Minnesota Academy of Family Physicians (MAFP) lobbyist Dave Renner, CAE, shares an update on the start of the 2024 legislative session.
Back in Session
It’s a non-budget year. Minnesota lawmakers reconvened on February 12, 2024. This is the second year of the biennium (budget cycle), which is the “short” session that typically focuses on policy and bonding proposals. Since it’s an even-numbered year, the session is one month shorter than odd-numbered years. The legislature is required by the Minnesota Constitution to adjourn no later than May 20, 2024.
Spending will be limited. The state has a $2.4 billion budget surplus. A supplemental budget proposal is likely; however, additional spending is expected to be limited due to projections of future state shortfalls.
The Democrats maintain a small majority in both bodies. Representative Melissa Hortman (DFL-Brooklyn Park) remains as Speaker of the House. Senator Erin Murphy (DFL-St. Paul) was selected as the new Majority Leader.
MAFP Legislative Priorities
Issues we’re championing:
- Increasing investment in primary care through Medicaid reimbursement rate increases and incremental primary care spending goals.
- Expanding and diversifying the primary care workforce and pipeline by increasing training opportunities for family physicians in rural and underserved areas through rural training tracks, grants to support medical education and the expansion of loan forgiveness programs.
- Limiting mid-year formulary changes and simplifying prior authorization processes.
Issues we’re collaborating on:
The MAFP will continue to work with partners to influence important issues impacting patients and family medicine, including (but not limited to):
- Harm reduction and decriminalization of drug use.
- Increasing access to care and affordability of prescription drugs.
- Removing slavery from the Minnesota constitution and penal system.
Read more about our legislative priorities.
Prior Authorization Reform: Legislation Passes First Committee
Legislation—HF 3578 (Representative Kristin Bahner, DFL-Maple Grove)—to limit the use of prior authorization for critical health care treatments was the first bill heard in the Minnesota House Health Finance and Policy Committee, this session.
HF 3578 prohibits prior authorization for services deemed too important to delay:
- Medications to treat substance use disorders.
- Outpatient mental health treatment.
- Treatments to fight cancer (consistent with national cancer-care guidelines).
- Generic drugs deemed therapeutically equivalent by the Food and Drug Administration.
- Preventive services recommended by the U.S. Preventive Services Task Force.
- Pediatric hospice services and neonatal abstinence programs.
- Treatments covered through value-based arrangements.
Additionally, the legislation limits prior authorization requirements for chronic conditions to one-time only and directs the Minnesota Commissioner of Commerce to develop a “gold card” program for physicians with prior authorization approval rates above the seventieth percentile.
MAFP member and Minnesota Medical Association President Laurel Ries, MD, testified in support of the bill: “Death of a thousand cuts used to be a form of torture. Now it is a way of life with prior authorization. Prior authorization, when recommended medical care must be pre-approved by health plans, is a leading dissatisfier for patients and providers alike.”
In a letter to the House Health Finance and Policy Committee, MAFP President Bob Jeske, MD, wrote, “Every family physician has countless stories of the detrimental delays caused by prior authorizations, and it is a major driver of physician as well as health care team burnout. These delays result in patients being denied access to vital medications…in addition to delaying discovery of life-altering diagnoses.”
HF 3578 passed on a strong voice vote and was referred to the Minnesota House Commerce Finance and Policy Committee, and the Senate companion bill, SF 3532, authored by Senator Kelly Morrison, MD (DFL-Deephaven), was referred to the Minnesota Senate Commerce and Consumer Protection Committee.
Childcare Vaccine Legislation
A bill—SF 610 (Senator Liz Boldon, DFL-Rochester)—to allow childcare centers and family childcare programs to require children older than two months to be fully vaccinated, unless there is a medical exemption, was heard by the Minnesota Senate Health and Human Services Committee.
