implement this act consistent with this section.
12.16 (b) The 1332 waiver must request that the state receive 100 percent of the value of
12.17premium tax credits and cost-sharing reductions that MinnesotaCare Plan enrollees with
12.18household incomes less than or equal to 250 percent of the federal poverty guidelines would
12.19receive if the MinnesotaCare Plan enrollees enrolled in a qualified health plan through
12.20MNsure, rather than the 95 percent of the value of premium tax credits and cost-sharing
12.21reductions the state receives for enrollees in a basic health program. The waiver must require
12.22that additional federal funding must be dedicated to supporting lower costs for MinnesotaCare
12.23Plan enrollees.
12.24 Subd. 2.Request to suspend basic health program.(a) Given the administrative burden
12.25on both the federal government and the state to conduct a basic health program blueprint,
12.26the commissioner of human services, in coordination with the commissioner of commerce
12.27and the Board of Directors of MNsure, must submit an application to suspend the state's
12.28basic health program, MinnesotaCare, pursuant to Code of Federal Regulations, title 42,
12.29section 600.140, to the United States Secretary of Health and Human Services.
12.30 (b) The application must request to suspend the basic health program prior to
12.31implementation of the 1332 waiver requested under this section and for the duration of the
12.32waiver, and to maintain the state's current basic health program trust fund for allowable
12.33uses.
12Sec. 14.
REVISOR RSI/ES 25-0395503/26/25 13.1 Subd. 3.Current MinnesotaCare enrollees.(a) The 1332 waiver requested under this
13.2section must not impact the experience of current MinnesotaCare enrollees. Upon federal
13.3approval of the 1332 waiver, current MinnesotaCare enrollees who are eligible to enroll in
13.4a MinnesotaCare Plan must be automatically enrolled in a MinnesotaCare Plan offered by
13.5the enrollee's current health carrier or county-based purchasing plan, unless the enrollee
13.6selects a different plan. When an enrollee transitions from MinnesotaCare to a MinnesotaCare
13.7Plan, the eligibility and enrollment processes must not change and the premiums, cost-sharing
13.8requirements, and covered benefits must remain the same for current MinnesotaCare
13.9enrollees.
13.10 (b) Pursuant to Minnesota Statutes, chapter 256L, suspension of the state's basic health
13.11program does not prohibit the commissioner of human services from continuing to administer
13.12MinnesotaCare for individuals who meet the eligibility requirements for MinnesotaCare
13.13but do not qualify to enroll in a MinnesotaCare Plan established under a 1332 waiver
13.14requested under this section.
13Sec. 14.
REVISOR RSI/ES 25-0395503/26/25