Bills: HF3439, HF3763

Keywords: Medical Assistance, Medicaid, MNsure, MinnesotaCare, disability determination, expedited eligibility, state medical review team, compassionate allowance, rare disease, home and community-based services, long-term care, managed care, county-based purchasing, eligibility redetermination, periodic data matching, death master file, Social Security Administration, program integrity, income eligibility, asset test

Summary: The House Health Finance and Policy Committee met on March 4, 2026, approved the minutes from its February 25 and March 2 meetings, and then heard a presentation from Katherine Castanza of the National Conference of State Legislatures on Medicaid eligibility changes in the federal One Big Beautiful Bill Act (HR1/OB3). The presentation focused on provisions affecting Medicaid expansion adults ages 19 to 64, including new work and community engagement requirements, changes to retroactive eligibility, quarterly death master file checks, address verification requirements, six-month redeterminations for expansion enrollees, and new limits on some lawful permanent residents and other immigrant groups. Castanza also discussed state implementation issues, including the need for new data-sharing systems, system modernization, outreach, and options for helping people transition to other coverage if they lose eligibility. She said the work and community engagement rules take effect January 1, 2027, with states given flexibility on look-back periods, consecutive versus nonconsecutive months, and optional hardship exemptions, and noted that CMS guidance is not expected until June 2026. She also described federal support for implementation, including $200 million in grants and a 90% federal match for eligibility system work, while warning that the fast timeline could lead to coverage losses, churn, and challenges for special populations such as caregivers, people with behavioral health conditions, incarcerated individuals, and rural residents. She further explained that an erroneous payment provision could expose states to federal recoupment later if eligibility errors increase. During member questions, Representative Beerman asked about the overall size of the Medicaid cuts and the cumulative national impact; Castanza said estimates vary by state and cited KFF analysis suggesting states could lose 4% to 19% of federal Medicaid revenue, with a newer RAND analysis recently released. Beerman also asked about the history and effectiveness of state work requirements, but that discussion was not completed in the excerpt. Representative Elkins noted the presentation was not initially posted on the committee website, and the chair said it had since been posted.

Bills: HF3388, HF400

Keywords: HF3388, Minnesota premium security plan, reinsurance, health insurance, group health carriers, MCHA, MNsure, individual market, premium stabilization, carrier assessment, health insurance assessment, premium security plan account, state innovation waiver, high-risk pool, reinsurance payments, healthcare premiums, insurance carriers, deferral of assessment, financially impaired condition, HF400

Summary: The committee approved the minutes from the prior day and then heard House File 400, a bill described as a defrayal measure for health insurance mandates. Representative Perryman said the bill would not block future mandates, but would require the state to pay the added costs of any new mandated benefits so those costs would not be shifted to premium payers. She and supporters framed the bill as a way to protect affordability for Minnesota employers, workers, and families, especially in the fully insured market. Testimony in support came from the Minnesota Chamber of Commerce and the Minnesota Council of Health Plans. They argued that Minnesota has a high number of mandated benefits, that each new mandate adds cost to premiums, and that businesses—especially small and midsize employers—are already struggling with rising health insurance costs. The health plans representative said the bill would use the existing Commerce defrayal process to reimburse plans for eligible mandate-related claims, allowing those costs to be removed from premium rates. Several members echoed support, saying the bill would improve transparency by showing the fiscal impact of proposed mandates and help prevent people from being priced out of coverage. Members also explored how mandates apply in the market and how premiums are set. Deputy Commissioner Julia Dryer explained that, unless otherwise specified, mandates generally apply to the individual, small group, and fully insured large group markets, while self-insured ERISA plans and other markets are generally outside that scope. Representative Elkins noted that the affected market is relatively small and said small businesses are increasingly moving to self-insured plans because of cost. He and others raised concerns about affordability, while Representative Smith argued that mandates often ensure needed care and that the bill shifts costs to taxpayers rather than insurers. Representative Bacham added a personal example from tribal self-insurance, saying preventive physicals had saved lives and asking whether other factors besides mandates are driving insurer costs. No amendments were offered, and the bill was laid over for possible future consideration.

