1.1                          A bill for an act
  1.2             relating to health; allowing payments to be made for 
  1.3             the employee share of employer-subsidized insurance 
  1.4             for children; requiring the commissioner of human 
  1.5             services to submit a plan to obtain funding under the 
  1.6             state children's health insurance program; amending 
  1.7             Minnesota Statutes 1997 Supplement, section 256L.07, 
  1.8             subdivisions 2 and 3; proposing coding for new law as 
  1.9             Minnesota Statutes, chapter 256M. 
  1.10  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.11     Section 1.  Minnesota Statutes 1997 Supplement, section 
  1.12  256L.07, subdivision 2, is amended to read: 
  1.13     Subd. 2.  [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 
  1.14  COVERAGE.] (a) To be eligible for subsidized premium payments 
  1.15  based on a sliding scale, a family or individual must not have 
  1.16  access to subsidized health coverage through an employer, and 
  1.17  must not have had access to subsidized health coverage through 
  1.18  an employer for the 18 months prior to application for 
  1.19  subsidized coverage under the MinnesotaCare program.  The 
  1.20  requirement that the family or individual must not have had 
  1.21  access to employer-subsidized coverage during the previous 18 
  1.22  months does not apply if:  (1) employer-subsidized coverage was 
  1.23  lost due to the death of an employee or divorce; (2) 
  1.24  employer-subsidized coverage was lost because an individual 
  1.25  became ineligible for coverage as a child or dependent; or (3) 
  1.26  employer-subsidized coverage was lost for reasons that would not 
  1.27  disqualify the individual for unemployment benefits under 
  2.1   section 268.09 and the family or individual has not had access 
  2.2   to employer-subsidized coverage since the loss of coverage.  If 
  2.3   employer-subsidized coverage was lost for reasons that 
  2.4   disqualify an individual for unemployment benefits under section 
  2.5   268.09, children of that individual are exempt from the 
  2.6   requirement of no access to employer subsidized coverage for the 
  2.7   18 months prior to application, as long as the children have not 
  2.8   had access to employer subsidized coverage since the 
  2.9   disqualifying event.  The requirement that the family or 
  2.10  individual must not have had access to employer-subsidized 
  2.11  coverage during the previous 18 months does apply if 
  2.12  employer-subsidized coverage is lost due to an employer 
  2.13  terminating health care coverage as an employee benefit, unless 
  2.14  that coverage was provided under section 256M.03.  
  2.15     (b) For purposes of this requirement, subsidized health 
  2.16  coverage means health coverage for which the employer pays at 
  2.17  least 50 percent of the cost of coverage for the employee, 
  2.18  excluding dependent coverage, or a higher percentage as 
  2.19  specified by the commissioner.  Children are eligible for 
  2.20  employer-subsidized coverage through either parent, including 
  2.21  the noncustodial parent.  The commissioner must treat employer 
  2.22  contributions to Internal Revenue Code Section 125 plans as 
  2.23  qualified employer subsidies toward the cost of health coverage 
  2.24  for employees for purposes of this subdivision. 
  2.25     Sec. 2.  Minnesota Statutes 1997 Supplement, section 
  2.26  256L.07, subdivision 3, is amended to read: 
  2.27     Subd. 3.  [PERIOD UNINSURED.] To be eligible for subsidized 
  2.28  premium payments based on a sliding scale, families and 
  2.29  individuals initially enrolled in the MinnesotaCare program 
  2.30  under section 256L.04, subdivisions 5 and 7, must have had no 
  2.31  health coverage for at least four months prior to application.  
  2.32  The commissioner may change this eligibility criterion for 
  2.33  sliding scale premiums in order to remain within the limits of 
  2.34  available appropriations.  The requirement of at least four 
  2.35  months of no health coverage prior to application for the 
  2.36  MinnesotaCare program does not apply to: 
  3.1      (1) families, children, and individuals who apply for the 
  3.2   MinnesotaCare program upon termination from or as required by 
  3.3   the medical assistance program, general assistance medical care 
  3.4   program, or coverage under a regional demonstration project for 
  3.5   the uninsured funded under section 256B.73, the Hennepin county 
  3.6   assured care program, or the Group Health, Inc., community 
  3.7   health plan; 
  3.8      (2) families and individuals initially enrolled under 
  3.9   section 256L.04, subdivisions 1, paragraph (a), and 3; 
  3.10     (3) children enrolled pursuant to Laws 1992, chapter 549, 
  3.11  article 4, section 17; or 
  3.12     (4) individuals currently serving or who have served in the 
  3.13  military reserves, and dependents of these individuals, if these 
  3.14  individuals:  (i) reapply for MinnesotaCare coverage after a 
  3.15  period of active military service during which they had been 
  3.16  covered by the Civilian Health and Medical Program of the 
  3.17  Uniformed Services (CHAMPUS); (ii) were covered under 
  3.18  MinnesotaCare immediately prior to obtaining coverage under 
  3.19  CHAMPUS; and (iii) have maintained continuous coverage; or 
  3.20     (5) children who lose coverage under section 256M.03 due to 
  3.21  an employer terminating health coverage as an employee benefit 
  3.22  or due to an employee layoff. 
