For the first time in the state’s history, the majority of the lawmakers in office trusted Minnesotans to make their own decisions when it comes to their health care. DFLers worked hard to ensure politics didn’t interfere when it came to Minnesotans accessing reproductive, gender-affirming, and sexual health care services. The new DFL majority modernized the state’s laws to reflect the trust and independence that Minnesotans asked for when it comes to bodily autonomy.
The Protect Reproductive Options Act (PRO Act)
The “Protect Reproductive Options Act,” or “PRO Act,” enshrines into Minnesota law that every individual has a fundamental right to make autonomous decisions about the individual’s reproductive health, including the fundamental right to use or refuse reproductive health care.
Reproductive health care is defined as “health care offered, arranged, or furnished to prevent pregnancy, terminating a pregnancy, managing pregnancy loss, or improving maternal health and birth outcomes.” Reproductive health care includes, but is not limited to, contraception, sterilization, preconception care, maternity care, abortion care, family planning and fertility services, and counseling regarding reproductive health care.
The PRO Act further states that every individual who becomes pregnant has a fundamental right to continue the pregnancy and give birth, or to obtain an abortion, and to make autonomous decisions about how to exercise this fundamental right. DFLers made sure that Minnesota’s law specifies that the principles of individual liberty, personal privacy, and equality established in the Minnesota Constitution ensure the fundamental right to reproductive freedom.
To protect this right for people across the state, local governments may not regulate an individual’s ability to freely exercise the fundamental rights outlined in the Protect Reproductive Options Act in a more restrictive manner.
Enshrining into law that every individual in Minnesota has a fundamental right to make autonomous decisions about their reproductive health will not only ensure a full range of reproductive health care options for Minnesotans but also for people across the country that travel to Minnesota because their state stripped them of this fundamental right.
Reproductive Freedom Defense Act
The DFL majority passed the Reproductive Freedom Defense Act (RFDA) to provide legal protection for those who seek abortion care and those that provide it in Minnesota.
The RFDA protects the health records of patients that received care in Minnesota and allows medical professionals to legally practice in Minnesota even if they were disciplined, penalized, or imprisoned in another state for practicing licensed medical care related to reproductive health care. The RFDA allows Minnesota courts to ignore and refuse to enforce judgments focused on reproductive health care from other states. Minnesota law now allows individuals sued for obtaining reproductive health care to recoup their defense costs. Lastly, because DFLers passed the RFDA, individuals can travel to Minnesota for reproductive care and are protected from apprehension, arrest, or extradition for doing so in Minnesota.
Abortion bans and restrictions criminalize not only abortion but also pregnancy care and loss. Legal protections are necessary for medical professionals to provide the full spectrum of reproductive health care without fear of losing their medical license, being imprisoned, or being sued for providing standard medical care.
Long-Acting Reversible Contraceptives (LARC)
Now long-acting reversible contraception (LARC) methods are covered following birth in the inpatient hospital setting for people enrolled in Medical Assistance, and labor and delivery providers will be reimbursed for this care. Long-acting reversible contraception (LARC) methods, such as intra-uterine devices (IUDs), are among the most effective forms of contraception. They can be safely placed immediately following childbirth prior to hospital discharge. Minnesota used to require the new parent on Medical Assistance to return to an outpatient setting 4-6 weeks postpartum to receive this service.
Contraceptive Coverage and Supply
Minnesotans can be assured that they can access contraceptive care – whether to prevent pregnancy or for therapeutic reasons – without out-of-pocket costs. DFLers took necessary steps to protect health care coverage threatened by federal ideological judges. This essential policy clarification will codify the right to access contraceptive care in Medical Assistance, MinnesotaCare, and Health Plans.
Medical Assistance and MinnesotaCare Abortion Coverage
The law now reflects the nearly thirty-year policy that Minnesota does not discriminate against reproductive health care services for enrollees in Medical Assistance and MinnesotaCare. Since 1995, Minnesota’s policy has been to cover abortion care for Minnesotans enrolled in Medical Assistance because of the Minnesota Supreme Court case Doe v. Gomez. However, the laws contradicted that policy and abortion coverage was unjustly excluded for MinnesotaCare enrollees.
Medical Assistance Reimbursement Rates for Family Planning Services
Payment rates for family planning and abortion services were increased by 20% for Medical Assistance enrollees. This is 10% higher than the Governor’s proposal and the first update to the base rate in over a decade.
SUPPORTING PREGNANT PEOPLE
Medical Assistance Doula Rate & Direct Reimbursement
Payments for doula services for Medical Assistance enrollees provided by a certified doula are now $100 per prenatal or postpartum visit and $1,400 for providing doula services at birth. Additionally, now DHS will directly reimburse doulas for their services instead of having to go through a licensed health care professional. Removing this barrier will help increase doulas working with Minnesota’s public program enrollees.
Right for a Pregnant Patient to Have a Designated Support Person Present
The Health Care Bill of Rights was modified to include the right for a pregnant person to have a designated support person physically present while receiving health care services, including during a hospital stay. A “designated support person” is anyone who provides comfort to the pregnant person. In addition, the law clarifies that doulas and midwives do not count as a designated support person. A facility may determine if the support person is a threat to the safety and well-being of the patient or staff or if their presence interferes with providing standard medical care.
Healthy Beginnings, Healthy Families Act
This act sustains the Minnesota Perinatal Quality Collaborative, establishes the Minnesota Partnership to Prevent Infant Mortality, increases access to culturally relevant developmental and social-emotional screening and connections to services during the early childhood period, and sustains and expands the Jail Model Practices Learning Community in Minnesota jails.
