SF3775

Purpose

This bill changes whether abortion and abortion-related services must be covered by state health programs and plans. It aims to remove abortion coverage from Medical Assistance (MA) and MinnesotaCare, and restrict abortion coverage as a mandatory benefit for health plans, while making specific carve-outs and repealing certain existing requirements.

Main Provisions

• Abortion coverage in MA and MinnesotaCare:
  • Eliminates coverage of abortions and abortion-related services in Medical Assistance (MA) and MinnesotaCare programs.
• State employee plans:
  • Prohibits coverage of abortions and abortion-related services (including preabortion and follow-up care) in hospital/medical benefits for state employees under the State Employees Group Insurance Program (SEGIP).
• Health plan requirements and carve-outs:
  • Amends Minnesota Statutes to make clear when the new restrictions apply to health plans. The bill creates exclusions so that:
  • The restrictions do not apply to certain plans such as managed care organizations (MCOs) or county-based purchasing plans when they serve enrollees in public health care programs.
  • The restrictions also do not apply to health plans that are not large group health plans.
  • This means the abortion coverage prohibition is targeted mainly at large group plans; non-large group plans and some public program plans are exempt from the new restriction.
• Repeals of existing requirements:
  • Repeals Minnesota Statutes 2024 section 62Q.524 subdivisions 4 and 5 (reimbursement provisions related to abortion coverage) and repeals Minnesota Statutes 2024 section 256B.0625 subdivision 16 (the MA abortion coverage mandate).
• Appendix note (what was previously required):
  • The bill references repealed text that previously described how abortion coverage could be handled and reimbursed under certain conditions, which would no longer apply after this bill.

What Changes Compared to Current Law

• Abortion coverage is removed as a required benefit for MA and MinnesotaCare.
• Abortion coverage is prohibited in state employee health plans (SEGIP).
• Reimbursement mechanisms and mandates tied to abortion coverage are repealed.
• The reach of the restriction is narrowed by carve-outs, so not all plans are affected (non-large group plans and some public program plans may continue to set their own coverage decisions).

Potential Impacts

• Access to abortion services for enrollees in MA and MinnesotaCare could be reduced.
• Large group health plans would be the primary plans still subject to the new restriction; non-large group plans may retain more flexibility.
• State employee benefits would no longer include abortion coverage.
• Administrative changes will be needed to align with repealed sections and new exclusions.

Relevant Terms

abortion, abortion-related services, preabortion services, follow-up services, medical assistance (MA), MinnesotaCare, State Employees Group Insurance Program (SEGIP), large group health plan, non-large group health plan, health plan, mandatory health benefit, exclusions, repeal, reimbursement, commissioner of commerce, managed care organizations (MCOs), county-based purchasing plans, public health care program enrollees, 62Q.524, 256B.0625.