SF 2859 requires the Commissioner of Human Services to seek federal authority to allow individuals with income above the maximum income eligibility level for the MinnesotaCare program to purchase coverage through the MinnesotaCare program.  As part of the waiver, the commissioner shall also seek authority to permit individuals who are eligible for advanced tax credits and cost-sharing credits to use these credits to purchase the MinnesotaCare purchase option.  The commissioner shall also request as part of the waiver authority to permit the MinnesotaCare purchase option to be offered through MNsure as a coverage option and to be compared with the qualified health plans offered through MNsure.

SF 2859 requires the commissioner to coordinate the administration of the MinnesotaCare purchase option with the MinnesotaCare program to maximize efficiency and improve continuity of care.  The MinnesotaCare purchase option must include, at the minimum, the following:  (1) an annual per enrollee premium rate similar to the average rate paid to managed care plans under section 256L.12; (2) a benefit set equal to the MinnesotaCare benefits; (3) limited annual enrollment coordinated with the same annual enrollment periods established for MNsure; (4) ability of the commissioner to adjust the purchase option’s actuarial value to a value no lower than 87 percent; (5) reimbursement mechanisms to address potential reductions in revenue for MNSure operations; and (6) reimbursement mechanisms to address potential increased costs to the MinnesotaCare program.

The commissioner shall report to the legislature on the progress of receiving federal approval and the results from the actuarial and economic analyses that are required for the waiver proposal by March 1, 2017.  Any implementation of the waiver that requires state financial contribution shall be contingent on further legislative action to approve of the state’s contribution.

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