1.1.................... moves to amend H.F. No. 42, the first engrossment, as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. Minnesota Statutes 2008, section 62A.65, subdivision 5, is amended to read:
1.4    Subd. 5. Portability and conversion of coverage. (a) No individual health plan
1.5may be offered, sold, issued, or with respect to children age 18 or under renewed, to a
1.6Minnesota resident that contains a preexisting condition limitation, preexisting condition
1.7exclusion, or exclusionary rider, unless the limitation or exclusion is permitted under this
1.8subdivision and under chapter 62L, provided that, except for children age 18 or under,
1.9underwriting restrictions may be retained on individual contracts that are issued without
1.10evidence of insurability as a replacement for prior individual coverage that was sold
1.11before May 17, 1993. The individual may be subjected to an 18-month preexisting
1.12condition limitation, unless the individual has maintained continuous coverage as defined
1.13in section 62L.02. The individual must not be subjected to an exclusionary rider. An
1.14individual who has maintained continuous coverage may be subjected to a onetime
1.15preexisting condition limitation of up to 12 months, with credit for time covered under
1.16qualifying coverage as defined in section 62L.02, at the time that the individual first is
1.17covered under an individual health plan by any health carrier. Credit must be given for
1.18all qualifying coverage with respect to all preexisting conditions, regardless of whether
1.19the conditions were preexisting with respect to any previous qualifying coverage. The
1.20individual must not be subjected to an exclusionary rider. Thereafter, the individual must
1.21not be subject to any preexisting condition limitation, preexisting condition exclusion,
1.22or exclusionary rider under an individual health plan by any health carrier, except an
1.23unexpired portion of a limitation under prior coverage, so long as the individual maintains
1.24continuous coverage as defined in section 62L.02.
1.25(b) A health carrier must offer an individual health plan to any individual previously
1.26covered under a group health plan issued by that health carrier, regardless of the size of
1.27the group, so long as the individual maintained continuous coverage as defined in section
2.162L.02 . If the individual has available any continuation coverage provided under sections
2.262A.146 ; 62A.148; 62A.17, subdivisions 1 and 2; 62A.20; 62A.21; 62C.142; 62D.101; or
2.362D.105 , or continuation coverage provided under federal law, the health carrier need not
2.4offer coverage under this paragraph until the individual has exhausted the continuation
2.5coverage. The offer must not be subject to underwriting, except as permitted under this
2.6paragraph. A health plan issued under this paragraph must be a qualified plan as defined
2.7in section 62E.02 and must not contain any preexisting condition limitation, preexisting
2.8condition exclusion, or exclusionary rider, except for any unexpired limitation or
2.9exclusion under the previous coverage. The individual health plan must cover pregnancy
2.10on the same basis as any other covered illness under the individual health plan. The offer
2.11of coverage by the health carrier must inform the individual that the coverage, including
2.12what is covered and the health care providers from whom covered care may be obtained,
2.13may not be the same as the individual's coverage under the group health plan. The offer
2.14of coverage by the health carrier must also inform the individual that the individual, if
2.15a Minnesota resident, may be eligible to obtain coverage from (i) other private sources
2.16of health coverage, or (ii) the Minnesota Comprehensive Health Association, without a
2.17preexisting condition limitation, and must provide the telephone number used by that
2.18association for enrollment purposes. The initial premium rate for the individual health
2.19plan must comply with subdivision 3. The premium rate upon renewal must comply with
2.20subdivision 2. In no event shall the premium rate exceed 100 percent of the premium
2.21charged for comparable individual coverage by the Minnesota Comprehensive Health
2.22Association, and the premium rate must be less than that amount if necessary to otherwise
2.23comply with this section. An individual health plan offered under this paragraph to a
2.24person satisfies the health carrier's obligation to offer conversion coverage under section
2.2562E.16 , with respect to that person. Coverage issued under this paragraph must provide
2.26that it cannot be canceled or nonrenewed as a result of the health carrier's subsequent
2.27decision to leave the individual, small employer, or other group market. Section 72A.20,
2.28subdivision 28 , applies to this paragraph.