Bills: HF4502, HF3388, HF4106, HF400, HF4138, HF4118, HF4203

Keywords: trusted contact, financial exploitation, elder abuse, elder financial abuse, fraud prevention, financial institution, banking, credit union, broker-dealer, account security, dormant account, consumer protection, scam, suspicious activity, protective services, law enforcement reporting, Minnesota Statutes chapter 45A, HF3388, Minnesota premium security plan, reinsurance

Bills: HF4371, HF4317, HF2817, HF3496, HF4151, HF3826, HF4425, HF3990

Keywords: HF4371, Minnesota background checks, Bureau of Criminal Apprehension, BCA, Office of the Legislative Auditor, Legislative Auditor, criminal history records, national criminal history record information, public safety, statutory amendment, section 299C.76, requesting agency, state audit, oversight, background screening, criminal records, county agencies, MNsure, Department of Revenue, Department of Human Services

Transcript Highlights:

• It was a little different back then; that program operated outside of MNSure at the time.
• Usually these would be just on-exchange because MNSure is used to operating that way.
• indirect money coming to MNSure.
• Senator Wicklund said they need to talk with MNSure more about what the risk is to this.
• He then asked one more question about the switch over to MNSure.

Keywords: 1187, senate, all

Transcript Highlights:

• I'm the senior director of public affairs for MNSure.
• public affairs for MNSure. public affairs for MNSure.
• through MNSure. through MNSure.
• All MNSure required reports are accessible via the legislative library.
• > are All MNSure required reports are All MNSure required reports are accessible<00:25:41.200>

Keywords: 1187, senate, all

Transcript Highlights:

• Open enrollment on MNSure begins on November 1st.
• I know MNSure is coming today so they can talk all about the shopping experience.
• I’m Libby Cullum, CEO of MNSure, Minnesota’s official health insurance marketplace.
• So, each year, MNSure helps thousands of Minnesotans apply and enroll in coverage.
• So, each year, MNSure helps thousands of Minnesotans apply and enroll in coverage.

Keywords: 1187, senate, all

Transcript Highlights:

• There are appropriations for MNsure, and these are to offset reduced revenue that was identified in the
• 04:45.680> appropriations<00:04:46.880> uh<00:04:47.199> for<00:04:47.440> mnsure
• there are appropriations uh for mnsure there are appropriations uh for mnsure and<00:04:49.199><
• ><00:05:12.720> uh<00:05:13.120> operation<00:05:13.759> of<00:05:13.919> mnsure
• <00:05:14.880> uh calendar year uh operation of mnsure uh calendar year uh operation of mnsure

Keywords: 1187, senate, all

Summary: The committee reviewed a side-by-side comparison and fiscal analysis of Senate File 3472, a reinsurance-related bill affecting the premium security plan account, MinnesotaCare, and related health care funding. Staff explained the Senate and House versions of the bill, including how the Senate proposal extends reinsurance for five years and uses a projected $1.087 billion general fund transfer to fully fund claims and administrative costs through fiscal year 2028, while the House version conditions continuation of the program on federal approval of the state innovation waiver. The fiscal presentation also covered appropriations for MNsure, a mental health parity and substance abuse office, and House provisions for delivery reform and a public option study, along with a House transfer of $110.674 million to the health care access fund. Members debated the budget horizon and whether costs should be forecast beyond fiscal year 2025. Representative Schultz argued that the spreadsheet understated the broader fiscal impact of reinsurance and warned about future funding cliffs for MinnesotaCare and other health programs, while other members and staff noted that the state’s standard forecast ends in fiscal year 2025 and that the fiscal note only estimated reinsurance costs through the five-year extension. Supporters said reinsurance was the best available option to reduce premium increases, especially in rural areas, and some pointed to a public option as a longer-term alternative. Opponents argued reinsurance does not address underlying health care costs or deductibles and urged consideration of other reforms. House Research then walked through the policy differences. House-only provisions would change Minnesota Comprehensive Health Association board membership, require platinum plans in certain markets, expand postnatal coverage, require a prescription drug benefit in some plans, set a minimum actuarial value for MinnesotaCare, create an Office of Mental Health Parity and Substance Abuse Accountability, and direct reports on delivery reform and a public option. The shared provisions would extend the premium security program to 2027 and delay the transfer of remaining premium security plan funds to the health care access fund until 2029, with the House language again contingent on federal waiver approval. No formal vote was taken in the excerpt; the chair closed discussion after hearing no further questions and indicated members would be contacted about next steps.

