HF4041

Purpose

• Remove abortion coverage from state health programs and most private plans, and repeal existing requirements that currently mandate or fund abortion services.

Main Provisions

• Abortion coverage prohibition for plans under 43A.22 to 43A.31:
  • Hospital and medical plans offered under 43A.22–43A.31 must not cover abortions or abortion-related services, including preabortion and follow-up services.
• Repeals and removals of existing abortion coverage requirements:
  • Repeals Minnesota Statutes that currently require or reimburse abortion coverage in Medical Assistance (MA) and MinnesotaCare.
  • Repeals 62Q.524 subdivisions 4 and 5 and 256B.0625 subdivision 16 (which previously dealt with abortion coverage/reimbursement).
  • Repeals the section in 62Q.524C (Coverage of Abortions and Abortion-Related Services), including its Subd.4 (Reimbursement) and Subd.5 (Appropriation).
• State and plan-specific changes:
  • The State Employees Group Insurance Program (SEIGP) would be prohibited from including abortion coverage.
  • The state could self-insure hospital and medical plans to keep premiums stable (a provision in the amended 43A.22).

Affected Programs and Plans

• Medical Assistance (MA) and MinnesotaCare: abortions and abortion-related services would no longer be covered.
• State Employees Group Insurance Program (SEIGP): abortion coverage would be prohibited.
• Large group health plans vs. non-large group health plans:
  • The bill includes exclusions that affect how the new rules apply. Specifically, certain plans may be exempt from the new restrictions (e.g., non-large group health plans, and some plans serving public health care program enrollees). The exact carve-outs mean some non-large group plans could still cover abortions, while MA, MinnesotaCare, and SEIGP would be restricted.
• Other plans:
  • Managed care organizations (MCOs) and county-based purchasing plans may be exempt when they cover public health care program enrollees, depending on the scenario.

Significant Changes to Existing Law

• Abortion coverage is no longer required or funded for MA and MinnesotaCare.
• Abortion coverage is banned in the SEIGP.
• The state moves toward self-insurance for some hospital/medical plans to control premiums.
• Previous statutory provisions that required or reimbursed abortion coverage (under 62Q.524, 256B.0625) are repealed.
• The detailed provisions that previously outlined reimbursement and funding for abortion coverage are removed, effective immediately upon enactment.

Potential Implications (summary)

• Public funding and coverage for abortion services would be substantially reduced or eliminated for MA, MinnesotaCare, and SEIGP.
• Private plans that are not large group plans may remain unaffected or retain abortion coverage, depending on how the carve-outs apply to a given plan.
• Plan sponsors and enrollees relying on public programs would face less coverage for abortion services, potentially increasing out-of-pocket costs or changing access.

Relevant terms - abortion coverage - abortion-related services - preabortion services - follow-up services - Medical Assistance (MA) - MinnesotaCare - State Employees Group Insurance Program (SEIGP) - hospital and medical plans - 43A.22 to 43A.31 - 62Q.524 - 256B.0625 - 256B.0625 Subd.16 - 62Q.524C - reimbursement - commissioner of commerce - self-insure - large group health plan - non-large group health plan - managed care organizations (MCOs) - county-based purchasing plans - public health care program enrollees - appropriation