In an MAFP letter of support submitted to the committee, MAFP President Bob Jeske, MD, wrote, “Part of [our] work is helping our patients understand the importance of immunizations and the collective impact that being immunized has on our communities. Vaccinations are one of the most effective, highest yield medical breakthroughs. Since the advent of vaccines, innumerable illnesses have been averted; hospitalizations prevented; and lives saved. Vaccination remains one of the most important, effective public health tools at reducing, and in some cases even eliminating, communicable diseases.”
According to a report from the Minnesota Department of Health from the 2022-2023 school year, just under 90% of all children entering public school kindergarten were fully vaccinated, 82% for private schools and 73% for charter schools. The rates of parents using non-medical exemptions ranged from 4% to 10%.
Minnesota law currently allows parents to express a conscientious objection to vaccines for any reason. This loophole makes Minnesota’s childhood immunization laws among the weakest in the country and is a primary cause for the below-average vaccination rates in our state.
SF 610 was approved for possible inclusion in a future omnibus bill. The House companion bill, HF 367, has yet to be heard by the Minnesota House Children and Families Finance and Policy Committee.
Physician Wellness Bill
Legislation—SF 3531—to support physician well-being and mental health was introduced in the Minnesota Senate by Senator Kelly Morrison, MD (DFL-Deephaven).
SF 3531 would prohibit health system credentialing applications from inquiring about an applicant’s past health conditions, making the argument that these questions have no impact on a physician’s ability to practice, are intrusive and discourage physicians from seeking treatment.
Additionally, the bill would create:
- a program through which physicians can seek and obtain confidential care for career fatigue and wellness in a way that will not impact their careers.
- a statewide wellness recognition program to publicly recognize Minnesota health care institutions that have committed to creating and sustaining positive work environments that prevent burnout, foster professional well-being and support quality care.
SF 3531 includes a one-time investment into a statewide campaign to educate the health care workforce about the importance of clinician well-being, encourage physicians to get care when needed and reduce the stigma of mental health treatment.
The bill was referred to the Senate Health and Human Services Committee and has yet to be introduced in the Minnesota House of Representatives.
End-of-Life Option Act
The Minnesota Legislature is considering SF 1813/HF 1930, known as the End-of-Life Option Act. This bill authorizes the practice referred to as medical aid in dying for those who are in the last six months of life. It would establish guardrails, similar to those that exist in Oregon and 10 other states, including requiring that it be a voluntary decision by the patient and that no physician be required to participate.
The Minnesota House Health Finance and Policy Committee held a pre-session hearing on January 25, 2024, on the bill that included over 70 public testifiers (including physicians), both in support and in opposition.
Following the testimony, the committee passed the bill and re-referred it to the Minnesota House Public Safety Finance and Policy Committee. The bill has not received any hearings in the Senate, and it is not clear whether they have the votes to pass it.
Public Option Report
In 2023, the Minnesota Legislature directed the Minnesota Department of Human Services to do an actuarial analysis on public option models to evaluate the financial impact of establishing a public option. The report, Public Option Study, was released on January 30, 2024.
While there remains support among legislators to move forward with a public option, the estimated cost to implement this is between $943 million and $1.26 billion per year. With most legislative leaders saying there will be little new spending this year, it is unlikely that this will move forward at this time.
Ways You Can Take Action
- Attend Physicians’ Day at the Capitol: On February 28, 2024, the MAFP will host a lunch for family physicians, family medicine residents and medical students, which will include a message from MAFP member and Senator Alice Mann, MD, MPH. After lunch, we will join the Minnesota Medical Association and physician colleagues from across Minnesota for afternoon legislative meetings. mafp.org/event/pdac24
- Access Our Advocacy Modules: Get quick tips, watch short videos and find links to additional resources to help you prepare for legislative visits, use social media for advocacy and more: mafp.org/advocacy-modules.
- Follow Us Online: We regularly post updates and share legislative calls to action across our social media channels and via our advocacy blog.
Questions? Want more info on how you can get plugged into MAFP advocacy? Email office@mafp.org.