2.29(c) A health carrier must offer, sell, issue, and renew an individual health plan on a
2.30guaranteed issue basis, without any preexisting condition limitation, to individuals and
2.31their family members who exhaust temporary MinnesotaCare coverage for unemployed
2.32individuals under section 256L.07, subdivision 8, who are not eligible for regular
2.33MinnesotaCare coverage as determined by the commissioner of human services, and who
2.34apply for coverage from the health carrier within 63 days after denial of eligibility for
2.35regular MinnesotaCare coverage. Guaranteed issue coverage under this paragraph must be
2.36retroactive to the date of denial of eligibility for regular MinnesotaCare coverage. For
3.1purposes of this paragraph, "guaranteed issue" means that a health carrier shall not decline
3.2to cover under a health plan any individual or eligible dependent, including persons
3.3who become eligible dependents after issuance of the health plan. For purposes of this
3.4paragraph, "family" has the meaning provided in section 256L.07, subdivision 8. This
3.5paragraph expires July 1, 2011.
3.6EFFECTIVE DATE.This section is effective July 1, 2009, and applies to health
3.7plans offered, sold, issued, or renewed on or after that date.

3.8    Sec. 2. [256.0122] STATE SUBSIDY FOR COBRA PREMIUMS.
3.9The commissioner of human services shall provide to each assistance eligible
3.10individual who is eligible for premium assistance for COBRA benefits under the American
3.11Recovery and Reinvestment Act (ARRA) of 2009, title III, section 3001, with a state
3.12premium subsidy equal to an additional 25 percent of the total premium for COBRA
3.13continuation coverage. The assistance eligible individual's share of 35 percent of the
3.14premium for continuation coverage shall be proportionately reduced. The commissioner
3.15shall pay the state premium subsidy to the entity to whom the assistance eligible individual
3.16is required to pay COBRA premiums, on or before the dates the assistance eligible
3.17individual's COBRA premiums are due. The state premium subsidy must be paid for the
3.18period during which an assistance eligible individual receives the 65 percent premium
3.19subsidy under the ARRA. Employers subject to federal or state continuation law must
3.20provide assistance eligible individuals with notice of the additional state subsidy, in
3.21addition to any other notice required under the ARRA. This section expires December
3.2231, 2010.
3.23EFFECTIVE DATE.This section is effective retroactively from February 17, 2009.

3.24    Sec. 3. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision
3.25to read:
3.26    Subd. 8. Temporary MinnesotaCare coverage for unemployed individuals. (a)
3.27An individual is eligible for temporary MinnesotaCare coverage under this subdivision if
3.28the individual:
3.29(1) is involuntarily unemployed, but not for cause, and had been employed for at
3.30least 18 consecutive months prior to the loss of employment;
3.31(2) is not eligible for continuation coverage as described by the Consolidated
3.32Omnibus Budget Reconciliation Act of 1985 (COBRA), Public Law 99-272, as amended,
3.33or state continuation coverage under sections 62A.146, 62A.148, 62A.17, 62A.20,
4.162A.21, 62D.101, and 62D.105, and similar laws of other states under which a Minnesota
4.2resident is eligible;
4.3(3) has gross individual or family income that does not exceed 275 percent of the
4.4federal poverty guidelines; and
4.5(4) does not have available to them health coverage through Medicare or
4.6employer-subsidized coverage through a spouse. For purposes of this requirement,
4.7"employer-subsidized coverage" means health coverage for which the employer pays at
4.8least 50 percent of the cost of coverage for the employee or dependent.
4.9(b) Members of the individual's family are also eligible for MinnesotaCare under
4.10this subdivision. For purposes of this subdivision "family" has the meaning provided
4.11in Minnesota Rules, part 9506.0010, subpart 11, but also includes any individual who
4.12had been covered under health coverage provided by the most recent employer of the
4.13individual applying for temporary MinnesotaCare coverage.
