1.1.................... moves to amend H.F. No. 2294, the delete everything amendment
1.2(H2294DE2), as follows:
1.3Page 1, after line 4, insert:
1.4 "Section 1. Minnesota Statutes 2011 Supplement, section 62E.14, subdivision 4g,
1.5is amended to read:
1.6 Subd. 4g.
Waiver of preexisting conditions for persons covered by healthy
1.7Minnesota contribution program. A person may enroll in the comprehensive plan with
1.8a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for
1.9the healthy Minnesota contribution program, and has been denied coverage as described
1.10under section
256L.031, subdivision 6.
The six-month durational residency requirement
1.11specified in section 62E.02, subdivision 13, does not apply to individuals enrolled in the
1.12healthy Minnesota contribution program."
1.13Page 7, after line 16, insert:
1.14 "Sec. 10. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 1,
1.15is amended to read:
1.16 Subdivision 1.
Defined contributions to enrollees. (a) Beginning July 1, 2012, the
1.17commissioner shall provide each MinnesotaCare enrollee eligible under section
256L.04,
1.18subdivision 7, with family income equal to or greater than
200 150 percent of the federal
1.19poverty guidelines with a monthly defined contribution to purchase health coverage under
1.20a health plan as defined in section
62A.011, subdivision 3.
1.21(b) Enrollees eligible under this section shall not be charged premiums under
1.22section
256L.15 and are exempt from the managed care enrollment requirement of section
1.23256L.12
.
1.24(c) Sections
256L.03;
256L.05, subdivision 3; and
256L.11 do not apply to enrollees
1.25eligible under this section unless otherwise provided in this section. Covered services, cost
1.26sharing, disenrollment for nonpayment of premium, enrollee appeal rights and complaint
2.1procedures, and the effective date of coverage for enrollees eligible under this section shall
2.2be as provided under the terms of the health plan purchased by the enrollee.
2.3(d) Unless otherwise provided in this section, all MinnesotaCare requirements
2.4related to eligibility, income and asset methodology, income reporting, and program
2.5administration, continue to apply to enrollees obtaining coverage under this section.
2.6EFFECTIVE DATE.This section is effective July 1, 2014.
2.7 Sec. 11. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 2,
2.8is amended to read:
2.9 Subd. 2.
Use of defined contribution; health plan requirements. (a) An enrollee
2.10may use up to the monthly defined contribution to pay premiums for coverage under
2.11a health plan as defined in section
62A.011, subdivision 3, or as provided in section
2.12256L.031, subdivision 6.
2.13(b) An enrollee must select a health plan within
three four calendar months of
2.14approval of MinnesotaCare eligibility. If a health plan is not selected and purchased
2.15within this time period, the enrollee must reapply and must meet all eligibility criteria.
2.16The commissioner may determine criteria under which an enrollee has more than four
2.17calendar months to select a health plan.
2.18(c)
A health plan Coverage purchased under this section must:
2.19(1)
provide coverage for include mental health and chemical dependency treatment
2.20services; and
2.21(2) comply with the coverage limitations specified in section
256L.03, subdivision
2.221, the second paragraph.
2.23 Sec. 12. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 3,
2.24is amended to read:
2.25 Subd. 3.
Determination of defined contribution amount. (a) The commissioner
2.26shall determine the defined contribution sliding scale using the base contribution specified
2.27in
paragraph (b) this paragraph for the specified age ranges. The commissioner shall use a
2.28sliding scale for defined contributions that provides:
2.29(1) persons with household incomes equal to 150 percent of the federal poverty
2.30guidelines with a defined contribution equal to 106 percent of the base contribution;
2.31(1) (2) persons with household incomes equal to 200 percent of the federal poverty
2.32guidelines with a defined contribution of 93 percent of the base contribution;
2.33(2) (3) persons with household incomes equal to 250 percent of the federal poverty
2.34guidelines with a defined contribution of 80 percent of the base contribution; and
3.1(3) (4) persons with household incomes in evenly spaced increments between the
3.2percentages of the federal poverty guideline or income level specified in clauses (1)
3.3and (2) to (3) with a base contribution that is a percentage interpolated from the defined
3.4contribution percentages specified in clauses (1)
and (2) to (3).
