Our legislative rep Dave Renner, CAE, shares an update on the status of primary care payment reform, gives a recap on recent bills introduced that would interfere with vaccine access, shares more on what we’re following with the Governor’s budget proposal as well as provides updates on frontline worker pay and workers’ compensation legislation.
Primary Care Payment Reform Update
The Minnesota Academy of Family Physicians (MAFP) continues to promote updates to the state’s All-Payer Claims Database (APCD) to:
- better understand how health care is paid for in Minnesota.
- provide the needed data to continue to transform our health care payment system from one that rewards volume to one that rewards value and better health.
The legislation, which arose from discussions with a broader primary care stakeholder group, will:
- authorize the Minnesota Department of Health to collect non-claims, value-based payment data from all health plans.
- direct the department to report the percent of health care claims that are paid for primary care services and the percent that go to all other services.
Representative Jennifer Schultz (DFL-Duluth) and Senator Carla Nelson (R-Rochester) are working to introduce the bill soon.
The MAFP has had discussions with the Minnesota Department of Health and Governor Walz’s office to encourage them to support this legislation that will provide policy makers with the information they need to move further payment reforms.
Multiple Bills Introduced That Would Interfere With Vaccine Access
Several bills that increase barriers to vaccine access have been introduced:
- Senator Bruce Anderson (R-Buffalo) introduced SF2607, which would require health care providers to provide a new list of specific disclosures to the patient before administering a vaccine. Presented as improving informed consent, the impact would be to dissuade the patient from getting vaccinated. Providers would be required to disclose “that the health care provider administering the vaccine is not liable for harm to the patient caused by the vaccine or its administration,” and “that the patient or the patient’s parent or guardian, if the patient is a minor, may decline some or all vaccines,” among other similar disclosures. The bill also includes a lengthy “Vaccine Consent Form,” to be filled out for every vaccine administered.
- Senator Andrew Mathews (R-Princeton) introduced SF2820, which would prohibit enforcement of government vaccine mandates.
- Representative Eric Lucero (R-St. Michael) introduced HF2694, which would allow proof of presence of natural antibodies as an alternative to vaccination against COVID-19, a practice contradicting the Centers for Disease Control and Prevention public health guidelines.
- Representative Tim Miller (R-Prinsburg) introduced HF2834, which would require a provider to notify a patient whether a vaccine is developed or manufactured using aborted fetal tissue. This is in response to critics who believe the use of such vaccines conflict with certain religious beliefs.
Other bills outlaw governments from enforcing facemask requirements, prescribing distance between customers in private businesses and showing proof of vaccination to enter private businesses.
It is unclear whether any of these bills will receive a hearing this session; but, if they do, it is not likely any would pass into law.
MinnesotaCare Buy-in Program and More Included in Governor’s Budget Proposal
Governor Tim Walz’s supplemental budget proposal includes $2.5 billion for health and safety—the MAFP is following a number of the health care initiatives.
One request is for $145.7 million to create a MinnesotaCare buy-in program intended to expand health care access. This is sometimes referred to as a “public option” to allow MinnesotaCare to be sold as an option on the MNSure site.
Further, the Governor recommends changing Medical Assistance (MA) eligibility for children under 21 to offer 12 months of continuous coverage. This allows children to retain coverage for 12 months until they turn 21. At the end of the 12-month period, the child’s eligibility will be re-determined following standard MA eligibility.
The Governor also recommends funding to conduct a feasibility study on a proposal to offer free primary care to Minnesotans. This study will look at how the proposal could be structured and will include an actuarial analysis; evaluations on the impact to provider billing and reimbursement and to Minnesota’s existing goals to improve health care access; an evaluation on how it would interact with state and federal laws; and an estimated program cost.
The Governor also recommends the implementation of a comprehensive approach to address rising health care costs. This includes four separate initiatives to improve health care affordability:
- establishment of a health care spending target program.
- expansion of the prescription price transparency initiative.
- creation of an evidence base for the development of policy initiatives to constrain growth in spending.
- assessment of readiness of rural communities to participate in value-based payment arrangements: The MAFP APCD bill may assist with this fourth component.
Legislative committees are beginning to hold hearings to better understand the details of the Governor’s proposals.
Frontline Worker Pay
At the end of the 2021 legislative session, a legislative working group was tasked with developing a recommendation for $250 million, which was set-aside for the state’s frontline workers who were deemed essential during the COVID-19 pandemic. The recommendation was due by September 6, 2021, with the intent that the Governor would call a special session and both bodies would pass the working group’s recommendation. The deadline came and went; the working group had not reached a compromise; and no special session was called.
The legislature is taking that issue up again and took public testimony on a House proposal to increase the fund to $1 billion that would send $1,500 bonuses to 667,000 eligible people, including workers in health care, long-term care, emergency services, schools, childcare, hospitality and retail. The Senate’s proposal does not use state dollars, but rather $250 million to a narrower list of mostly health care workers.
First Bill Signed Includes Workers’ Compensation
Governor Walz signed legislation that renews a measure passed last year to allow some frontline workers to qualify for workers’ compensation if they contract COVID-19 on the job.
The bipartisan bill, HF1203, introduced by Senator Jeff Howe (R-Rockville) and Representative Dan Wolgamott (DFL-St. Cloud), is the first of the session to pass, and will impact more than 180,000 workers, including those in health care and long-term care. The previous measure expired at the end of 2021.