Perinatal Quality Collaboratives (PQCs) work to improve the quality of care for mothers and babies. PQC members identify health care processes that need to be improved and use the best available methods to make changes as quickly as possible. These efforts aim to reduce preterm births and severe pregnancy complications, in addition to reducing racial and ethnic disparities. PQCs strive to improve screening and treatment for mothers with opioid use disorder and increase vaccine confidence.
The Commissioner of Health will award grants to convene, coordinate, and implement data-driven strategies and culturally relevant activities to improve infant health by reducing preterm birth, sleep-related infant deaths, and address social and environmental determinants of health. Grantees must focus on the leading cause(s) of infant death and on policy, systems, and environmental changes that support infant health.
“Model jail practices” means a set of practices that correctional administrators can implement to remove barriers that may prevent children from cultivating or maintaining relationships with their incarcerated parents during and immediately after incarceration without compromising the safety or security of the correctional facility.
Additional funding is provided for the family home visiting program, a voluntary service for pregnant people and child caregivers most in need of support. A trained home visiting professional conducts home visits that ideally begin prenatally or shortly after the baby is born and continue until the family is stable and well-connected to supportive resources.
The Task Force on Pregnancy Health and Substance Use Disorders
This task force is established to recommend protocols for when medical professionals should administer a toxicology test and requirements for reporting prenatal exposure to a controlled substance. Evidence shows that white, Black, Indigenous, and People of Color pregnant people have substance use disorder equally. However, Black, Indigenous, and People of Color pregnant people are criminalized more for substance use. This task force aims to end the racial disparities in criminalizing pregnant people with substance use disorder and direct all pregnant people to resources and supports to help them recover while also becoming a parent.
PROMOTING EVIDENCE-BASED MEDICAL CARE & INFORMATION
Codifying Medical Assistance and MinnesotaCare for Gender-Affirming Coverage
It is now clear that enrollees on Medical Assistance and MinnesotaCare will have access to gender-affirming care. Minnesota has been covering gender-affirming care since OutFront Minnesota v. Piper in 2016. The Department of Commerce and the Department of Health articulated these expectations in bulletins because the law contradicted this policy.
Stopping Misinformation by Removing the Women’s Right to Know Act from Law
It is no longer a state policy to require health care professionals to counter their professional medical training by forcing them to provide patients seeking abortion care with misleading information. Now that the “24-hour” rule is gone, patients in Minnesota can access abortion services without the state interfering. By removing the misnamed Women’s Right to Know Act, taxpayers are no longer funding the distribution of biased information.
Redirecting Funding to Evidence-Based Programming and Ending the Positive Abortion Alternatives Program
Ending the Positive Abortion Alternatives program will redirect funding to programs that provide comprehensive and medically accurate resources for new and expecting parents. The state will no longer provide funding to nonprofits that only offer biased and misleading information to vulnerable Minnesotans. Existing nonprofits that do provide evidence-based medical information and a full range of resources for new and expecting parents without judgment will continue to serve people in their communities.
Trusting Women, Pregnant People, and Doctors (repealing archaic and harmful statutes)
DFLers removed some of the oldest laws in statute, laws that stigmatized abortion care, laws that were not based on standard medical practices, and laws that were unenforceable because they were ruled unconstitutional. Minnesota’s laws now entrust Minnesotans to be the decision-makers regarding their reproductive health care and licensed medical professionals can now provide the care they were trained to do without the government interfering.
Sexual and Reproductive Health Service Grants
Ongoing funding was nearly doubled for a grant program dedicated to family planning. The program was renamed “Sexual and Reproductive Health Service Grants” and the grantees can now provide information on the full range of reproductive care and sexual health information to the people they serve, with an emphasis on serving communities who historically face barriers to accessing sexual and reproductive health resources.
Did not pass:
Removing Parental Notification Requirements
The parental notification requirement for a minor seeking an abortion was not repealed (statute 144.343). The parental notification for the family planning grants (now Sexual and Reproductive Health Service Grants) was also not repealed (statute 145.925, subdivision 4).
Disposition of Aborted or Miscarried Fetuses
The requirement that the products of an abortion or miscarriage in a hospital, clinic, or medical facility must be deposited or disposed of in a specific manner is not repealed or amended (statute 145.1621).
Physician Requirement to Record and Report Abortion Data
A physician or facility performing an abortion obtains a form from the Commissioner of Health with a list of required data that must be collected on patients receiving abortion care. This requirement was not repealed (145.4131), but instead 145.4131, subd. 1 was amended. The new law maintains standard public health population-level data that MDH will collect but personal/identifiable data was removed from the reporting requirement. Examples of data that is no longer required to be reported are reasons for an abortion, if an abortion was a result of rape/incest, how the abortion was paid for, and if an abortion was “born alive” (which is now no longer statutorily defined because it is not an evidenced-based definition). Another change moved the reporting deadline from April 1 to September 30.
MDH Public Report on Abortion
MDH is still required to publicly report abortion data, 145.4134 was not repealed. The report date is changed to December 31 instead of July 1, and obsolete dates are stricken.
The “Born Alive” Statute
The entirety of the “born alive” statute was not repealed, 145.423, subd. 1 was modified to recognize an infant born alive as a human and has protection under the law and medical care is required, including the compilation of appropriate medical records, for the infant born alive.