3.5
|
|
19-29
|
$125
|
3.6
|
|
30-34
|
$135
|
3.7
|
|
35-39
|
$140
|
3.8
|
|
40-44
|
$175
|
3.9
|
|
45-49
|
$215
|
3.10
|
|
50-54
|
$295
|
3.11
|
|
55-59
|
$345
|
3.12
|
|
60+
|
$360
|
3.13(b) The commissioner shall multiply the defined contribution amounts developed
3.14under paragraph (a) by
1.20 for enrollees
who are denied coverage under an individual
3.15health plan by a health plan company and who purchase coverage through the Minnesota
3.16Comprehensive Health Association.
3.17EFFECTIVE DATE.This section is effective July 1, 2014, except that the
3.18amendment to paragraph (b) is effective July 1, 2012.
3.19 Sec. 13. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 6,
3.20is amended to read:
3.21 Subd. 6.
Minnesota Comprehensive Health Association (MCHA). Beginning
3.22July 1, 2012, MinnesotaCare enrollees
who are denied coverage in the individual
3.23health market by a health plan company in accordance with section
62A.65 are eligible
3.24for coverage through a health plan offered by the Minnesota Comprehensive Health
3.25Association
and may enroll in MCHA in accordance with section
62E.14. Any difference
3.26between the revenue and actual covered losses to MCHA related to the implementation of
3.27this section are appropriated annually to the commissioner of human services from the
3.28health care access fund and shall be paid to MCHA.
3.29 Sec. 14. Minnesota Statutes 2010, section 256L.07, subdivision 3, is amended to read:
3.30 Subd. 3.
Other health coverage. (a) Families and individuals enrolled in the
3.31MinnesotaCare program must have no health coverage while enrolled or for at least four
3.32months prior to application and renewal. Children enrolled in the original children's health
3.33plan and children in families with income equal to or less than 150 percent of the federal
3.34poverty guidelines, who have other health insurance, are eligible if the coverage:
3.35(1) lacks two or more of the following:
4.1(i) basic hospital insurance;
4.2(ii) medical-surgical insurance;
4.3(iii) prescription drug coverage;
4.4(iv) dental coverage; or
4.5(v) vision coverage;
4.6(2) requires a deductible of $100 or more per person per year; or
4.7(3) lacks coverage because the child has exceeded the maximum coverage for a
4.8particular diagnosis or the policy excludes a particular diagnosis.
4.9The commissioner may change this eligibility criterion for sliding scale premiums
4.10in order to remain within the limits of available appropriations. The requirement of no
4.11health coverage does not apply to newborns.
4.12(b)
Coverage purchased as provided under section 256L.031, subdivision 2, medical
4.13assistance,
general assistance medical care, and the Civilian Health and Medical Program
4.14of the Uniformed Service, CHAMPUS, or other coverage provided under United States
4.15Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or health
4.16coverage for purposes of the four-month requirement described in this subdivision.
4.17(c) For purposes of this subdivision, an applicant or enrollee who is entitled to
4.18Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
4.19Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to
4.20have health coverage. An applicant or enrollee who is entitled to premium-free Medicare
4.21Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility
4.22for MinnesotaCare.
4.23(d) Applicants who were recipients of medical assistance
or general assistance
4.24medical care within one month of application must meet the provisions of this subdivision
4.25and subdivision 2.
4.26(e) Cost-effective health insurance that was paid for by medical assistance is not
4.27considered health coverage for purposes of the four-month requirement under this
4.28section, except if the insurance continued after medical assistance no longer considered it
4.29cost-effective or after medical assistance closed."
4.30Renumber the sections in sequence and correct the internal references
4.31Amend the title accordingly