HF4041 (Legislative Session 94 (2025-2026))
Coverage of abortion services from medical assistance and MinnesotaCare programs eliminated, abortion and abortion-related services eliminated as a mandatory health benefit for health plans other than large group plans, and inclusion of coverage in State Employees Group Insurance Program prohibited.
Related bill: SF3775
AI Generated Summary
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
Bill text versions
- Introduction PDF PDF file
Actions
| Date | Chamber | Where | Type | Name | Committee Name |
|---|---|---|---|---|---|
| March 05, 2026 | House | Action | Introduction and first reading, referred to | Health Finance and Policy |
Citations
[
{
"analysis": {
"added": [],
"removed": [],
"summary": "Amends Minnesota Statutes 2024 section 43A.22 to specify benefits intent and to prohibit abortion coverage in hospital/medical plans.",
"modified": [
"Rewrites 43A.22 to include a provision that hospital or medical plans covered under 43A.22–43A.31 must not cover abortions or abortion-related services, including preabortion and follow-up services."
]
},
"citation": "43A.22",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "The bill provisions apply across the 43A.22–43A.31 range to prohibit coverage of abortions and abortion-related services.",
"modified": [
"Implements abortion coverage prohibition throughout sections 43A.22 through 43A.31."
]
},
"citation": "Minnesota Statutes 2024 sections 43A.22 to 43A.31",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Amends Subd.3 (Exclusion) to create specific exclusions from applicability for certain plan types.",
"modified": [
"This section does not apply to (1) managed care organizations or county-based purchasing plans when they provide coverage to public health care program enrollees under chapter 256B or 256L, (2) the State Employees Group Insurance Program under sections 43A.22 to 43A.31, and (3) any health plan that is not a large group health plan."
]
},
"citation": "62Q.524",
"subdivision": "subdivision 3"
},
{
"analysis": {
"added": [],
"removed": [
"Subdivision 4 repealed."
],
"summary": "Repeals Subd.4 (Reimbursement) of 62Q.524.",
"modified": []
},
"citation": "62Q.524",
"subdivision": "subdivision 4"
},
{
"analysis": {
"added": [],
"removed": [
"Subdivision 5 repealed."
],
"summary": "Repeals Subd.5 (Appropriation) of 62Q.524.",
"modified": []
},
"citation": "62Q.524",
"subdivision": "subdivision 5"
},
{
"analysis": {
"added": [],
"removed": [
"Subdivision 16 repealed."
],
"summary": "Repeals Subd.16 of 256B.0625.",
"modified": []
},
"citation": "256B.0625",
"subdivision": "subdivision 16"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "References to Chapter 256B are used to describe applicability to public health care program enrollees; no direct substantive change to Chapter 256B itself is shown in the text.",
"modified": [
"Used to define eligibility for public health care program enrollees within exclusions in 62Q.524 Subd.3"
]
},
"citation": "Minnesota Statutes 2024 chapter 256B",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "References to Chapter 256L appear in the exclusions, but no standalone modification to Chapter 256L is shown.",
"modified": [
"Used to describe applicability of exclusions for public health care program enrollees under 62Q.524 Subd.3"
]
},
"citation": "Minnesota Statutes 2024 chapter 256L",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Appended in the Appendix: Subd.4 describes payment and reimbursement for coverage under this section; payments are governed by 45 CFR 155.170.",
"modified": [
"Incorporates federal regulatory framework for reimbursements under this section."
]
},
"citation": "Code of Federal Regulations title 45 section 155.170",
"subdivision": ""
}
]Progress through the legislative process
In Committee