Transcript Highlights:

• <01:20:36.080> part frustrating is probably the MNSure part frustrating is probably the MNSure
• Whether that was the MNSure program.
• Um<01:21:09.760> and<01:21:10.040> so<01:21:10.960> the<01:21:11.040> MNSure<
• people who are Um and so the MNSure people who are paying<01:21:12.200> their<01:21:12.320>
• Not a single one of us is going to be able to provide care for MNSure or Medicaid patients, which is

Keywords: 1187, senate, all

Transcript Highlights:

• One of those is to assist individuals in obtaining individual market insurance through MNsure.
• MNsure is primarily financed by a 3.5% assessment on the premiums of the plans offered through MNsure
• One of those is to assist individuals in obtaining individual market insurance through MNsure.
• MNsure is primarily financed by a 3.5% assessment on the premiums of the plans offered through MNsure
• MNsure is primarily financed by a 3.5% assessment on the premiums of the plans offered through MNsure

Keywords: 1183, house

Summary: The meeting was an informational walkthrough for the Health Finance and Policy Working Group, focused on committee structure, budget basics, and major health-related accounts and programs. Staff explained the roles of House Research and House Fiscal, then reviewed key funds used by the committee, including the general fund, government special revenue fund, federal funds, the health care access fund, remediation account, and drinking water revolving fund. They also outlined the committee’s main budget areas, noting that medical assistance is the largest general fund item and that the Department of Health is a substantial agency funded by a mix of federal, general fund, and special revenue dollars. A major portion of the presentation covered subsidized health coverage programs. Staff described Medical Assistance (Minnesota’s Medicaid program) as an entitlement for eligible Minnesotans, with no premiums or cost sharing, and explained its managed care and fee-for-service delivery systems. MinnesotaCare was presented as a separate federal-state basic health program for people who are not eligible for MA, with income limits, premiums for adults age 21 and older, and cost-sharing requirements; staff noted that federal premium tax credit changes affect MinnesotaCare premium ranges. The presentation also summarized MNsure’s role in the individual market and in determining eligibility for premium tax credits, cost-sharing reductions, MinnesotaCare, and MA. The committee also received an overview of health-related licensing boards and occupational regulation. Staff said Minnesota has 16 health-related licensing boards, funded mainly through the state government special revenue fund and subject to legislative appropriation, and explained that health occupations may be regulated by the Department of Health, the Office of Emergency Medical Services, or the boards under chapter 214. Interstate licensure compacts were briefly noted as a way to ease practice across states. No bills were debated and no votes or formal actions were taken during the meeting.

Transcript Highlights:

• MNsure will reconcile these discounts with the insurance companies so that enrollees do not have to do
• Dan Andre: In the fiscal note, MNsure states that 77% of the individual market is on exchange.
• And also in the fiscal note, MNsure states that there would be a need for significant investment for
• Ending MNsure would save taxpayer money while still allowing Minnesotans the ability to access health
• Rather than further entrenching MNsure by adding another program to it, we suggest getting rid of MNsure

Keywords: 1187, senate, all

Transcript Highlights:

• low for everyone in the individual market, including those who buy insurance somewhere other than MNsure
• This is on the heels of MNsure announcing last week that we had record enrollment on the exchange in
• This is on the heels of MNsure announcing last week that we had record enrollment on the exchange in
• This is on the heels of MNsure announcing last week that we had record enrollment on the exchange in
• This is on the heels of MNsure announcing last week that we had record enrollment on the exchange in

Keywords: 1187, senate, all

Summary: The committee heard a reinsurance overview from Deputy Commissioner Julia Dryer of the Minnesota Department of Commerce on the Minnesota Premium Security Plan. She explained that reinsurance helps stabilize premiums in the individual market by reimbursing insurers for high-cost claims, and said Minnesota’s program has lowered premiums, preserved carrier participation, and helped maintain consumer choice. She warned that without continued funding, the program would be depleted and individual-market premiums could rise by about 25%, with potential losses in coverage and access to care. She also described the program’s structure under a federal 1332 waiver, the role of MCHA in administering the program, and the state’s receipt of more than $650 million in federal pass-through funds to date. Dryer said the current program is funded through the end of 2025, though the federal waiver authority runs through 2027. The governor’s proposal would create a new assessment on insurers, estimated at roughly 2% to 3%, to fund the state share of the program and avoid another full waiver submission. She noted that the proposal assumes MinnesotaCare funding would be held harmless and that the program would be reduced if federal basic health plan funding were negatively affected. She also said projected costs changed because individual-market enrollment has grown and enhanced federal subsidies were removed from the estimate. Members raised concerns about the proposal’s impact on premiums and the history of the fund. Senator Rasmusson argued the new assessment amounts to a large tax increase on health insurance and questioned who would be assessed and whether the surcharge would be capped. Dryer responded that the assessment would be based on annual claims experience and market conditions, with final amounts determined at the end of each year, not monthly. Senator Duckworth and Senator Frentz supported reinsurance as a way to keep premiums lower, while also questioning how the program should be financed. Senator Green asked about the mechanics of the assessment and the role of the department in setting it, and Senator H questioned why the fiscal note assumed 12% annual growth for program costs when general premium growth was lower. No vote or formal action was taken in the meeting.

