Minnesota Academy of Family Physicians (MAFP) lobbyist Dave Renner, CAE, shares an update on the legislative session, including the status of two budget bills, a conversion therapy ban, gender-affirming care protections and the Reproductive Freedom Defense Act.
House & Senate Pass Health Omnibus Budget Bill
On April 26, 2023, the Minnesota House passed the omnibus health budget bill on a 69-58 vote. A week prior, the Senate passed its version on a 35-32 vote margin.
Both bills address a number of MAFP priorities, including:
- language to repeal current statutes intended to obstruct access to reproductive health care services;
- language to update the All-Payer Claims Database to ensure the collection of non-claims-based payment information;
- grant funding to address health care worker safety;
- a two-year extension for coverage of audio-only telehealth;
- expansion of access to affordable health coverage (including increasing eligibility for MinnesotaCare from 200% to 250% of the federal poverty level, expanding coverage for undocumented Minnesotans, offering subsidies to purchase coverage with lower deductibles and planning to expand MinnesotaCare as a “public option” beginning in 2027); and
- creation of a Health Care Affordability Commission to establish and enforce health care spending limits (including efforts to increase the spending for primary care services with penalties for health care entities that are not compliant).
An MAFP priority included in the Senate bill but not the House: language to prohibit insurers and pharmacy benefit manufacturers from forcing a patient who is on a medication that is working for them to change medications during their contract year.
Another MAFP priority that is in the House bill but not the Senate: investments in growing the health care workforce through funding for a rural residency program, rural clinical training and loan forgiveness programs. The Senate workforce investments have a narrower impact, focusing mostly on the nursing workforce.
Other items in both bills include expanding Medical Assistance coverage for recuperative care services for Minnesotans experiences homelessness and an initiative to direct the Commissioner of Health to develop a statewide database for POLST (Provider Orders for Life Sustaining Treatment) forms.
Language differences will be reconciled in a conference committee of five senators and five representatives. The conference committee members include Representatives Tina Liebling (Rochester), Robert Bierman (Apple Valley), Dave Pinto (St. Paul), Heather Keeler (Moorhead) and Joe Schomacker (Luverne) and Senators Melissa Wiklund (Bloomington), Kelly Morrison, MD (Deephaven), Liz Bolden (Rochester), Robert Kupec (Moorhead) and Jim Abeler (Anoka.)
Two MAFP Priorities Included in Omnibus Commerce Bill
The omnibus commerce budget bill (SF 2744) includes two MAFP priorities:
- A study of ways to make primary care services free to patients. This is based on what was done during the pandemic by making COVID testing and vaccines free to patients. These services would still be covered by insurers that would be billed for services, but patients would not face any co-payments or co-insurance.
- A requirement for all health plans that provide coverage for alcoholism, mental health or chemical dependency care to provide reimbursement for the benefits delivered through the psychiatric Collaborative Care Model. This model is an evidence-based, integrated behavioral health service delivery method which includes a formal collaborative arrangement among a primary care team consisting of a primary care provider, care manager and psychiatric consultant.
While these provisions are identical in both the Senate and House bills, other differences will be reconciled by a conference committee of Senators Matt Klein, MD (Mendota Heights), July Seeberger (Woodbury) and Jordan Rasmusson (Fergus Falls), and Representatives Zack Stephenson (Coon Rapids), Carlie Kotyza-Wittuhn (Eden Prairie) and Tim O’Driscoll (Sartel).
Conversion Therapy Ban, Gender-Affirming Care & Reproductive Freedom Defense Act Signed into Law
Three bills were signed into law by Governor Tim Walz on April 27, 2023:
- HF 16 (Representative Hollins/Senator Dibble) prohibits the use of conversion therapy for individuals under the age of 18. The bill received bipartisan support in both the House and Senate floor votes. Similar legislation passed the Minnesota House in previous sessions, but never received a vote in the Senate until this year.
- HF 146 (Representative Finke/Senator Maye Quade) protects transgender people, their families and providers from legal repercussions if they travel to Minnesota for gender-affirming care. Specifically, the legislation prohibits enforcing out-of-state subpoenas, arrest warrants and extradition requests for those from other states who came to Minnesota to receive treatment.
- HF 366 (Representative Agbaje/Senator Morrison), also known as the Reproductive Freedom Defense Act, prevents state courts or officials from complying with extraditions, arrests or subpoenas related to care received in Minnesota. It also allows someone facing an abortion-related case against them in another state to countersue for associated costs, damages and attorney fees.
“Freedom is on the march in Minnesota. Decency is on the march on in Minnesota. Compassion is on the march in Minnesota,” Governor Walz said at the signing ceremony, “Hate and bigotry too are on the march, but we make very clear that march of bigotry and hate stops at Minnesota’s borders.”
All three laws were effective immediately.
Adult-Use Cannabis Passes Both Bodies
A bill legalizing adult-use cannabis passed the House and Senate floors last week and will now go to a conference committee to reconcile differences. The Governor previously indicated that he will sign the bill.