The 2023 Minnesota Legislative Session ended on Monday, May 22, two hours before the midnight deadline. In addition to passing a balanced budget for the next two-year period, the Minnesota Legislature passed many bills that the Minnesota Academy of Family Physicians (MAFP) strongly supports.
While this is being referred to as a historic session for the number of bills passed, it was clearly a good (policy) year for family physicians and their patients.
The status of many MAFP legislative priorities follows.
MAFP LEGISLATIVE PRIORITIES
Our 2023 legislative priorities included issues that the MAFP provided a leadership role in championing like:
- Updating the All-Payer Claims Database.
- Expanding and diversifying the primary care workforce and pipeline.
- Limiting mid-year formulary changes.
- Simplifying prior authorization processes.
The MAFP also continued to work with partners on advocacy around important issues impacting our patients and primary care, including reproductive health care, paid family leave, gun safety measures, gender-affirming care, non-compete clauses and more. See all 2023 legislative priorities.
What Passed:
All-Payer Claims Database Update and Primary Care Spending Study
(Health and Human Services (HHS) Omnibus Bill, page 106)
The All-Payer Claims Database (APCD) is the state’s research tool to review where health care dollars are spent. The APCD currently only collects data from insurance claims. The bill requires the state to 1) begin collecting non-claims-based data, like value-based payments, to provide a more accurate picture of health care spending and 2) study how much is spent on primary care services.
Single Payer Study and Public Option
(HHS Omnibus Bill, pages 697 and 701)
The HHS bill directs the Minnesota Commissioner of Health to study the benefits and costs of a legislative proposal for a universal health care financing system. The analysis must measure the performance of the proposed Minnesota Health Plan (single payer) and the current system related to coverage, benefit structure, underinsurance, system capacity and health care spending. A report is due January 15, 2026.
The bill also requires actuarial and economic analysis for implementation of a public option. This would allow Minnesotans to choose MinnesotaCare as a coverage option through MNSure. The analysis must include impacts on enrollment, the individual insurance market, provider reimbursement rates and the state budget. A report is due February 1, 2024, prior to a January 1, 2027, implementation of a public option.
Audio-Only Telehealth Coverage
(HHS Omnibus Bill, page 66)
Public and private coverage for audio-only telehealth services was extended until July 1, 2025, and the state will study the effectiveness of audio-only services.
Rural Health Care Workforce Funding
(HHS Omnibus Bill, pages 190, 191 and 193)
New funds have been allocated for the training of physicians and other health care professionals in rural and underserved areas and grants provided to augment existing clinical training programs that add rural or underserved rotations in primary care settings. Funding for a new primary care rural residency program has also been provided, along with grants to training sites for medical students and other health care professionals that train in health professional shortage areas.
Firearm Safety Measures
(Public Safety Omnibus Bill, pages 274 and 288)
The legislature passed two firearm safety measures: 1) An extension of current law that requires a criminal background check for the purchase of a firearm from a gun store to also apply to the private sale, transfer or sale at a gun show of a handgun or a semiautomatic military-style assault weapon. 2) The establishment of a process for a family member or law enforcement to petition the court for an extreme risk protection order (or “red flag law”) if a person is considered a risk to themselves or others, which, if granted, permits law enforcement to temporarily remove a firearm from that person.
Ban on Non-Compete Clauses
(Jobs Omnibus Bill, page 66)
The use of restrictive covenants, or non-compete clauses, in employment contracts are prohibited for contracts signed on or after July 1, 2023. This applies to all employment contracts, including those used for physicians. It does not prohibit the use of nondisclosure agreements or agreements designed to protect trade secrets, and employers can still restrict the access to “client or contact lists” used to solicit customers.
Study on Free Primary Care
(Commerce Omnibus Bill, page 8)
The Minnesota Commissioner of Commerce is directed to conduct a feasibility study on a proposal to offer free primary care to Minnesotans. The idea for this is based on how Minnesota navigated COVID testing and vaccines, which were covered by insurance with no cost-sharing for the patient. Removing cost-sharing reduces barriers for patients to receive the primary care and preventive services they need.
Psychiatric Collaborative Care Model
(Commerce Omnibus Bill, page 55)
Health plans that provide mental health and chemical dependency coverage must reimburse for the Psychiatric Collaborative Care Model, effective January 1, 2025. This is a federal model that includes a primary care provider, care manager and psychiatrist consultant.
Paid Family and Medical Leave
(House File 2)
Beginning January 1, 2026, the state will require employers to offer paid family and medical leave to their employees. Each employee may take up to 12 weeks of family leave to care for a family member and 12 weeks of medical leave for a pregnancy or serious health condition. The maximum combined leave can be no more than 20 weeks in a year. Employers will pay a new payroll tax of .7%, which cannot be raised higher than 1.2% in the future.
Reproductive Health Care Protections
(House File 1)
A top priority for the legislature this year was to ensure continued access for reproductive health care services, including abortion. One of the first bills passed was HF 1, which states that “every individual has a fundamental right to make autonomous decisions about the individual’s own reproductive health, including the fundamental right to use or refuse reproductive health care.” In addition, bills were passed to protect patients from other states, and the providers who care for them, who come to Minnesota for abortion care, and the legislature also expanded coverage to include postpartum long-acting reversible contraception.
Gender-Affirming Care
(House File 146)
This legislation protects children who come to Minnesota to receive gender-affirming care from extradition to their home state if that state prohibits these services.
What Didn’t Pass:
Limits on Mid-Year Formulary Changes
The one MAFP priority that did not pass this year was prohibition on insurers and pharmacy benefit managers (PBMs) from forcing a patient who is on a medication that is working for them to change medications during the middle of their contract year because the insurer or PBM received a financial incentive to change their covered drugs. This was omitted from the final HHS bill because of the large cost projected for state employee coverage.
Thank you to MAFP members and leaders, especially outgoing President Alex Vosooney, MD, and the MAFP Legislative Committee, chaired by Nicole Chaisson, MD, MPH, for their testimonies, letters and advocacy on behalf of patients and family medicine.