  3.23     Sec. 3.  [256M.01] [DEFINITIONS.] 
  3.24     Subdivision 1.  [APPLICABILITY.] For purposes of this 
  3.25  chapter, the terms defined in this section have the meanings 
  3.26  given. 
  3.27     Subd. 2.  [COMMISSIONER.] "Commissioner" means the 
  3.28  commissioner of human services. 
  3.29     Subd. 3.  [EMPLOYER-SUBSIDIZED 
  3.30  INSURANCE.] "Employer-subsidized insurance" has the meaning 
  3.31  provided in section 256L.07, subdivision 2. 
  3.32     Sec. 4.  [256M.03] [COVERAGE OF CHILDREN INELIGIBLE FOR 
  3.33  MINNESOTACARE.] 
  3.34     Subdivision 1.  [PAYMENTS FOR EMPLOYER-SUBSIDIZED 
  3.35  COVERAGE.] A child who would otherwise be eligible for coverage 
  3.36  under MinnesotaCare, except for the availability of 
  4.1   employer-subsidized coverage, is eligible for payment of the 
  4.2   employee share of employer-subsidized coverage for the child 
  4.3   under the state children's health insurance program, according 
  4.4   to the sliding scale in subdivision 2.  In order to be eligible 
  4.5   under this subdivision, a child must not have 
  4.6   employer-subsidized coverage at the time of application for 
  4.7   payment, and the employer-subsidized coverage must qualify as 
  4.8   benchmark coverage or benchmark equivalent coverage under title 
  4.9   21 of the Social Security Act, section 2103.  Payments shall be 
  4.10  made directly to the employer providing employer-subsidized 
  4.11  insurance. 
  4.12     Subd. 2.  [SLIDING SCALE PAYMENTS.] The commissioner shall 
  4.13  determine payment levels under subdivision 1 using a sliding 
  4.14  scale based upon household income.  The sliding scale must pay a 
  4.15  higher proportion of the cost of dependent coverage for each 
  4.16  child as household income decreases, subject to a maximum 
  4.17  payment limit of 80 percent of the employee cost for 
  4.18  employer-subsidized coverage for the child.  Aggregate 
  4.19  cost-sharing, including premium payments, for children eligible 
  4.20  under this section shall be consistent with the cost-sharing 
  4.21  limits specified in title 21 of the Social Security Act, section 
  4.22  2103(e)(3). 
  4.23     Subd. 3.  [LIMITATION.] The availability of payments under 
  4.24  this section is subject to the limits of available 
  4.25  appropriations.  The commissioner may set limits on the number 
  4.26  of children receiving payments under this section, or modify 
  4.27  payment levels, in order to remain within the limits of 
  4.28  appropriations. 
  4.29     Subd. 4.  [ADVISORY TASK FORCE.] The commissioner shall 
  4.30  convene an advisory task force comprised of representatives of 
  4.31  small businesses, health plan companies, and insurance agents in 
  4.32  order to develop a plan to implement this section. 
  4.33     Sec. 5.  [256M.05] [MAINTENANCE OF EMPLOYER SUBSIDY.] 
  4.34     Employers providing employer-subsidized coverage to 
  4.35  employees who receive payments on behalf of an employee eligible 
  4.36  under section 256M.03, subdivision 1, shall maintain at least 
  5.1   the same percentage level of subsidy for employee and family 
  5.2   coverage that was in place on July 1, 1998, for a period of one 
  5.3   year following receipt of the initial payment for an eligible 
  5.4   employee.  After the initial year, an employer may not decrease 
  5.5   the percentage level of subsidy to employee and family coverage 
  5.6   by more than five percentage points. 
  5.7      Sec. 6.  [SUBMITTAL OF PLAN TO ACCESS STATE CHILDREN'S 
  5.8   HEALTH INSURANCE FUNDING.] 
  5.9      The commissioner of human services shall submit a plan to 
  5.10  implement Minnesota Statutes, sections 256M.01 to 256M.05, to 
  5.11  the secretary of health and human services by July 1, 1998, in 
  5.12  order to obtain funding through the state children's health 
  5.13  insurance program established in title 21 of the Social Security 
  5.14  Act.  The commissioner shall also request a waiver to purchase 
  5.15  family coverage as specified in title 21 of the Social Security 
  5.16  Act, section 2105(c)(3).  Upon approval of the waiver, the 
  5.17  commissioner shall expand the definition of those eligible for 
  5.18  coverage under Minnesota Statutes, section 256M.03, to include 
  5.19  all adults eligible for coverage under the employee's policy. 
  5.20     Sec. 7.  [EFFECTIVE DATE.] 
  5.21     Sections 1 to 5 are effective only if federal funding under 
  5.22  the state children's health insurance program is made available 
  5.23  to the state.  If the funding is made available, sections 1 to 5 
  5.24  are effective on the date specified in the state plan.  The 
  5.25  commissioner of human services shall publish a notice in the 
  5.26  State Register if federal funding is made available to implement 
  5.27  sections 1 to 5 and shall notify the revisor of statutes.  
  5.28  Section 6 is effective the day following final enactment.