Transcript Highlights:

• When we looked at plans on MNSure, we found two things to be true.
• When we looked at plans on MNSure, we found two things to be true.
• When we looked at plans on MNSure, we found two things to be true.
• When we looked at plans on MNSure, we found two things to be true.
• When we looked at plans on MNSure, we found two things to be true.

Keywords: 918, senate, all

Summary: The Select Subcommittee first took up adoption of three previously prepared nonpartisan committee summary reports dated October 15, November 13, and November 21. Senator Rasmusson objected to the lack of advance notice about the day’s testifiers and criticized the practice of having nonpartisan staff summarize what he described as a partisan agenda. The chair responded that the committee’s purpose is to gather information, not hear bills, and that the summaries were intended as neutral resources for the Senate. Senator Coopek moved adoption, the motion was opposed by Rasmusson and another member, and the motion passed. The committee then turned to the day’s hearing on federal impacts on Minnesota, with the chair focusing on federal funding threats and the effect of congressional budget actions on health care, especially in greater Minnesota. The first presentation came from the Minnesota Department of Health on the state’s rural health transformation work. Assistant Commissioner Carol Broom introduced the team and described the rural hospital transformation program as a major opportunity to invest in rural health, while acknowledging longstanding challenges such as demographics, transportation barriers, and the financing of care. Nitha Moibi outlined the state’s rural health chart book and data showing an aging population, workforce shortages, and many health professional shortage areas, and described proposed strategies including workforce pipelines, bridge payments for low-volume birth hospitals, telehealth access points, mental health urgent care, and chronic disease prevention. Acting Assistant Commissioner Anna Ashby of the Minnesota Management and Budget office explained the state’s application to CMS for the Rural Health Transformation Program, which was created in federal law and awarded Minnesota just over $193 million for federal fiscal year 2026. She said the application was shaped by public comments, stakeholder meetings, and legislative outreach, and included initiatives on preventive care, workforce, care access, behavioral health, and provider financial stability. She also reviewed implementation constraints, including a January 30 revised budget deadline, limits on administrative spending, restrictions on using funds to offset Medicaid losses, and the need to show measurable progress to remain eligible for future funding. The presentation noted that most year-one funding would go to rural hospitals, with additional support for federally qualified health centers, community mental health centers, tribal partners, and technical assistance.

Transcript Highlights:

• are part of, as opposed to a top-down approach, because we have a history recently of MNLARS and MNsure
• So just being skeptical of how MNLARS and how MNsure in our recent history have kicked the football,
• So just being skeptical of how MNLARS and how MNsure in our recent history have kicked the football,
• So just being skeptical of how MNLARS and how MNsure in our recent history have kicked the football,
• So just being skeptical of how MNLARS and how MNsure in our recent history have kicked the football,

Keywords: 1187, senate, all

Transcript Highlights:

• The Chair thanked the Commissioner and said, “And now we will move to MNSure.”
• My name is Erica Helvik Anderson and I'm the Senior Director of Public Affairs for MNSure.
• She said that, as part of the Governor's supplemental budget, MNSure has one budget-neutral proposal,
• She said that while planning for the modernization, MNSure noted the federal administration change and
• Erica Helvik Anderson said MNSure currently does not have authorization for funding for any other

Keywords: 1187, senate, all

Transcript Highlights:

• On average, families buying coverage through MNsure are now paying more than $2,100 more per year.
• of Minnesotans purchasing insurance of Minnesotans purchasing insurance through<00:57:47.280> MNSure
• through MNSure. through MNSure.
• <00:57:52.680> enrollees,<00:57:53.200> roughly about 62% of MNSure enrollees, roughly
• about 62% of MNSure enrollees, roughly 89,000<00:57:54.880> Minnesotans,<00:57:55.840> are

Keywords: 1187, senate, all

Transcript Highlights:

• Could you speak to the importance of that and the cost of families that would get coverage from the MNsure
• get coverage from families that would get coverage from the<00:47:38.480> um the um the um MNsure
• 40.040> cuz<00:47:40.200> I'm<00:47:40.320> concerned<00:47:40.640> about MNsure
• system cuz I'm concerned about MNsure system cuz I'm concerned about those<00:47:41.080> folks

Keywords: 918, senate, all

Summary: The committee met to walk through nonpartisan side-by-side comparisons of House File 4188, focusing on differences between House and Senate language across consumer protection, insurance, financial services, health, and technical provisions. Staff highlighted numerous Senate-only items, including rules for financial providers communicating through trusted contacts, virtual currency requirements for banks and credit unions, a prohibition on virtual currency kiosks beginning in 2026, mortgage servicing and student loan servicing changes, the Rental Home Marketplace Guarantees Act, insurance and travel-related provisions, scrap metal licensing changes, protections related to minors accessing chatbots and AI companions, and several technical or conforming repealers. Staff also noted that some provisions were identical or substantially similar between the chambers, including mortgage originator standards, student loan borrower protections, securities-related changes, unclaimed property provisions, and technical updates in the bill’s miscellaneous articles. The Senate-only health-related articles were also summarized, including repeal of the prescription drug affordability advisory council, technical changes to the reinsurance program, and a series of health insurance provisions on enrollment-growth notices, limits on officer and director salary increases under certain capital conditions, guaranteed issue rights for certain Medicare supplement enrollees, data-sharing between Commerce and Health, restrictions on using artificial intelligence alone to deny claims, reimbursement for clinical trainees, home care nursing coverage, and PBM transparency. The Senate’s telecommunications article was described as largely technical and conforming, with repeals of obsolete statutes. Staff also noted that some standalone bills had already passed and would be removed from the comparison report. Public testimony followed. Thomas Elness of AARP Minnesota supported inclusion of the cryptocurrency kiosk bill, expressed support for guaranteed issue protections for a narrow group of consumers affected by discontinued plans, and urged adoption of changes to the consumer protection restitution account, including raising the cap to $10 million per fiscal year. Representative Lee testified that the restitution account proposal should be treated as policy rather than finance because it has a zero fiscal note, and said the House would accept the Senate’s $10 million cap. Robin Rowan, representing the Minnesota Insurance and Financial Services Council and the U.S. Travel Insurance Association, urged adoption of Senate travel insurance language, requested a House-style change to lead-generation recordkeeping language, and supported a Senate provision allowing employers and insurers to coordinate notice to employees when group policies are cancelled. The Department of Commerce then responded to questions, explaining that the prescription drug affordability council would be sunset because the board already has other avenues for public input, that the reinsurance changes were technical and did not alter the prior agreement, and that the abandoned cryptocurrency provisions rely on statutory definitions of inactivity and known examples such as keys stored in safes or deposit boxes.

Transcript Highlights:

• But I remember MNSure was a huge one. Representative Torkelson probably can attest to some of that.
• I'm failing to remember them all, but I remember MNSure was a huge one.

Keywords: 1183, house

Transcript Highlights:

• How many people went to MNSure? How many people, um, you know, had employer insurance?
• How many people went to<01:20:38.640> MNSure?
• <01:20:39.600> How<01:20:39.760> many<01:20:40.000> people, to MNSure?
• How many people, to MNSure?

Bills: HF4401, HF4466

Keywords: HF4401, Minnesota Medical Assistance, dental reimbursement, dental rates, critical access dental providers, Medicaid dental, MinnesotaCare, managed care plans, county-based purchasing plans, fee-for-service, oral health access, safety-net clinics, federally qualified health centers, rural health clinics, Indian health services, state-operated dental clinics, low-income patients, children's dental care, provider reimbursement, dental access

Transcript Highlights:

• So, they don't need to maintain multiple passwords if they are a customer of MNsure, if they are needing
• multiple passwords if they are a<00:43:11.920> customer<00:43:12.440> of<00:43:12.600> MNsure
• if<00:43:13.680> they<00:43:14.040> are<00:43:14.840> uh, a customer of MNsure
• , if they are uh, a customer of MNsure, if they are uh, needing<00:43:15.160> to<00:43:15.280>

Bills: HF1338

Keywords: Inspector General, Office of the Inspector General, state oversight, government accountability, fraud, waste, abuse, audit, investigation, subpoena, whistleblower, public integrity, transparency, state agencies, executive branch, public funds, taxpayer funds, law enforcement oversight, public safety programs, advisory council