House lawmakers OK $7.1 billion omnibus health bill that seeks to purge restrictive abortion statutes

The topic of reproductive health care often generates heated debate. And Wednesday night on the House Floor was no different.

With House language substituted in an earlier committee hearing, HF2930/SF2995* was passed, as amended, 69-58 by the House. It includes provisions addressing abortion coverage, the 24-hour waiting period, and the presence of a designated support person while receiving reproductive health care.

It now returns to the Senate, where the bill was initially passed 35-32 along party lines April 19. Presumably, a conference committee will be scheduled to craft a final draft.

Rep. Tina Liebling

Sponsored by Rep. Tina Liebling (DFL-Rochester), the omnibus health finance bill would appropriate $7.1 billion in the 2024-25 biennium, including $6.19 billion for the Department of Human Services and $908.84 million for the Department of Health.

“It de-privatizes our public health care programs, streamlines bureaucracy, and saves money that we now spend on layers of administration instead of actual health care,” Liebling said. “It reduces barriers to care and covers more Minnesotans, including folks who are undocumented who will be able to join our MinnesotaCare program if they qualify financially.”

“All Minnesotans deserve affordable, high-quality health care no matter your zip code, income, or background. That’s why our health budget takes significant steps to reduce the cost of health care and expand access,” House Majority Leader Jamie Long (DFL-Mpls) said in a statement. “Our health budget builds on the important consumer protections in the Affordable Care Act by establishing a public option for health insurance, which will help to put people at the center of health care, not profits.” 

[MORE: Look at the total appropriations; Download the spreadsheet]

What about abortion?

Medical assistance coverage for medically necessary abortions would be codified by repealing language deemed unconstitutional under the state constitution in a 1995 Minnesota Supreme Court decision that limited abortion coverage.

Current statute bars the Department of Health from giving grants to nonprofits that perform abortions. The bill would repeal this prohibition, found unconstitutional by the 8th Circuit Court and the U.S. Supreme Court.

Other proposed changes to Minnesota law would:

• allow abortions to be administered at a birth center;
• broaden the scope of abortions covered by MinnesotaCare;
• eradicate a misdemeanor penalty for coercing a person to undergo an abortion or sterilization by threatening their federal assistance;
• stop requiring state-mandated printed information prior to certain reproductive health care services — found unconstitutional in court;
• abolish the positive abortion alternatives grant program;
• eliminate the informed consent in writing requirement and a mandatory 24-hour waiting period before an abortion — both were found unconstitutional in court; and
• remove medical obligations for “born alive” infants, while also providing what Liebling calls “comfort language” to clarify that an infant that is alive “shall be fully recognized as a human person” and therefore entitled to receive the same commensurate medical care anyone else would get.

An amendment unsuccessfully offered by House Minority Leader Lisa Demuth (R-Cold Spring) “would prohibit the dilation and extraction or partial birth abortion except when necessary to save the life of the mother.”

She said it would prohibit third-trimester abortions except in instances of rape, incest, or the health of the mother.

Other proposed changes include:

• allowing a pregnant person to have a designated support person with them during health care services;
• renaming “family planning grants” as sexual and reproductive health services grants and modifying subsequent requirements; and
• increasing payment rates by 20% for family planning and abortion services.

Some funding specifically relates to pregnancy, such as $199,000 for the task force on pregnancy health and substance use disorders and $260,000 for the African American Babies Coalition initiative for community-driven training and education.

[MORE: What’s in the bill? Read about the original proposal and committee-approved bill]

Major spending?

Financial provisions in the bill include:

• $265.84 million for adult mental health grants;
• $93.55 million for school-linked behavioral health services;
• $17 million for activities to support the 988 lifeline system;
• $4.37 million to establish the Office of African American Health; and
• $4.18 million to create the Office of American Indian Health.

Insurance?

Yes, MinnesotaCare still plans to transition to a “public option,” eliminating income restrictions. No, it may not be available soon as it would be effective Jan. 1, 2027 or upon federal approval.

Additional insurance changes would provide continuous medical assistance eligibility for children, carve outpatient prescription drugs out of medical assistance and managed care contracts, and require the Department of Human Services to reimburse health care providers directly for medical assistance and MinnesotaCare, using fee-for-service payment methods.

“Keep Nurses at Bedside” Act?

Language originally found in HF1700 is in the bill with an $23.11 million appropriation.

By Oct. 1, 2024, each hospital would need to establish a hospital nurse staffing committee and a hospital nurse workload committee and a year later would need to implement core staffing plans.

According to Rep. Sandra Feist (DFL-New Brighton), hospitals, nurses, and patients would benefit as the language, originally found in bill she sponsored, would “address the unsustainable status quo when it comes to trends around hospital staffing.”

Calling it a “mandate,” Rep. Joe Schomacker (R-Luverne) strongly opposes the portion of the core staffing plan that would set a “maximum number of patients” for each care unit for “whom a direct care nurse can typically safely care.”

“This ignores the individual needs of the patient,” he said. ‘This ignores the skills and experiences of the nurses.”

An amendment unsuccessfully offered by Schomacker would have removed many of the proposal’s provisions, such as the committees, the hospital core staffing plan and the daily staffing schedule.

Amendments

Besides a portion of a divided Liebling amendment, other successful amendments include one from Rep. Jeff Backer (R-Browns Valley) that would update mutual aid agreements for ambulance services.

An amendment unsuccessfully offered by Rep. Mary Franson (R-Alexandria), adding the so-called “Protect Reproductive Organs of Minors Act” was criticized by DFL members for trying to block gender-affirming care for minors.

Additional unsuccessful Republican amendments would have removed:

• the proposed “public option” from MinnesotaCare;
• undocumented Minnesotans from receiving medical assistance;
• the pharmacy carve-out;
• the “Keep Nurses at the Bedside Act”;
• language involving the health care affordability council; and
• the rate increase for family planning and abortion services.

Other unsuccessful Republican amendments would have kept or expanded:

• the “born alive” infant act;
• the positive abortions alternatives grant program; and
• designated support person provision for pregnant patients to extend to any patients, as amended.