Minnesota Academy of Family Physicians (MAFP) lobbyist Dave Renner, CAE, shares an update on the 2024 legislative session, including the status of bills on statewide health standards for schools, childhood vaccination, firearm safety, insurance coverage of in vitro fertilization, prior authorization and physician wellness.
State Budget Targets Released
Most of the legislative work ahead, this session, will be developing and passing supplemental budget bills. To facilitate that process, Minnesota House and Senate leaders and Governor Tim Walz agreed to budget targets on March 22, 2024, that add $477.5 million to the 2024-2025 biennial budget and $62.7 million for the next fiscal biennium.
These budget targets set the spending limits for each finance committee. For the Health and Human Services Committee, the target for new spending is just under $5 million.
The comparatively low health and human services target may hinder bills with large costs. To pass something this legislative session, bill authors will need to consider revisions to lower the fiscal impact to the state.
Although Minnesota Management and Budget forecasted a $3.7 billion budget surplus in February 2024, state leaders have been reluctant to pass any new spending measures due to an anticipated structural imbalance in future years.
Statewide Health Education Standards for Schools
The Statewide Health Education Standards Act, SF 3746 (Senator Kunesh, DFL – New Brighton) and HF 3682 (Representative Kotyza-Witthuhn, DFL – Eden Prairie), which will establish a state health standard for every public school, is on track to passing this year. Currently, the health curriculum in public schools is set at the local level.
The legislation has been criticized by Republicans who have argued the standards should be decided at the local level, rather than statewide. Supporters continue to argue that the bill will help ensure consistent access to health education in every corner of the state.
Bill Status: The bill has passed the Education Finance and Policy committees in both bodies and has been laid over for inclusion in an education omnibus bill.
Childhood Vaccination Legislation Heard in Both Bodies
The House Children and Families Finance and Policy Committee passed HF 367 (Representative Freiberg, DFL – Minneapolis)—a bill that would allow childcare facilities to require that children meet certain vaccination requirements to be accepted into their program. While the bill does not remove a parent’s right to opt out of childhood vaccine requirements, it would allow a childcare center to require adherence to all recommended vaccines to enroll in their program.
Proponents argued that this bill will increase childhood vaccination rates, which have decreased in recent years. Minnesota’s kindergartners have immunization rates below the national average. According to a report from the Minnesota Department of Health from the 2022-2023 school year, only 89% of kindergarten students entering public school were fully vaccinated.
HF 367 aims to reverse the decline. Most childhood vaccinations and boosters occur between 2 months of age and 2 years of age. By removing the non-medical exemption for childcare centers and family childcare programs, the rates of fully vaccinated children in communities will increase.
Minnesota’s weak vaccination laws have been a primary driver for Minnesota’s lower vaccination rates. Current Minnesota law allows parents to express a conscientious objection to vaccines for any reason.
Bill Status: The Senate companion bill, SF 610 (Senator Bolden, DFL – Rochester), was already heard in the Health and Human Services Committee earlier this session. The House bill is also on track to passing, following a party-line vote, in the House Children and Families Finance and Policy Committee.
Firearm Safety Legislation Moving in Both Bodies
Two firearm safety bills are working their way through the Capitol.
Safe Storage
On March 22, 2024, the Senate Judiciary Committee heard and passed SF 4312 (Senator Gustafson, DFL – Vadnais Heights), which would require that firearms be secured with a locking device, unloaded and kept separately from ammunition.
The MAFP submitted a letter of support for the bill. MAFP President Bob Jeske, MD, wrote: “Mandated safe storage of firearms is a commonsense solution for preventing firearm related deaths, accidents and suicides and protecting all Minnesotans. As a hunter who owns firearms, I already take these steps to safely store my firearms and help protect my family.”
According to the Centers for Disease Control and Prevention, death by firearm is the leading cause of death for children in the U.S.
- On average, 22 children and young adults die each day from firearm injuries.
- National studies have found that up to 32% of youth firearm deaths by firearm injury could be prevented if household firearms were properly secured in accordance with standard firearm safety practices.
- Among children younger than 15 years old, unintentional shooting deaths have reduced by 23% in states with safe storage laws.
Reporting Lost or Stolen Firearms
The committee also heard and passed SF 606 (Senator Westlin, DFL – Plymouth), which would require that lost or stolen firearms be reported to law enforcement within 48 hours.
In 2023, the Minnesota Legislature passed significant firearm safety legislation, including universal background checks for firearm exchanges and the authorization of extreme risk protection orders, otherwise known as “red flag” laws. Safe storage requirements and mandatory reporting of lost or stolen firearms did not pass in 2023 but are on track to pass in 2024.
Bill Status: SF 4312 and SF 606 were referred to the Finance Committee—the last committee stop before a floor vote. Both bills’ House companions are also moving towards passage.
MAFP Supports Mandating Coverage for In Vitro Fertilization
The MAFP supports SF 1704 (Senator Maye Quade, DFL – Apple Valley), the Minnesota Building Families Act, which mandates insurance coverage of in vitro fertilization (IVF) services.
Supporters testified that one in seven women have trouble getting pregnant or carrying a baby to term and, as a result, turn to alternatives such as IVF. However, Minnesota is 1 of 29 states that doesn’t require insurance carriers to cover those costs. While some employer-based plans cover IVF, it is not required, and tens of thousands of families experience infertility with no coverage.
Bill Status: The Senate Health and Human Services Committee laid the bill over for inclusion in a Senate health omnibus bill. The companion bill, HF 1658 (Representative Brand, DFL – St. Peter), is also on track for inclusion in a House health omnibus bill.
Support for Prior Authorization Reform Remains Strong
Legislation to reduce the burden of prior authorization for critical health care services remains strong (see our most recent legislative update on prior authorization).
In the last Senate hearing, the bill received bipartisan support and will now be considered a part of the Health and Human Services omnibus bill. While there have been no formal fiscal notes for the bill yet, preliminary estimates show large costs to state programs related to medications.
Because the state receives hundreds of millions of dollars each year in drug rebates from pharmaceutical manufacturers, bills that allow patients to access drugs that are not on the preferred drug lists results in loss of those rebate dollars, even if the drug on the preferred drug list is not the best one for the patient.
Bill Status: The bill authors are reviewing options to reduce the cost of the bill and pass protections for patients to access the care they need.
Physician Wellness Legislation Passed Senate Judiciary Committee
A bill, SF 3531, to improve physician wellness went before its second committee in the Senate on March 27, 2024.
“Our physicians are in trouble. Burnout for health care professionals is a real problem that is getting worse,” said Senator Kelly Morrison, MD, the bill’s chief author. Morrison cited that 6 in 10 physicians have experienced symptoms of burnout; 1 in 3 have felt hopelessness or that they have no purpose; and more than half know another physician who has considered, attempted or died by suicide.
The legislation has four parts:
- Prohibits health system credentialing applications from inquiring about an applicant’s past health conditions.
- Creates a program through which physicians can seek and obtain professional help to address career fatigue and wellness, confidentially.
- Develops 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.
- Includes a one-time investment in 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.
Bill Status: The bill previously passed the Senate Health and Human Services Committee with bipartisan support. In the Judiciary Committee, there was comparatively little discussion on the legislation before the committee passed it unanimously and referred it back to the Health and Human Services Committee to evaluate fiscal appropriations in the bill for possible inclusion in their Health and Human Services omnibus bill.
Posted by: Emie Buege, MAFP social media manager