Health and Human Services (HHS) Omnibus Budget Bill
A historic HHS budget bill passed the Legislature during the June special session, appropriating over $16 billion in general fund spending on investments to support families and individuals across Minnesota. An influx in federal money helped the state appropriate additional resources for childcare, home-and community-based services, and resources for mental health care and substance abuse treatment. With a strong focus on families, children, and individuals with disabilities, this bill is a vast improvement from the original Senate position. Along with a zero-budget target, the Senate Republican omnibus bill included several controversial positions like abortion restrictions and underfunding our state health and human services agencies, all of which were taken out of the final bill. (HF 33)
Notable items in HF 33 include:
Twelve months of postpartum Medical Assistance (MA) coverage
In Minnesota, women who qualify for MA due to pregnancy only receive coverage for 60 days postpartum. Loss of health coverage so soon after birth has contributed to disparities in postpartum mental and physical health among mothers of color, American Indian mothers, and low-income mothers. Extending this to 12 months will support continuous care and address disparities maternal morbidity and mortality.
Minnesota Family Investment Program (MFIP) onetime payments and annual adjustment
Federal dollars are leveraged in this bill to administer a one-time, $435 payment to over 32,000 enrolled families. Most of these families were ineligible for state and federal unemployment payments despite having been seriously impacted by the COVID-19 pandemic. In addition, a mix of state and federal dollars will provide an annual cost of living adjustment to MFIP, based on the consumer price index (CPI). The MFIP cash benefit has only been increased once in the past 35 years; an annual adjustment makes sure that families living in poverty have support that better reflects their needs.
Childcare investments
Childcare has been the backbone of our economy long before the COVID-19 pandemic; DFLers pushed for continued investments to increase access to care and to offer sustainable resources for providers who regularly operate at thin margins. Federal dollars are used to increase the childcare assistance program (CCAP) rates to the 40th percentile of the 2021 provider survey for infants and toddlers, 30th percentile for preschool and school aged. In addition, this bill allocates over $300 million in other federal funding is allocated for childcare initiatives to revitalize and support the childcare industry.
Dignity in Pregnancy and Childbirth Act
In Minnesota, black women are over twice as likely to die of pregnancy or childbirth related causes than their white counterparts, and the Native American maternal mortality rate is about four times higher. Disparities in these areas cannot be explained by a women’s socio-economic status, education, or general health, proving that change is needed in the way prenatal and obstetric care is provided. This bill will require hospitals with obstetric care and birth centers to provide continuing education on anti-racism and implicit bias to health care workers, direct our state health department to address barriers to midwife and doula services, and identify steps to diversify the midwifery/doula workforce to work on reducing these disparities.
PCA and home care rate increases
A major difficulty of the PCA program is a workforce shortage and high turnover as funding has struggled to keep pace with the program’s needs. Along with a 15% rate increase for PCAs that reflects the SEIU contract agreement, this bill creates a new payment methodology and applies it to a range of PCA services and the upcoming “Community First Services and Supports” that begin this fall. In addition, home health care providers will also see a rate increase under this bill.
Increased funding for homelessness supports
This bill includes additional funding for emergency services program grants, a flexible funding source that supports homelessness providers, emergency shelter grants to increase Minnesota’s shelter bed capacity, and community living infrastructure grants aimed at helping people with disabilities with housing instability get and retain housing.
New grants and services for individuals with disabilities
Additional dollars available for home-and community-based services resulting from a recent federal relief bill will have a huge impact for people with disabilities. Funding to help people move from provider-controlled settings to independent settings, creating incentives and provider grants to increase the direct care workforce, initiatives to shift service models from congregate care and subminimum wage settings, and increasing grants focused on respite care providers are all included in this bill.
Minnesota Telehealth Act
The Legislature loosened certain restrictions last year to make sure people could access the care they needed from their home during the pandemic. This bill includes an update to our state’s telehealth laws throughout the health and social services sectors, and an expansion to allow more providers to utilize telehealth. While this is a big step towards modernizing our telehealth laws, more updates will be needed in the years to come as providers and policymakers continue to learn about the opportunities and impacts of telehealth services.
Reinsurance
A one-year extension to the state’s reinsurance program was included in the HHS budget bill. This will continue to cover certain high-cost claims for insurers during the 2022 benefit year. For more information, see the Commerce section.
2021 HHS legislation that passed
Frontline health care worker payments
An agreement between legislative leaders and the Walz administration will allocate $250 million in direct financial support for frontline workers during the pandemic. A working group will be established to determine how this money is allocated, with a condition that the recipients must include long-term care workers. See the Taxes section for more information. (HF 9)
Medical cannabis updates
In addition to a massive budget bill, a policy package of HHS reforms passed and was signed into law during regular session. Along with non-controversial policy items, this bill included a major update to the state’s medical cannabis program: including raw cannabis as an allowable form of use.
The state’s medical cannabis laws were some of the most restrictive in the country by prohibiting the use of raw cannabis; other allowable forms and delivery methods of cannabis are more processed and more expensive. Adding the raw cannabis plant to this list will significantly reduce cost for patients in the program, which is not covered by insurance. Other changes included in this bill would continue modifications made during the pandemic for curbside pickup and telehealth consultation options. (HF 2128)
PsyPact
The Legislature passed a bill this session to expand access to mental health services across state lines. This allows Minnesota to join 14 other states into the Psychology Interjurisdictional Compact, or PsyPact, and allows certain psychologists to engage in telepsychology or face-to-face mental health services with patients in other member states in the compact without needing additional state licenses.
There has been a huge need to increase access to mental health services for years. PsyPact will provide continuity of care if someone relocates or travels out of state and wants to continue to use their current mental health provider. There’s also language to enhance patient protections and require anyone practicing as part of the compact to be aware of local resources in case of an emergency. As Minnesota recovers from this pandemic, entering into this multi-state agreement will be another tool to improve access to care and promote cooperation between states regarding licensure and regulation. (SF 193)
2021 HHS legislation that did not pass
Increased eligibility to SNAP benefits
Senate Republicans voted down an amendment to the HHS budget bill that would have increased the income eligibility for SNAP food benefits. This amendment would have allowed up to 3,500 additional low-income families to access this important program and permitted families in the program to increase their earnings while retaining their food benefits. This would only cost the state $14,000 over four years and leverage millions in federal funds we’re currently leaving on the table. Especially as the state continues to recover from a pandemic that hit low-income families the hardest, Senate DFLers were extremely disappointed that this amendment was not accepted to support hungry families.
Tackling prescription drug prices
Senate Republicans not only refused to accept numerous House provisions in omnibus negotiations that would have begun to tackle outrageous prescription drug prices, but they also didn’t even grant a hearing to any of the DFL proposals this session that could offer relief for Minnesotans. Senate Republicans blocked amendments on the floor that would have established a prescription drug affordability review board and prohibited insurers from changing drug formularies in a plan year if it increased prices. They also refused to consider provisions like prohibiting price gouging for prescription drugs and asking insurers to offer a plan that includes a pre-deductible, flat copay on prescription drugs.