4.14(c) Individuals and family members eligible under this subdivision are exempt from
4.15subdivisions 2 and 3; and section 256L.17. All other requirements of this chapter apply.
4.16(d) The commissioner of employment and economic development shall provide
4.17all individuals who make application for unemployment benefits under chapter 268, a
4.18Minnesota emergency unemployment compensation program, or a federal emergency
4.19compensation program, with written notice that the individual and family members
4.20may be eligible under this subdivision for temporary MinnesotaCare coverage, and an
4.21application for this coverage. This information must be provided by the commissioner of
4.22employment and economic development at the same time that information about eligibility
4.23for unemployment benefits is provided.
4.24(e) Individuals and family members shall submit applications for temporary
4.25MinnesotaCare coverage to the commissioner of human services. The commissioner
4.26of human services shall determine eligibility for persons seeking coverage under this
4.27subdivision, using the procedures specified in this chapter, unless otherwise provided
4.28in this subdivision.
4.29(f) Individuals eligible under this subdivision shall receive coverage for the health
4.30services provided under section 256L.03 to nonpregnant adults with children, except
4.31that the annual limit on inpatient hospital services in section 256L.03, subdivision 3,
4.32shall not apply.
4.33(g) Individuals eligible under this subdivision shall receive coverage on a
4.34fee-for-service basis with state-only funds, and are exempt from managed care enrollment
4.35under section 256L.12. The commissioner of human services shall seek federal approval
4.36for matching funds within 30 days of the effective date of this subdivision.
5.1(h) Individuals eligible under this subdivision shall pay premiums as determined
5.2under section 256L.15. These individuals are subject to the cost-sharing requirements
5.3specified in section 256L.03, subdivision 5, except that the ten percent coinsurance
5.4requirement for inpatient hospital services shall not apply. Individuals eligible under this
5.5subdivision are exempt from disenrollment for failure to pay premiums.
5.6(i) Individuals and family members are eligible under this subdivision for 145 days
5.7of coverage, regardless of whether the eligibility criteria under paragraph (a) continue to
5.8be met after the initial determination of eligibility.
5.9(j) Coverage under this subdivision is secondary to a plan of insurance or benefit
5.10program under which an individual or family member has coverage, and the commissioner
5.11of human services shall apply the procedures in section 256L.05, subdivision 3, paragraph
5.12(d). To be eligible under this subdivision, individuals and family members must comply
5.13with section 256L.04, subdivision 2.
5.14(k) Individuals and family members who are no longer eligible under this
5.15subdivision may reapply for MinnesotaCare. The commissioner of human services shall
5.16provide individuals covered under this subdivision with reapplication materials no later
5.17than 115 days from the effective date of coverage. All eligibility, premium payment,
5.18and other requirements of this chapter shall apply at the time of reapplication. The
5.19effective date of coverage for persons reapplying shall be the day following the last day
5.20of coverage under this subdivision, for persons who have submitted a written request for
5.21retroactive MinnesotaCare coverage with a completed application within 30 days of the
5.22loss of eligibility. The applicant must provide all required verifications within 30 days of
5.23the written request for verification. For all other persons, the effective date of coverage is
5.24the day specified in section 256L.05, subdivision 3. Individuals denied MinnesotaCare
5.25coverage upon reapplication are eligible to purchase private sector individual health
5.26coverage on a guaranteed issue basis, as provided in section 62A.65, subdivision 5,
5.27paragraph (c), and health carriers as defined in that section must accept applicants and
5.28issue coverage on that basis.
5.29(l) This subdivision expires July 1, 2011.
5.30EFFECTIVE DATE.This section is effective July 1, 2009.

5.31    Sec. 4. APPROPRIATION.
5.32(a) $....... is appropriated from the health care access fund to the commissioner
5.33of human services for the biennium beginning July 1, 2009, to implement Minnesota
5.34Statutes, section 256L.07, subdivision 8.
6.1(b) $....... is appropriated from the health care access fund to the commissioner
6.2of human services for the biennium beginning July 1, 2009, to implement Minnesota
6.3Statutes, section 256.0122."