Dear Neighbors,
With the State Fair and Labor Day behind us, the summer is drawing to a close. That also means that school has started. Best wishes for a successful school year to all the students, parents, teachers, and staff at Anoka-Hennepin and Osseo School Districts!
This week’s e-update takes a closer look at this year’s new state Health and Human Services budget.
Survey on Adult-Use Cannabis
It’s clear that Minnesotans would like us to have a public conversation on cannabis, but it remains to be seen which policies Minnesotans would like the Legislature to change. I’m asking for your input. Please take a moment to fill out this short survey.House Majority Leader Ryan Winkler recently authored an op-ed in the Star Tribune on this issue and announced that the House will be holding community conversations throughout the state to discuss this issue in depth. You can find more details here.
Health and Human Services Budget
All Minnesotans deserve access to high-quality, affordable health care. This session, House DFLers worked to ensure all Minnesotans can afford their health insurance premiums and prescription drugs, and actually get the care they need when they need it. While Republicans stood with insurance companies, pharmaceutical companies, and corporate special interests, House DFLers stood with Minnesotans because we believe that everyone deserves access to affordable health care — no matter where you live or what you look like.
House DFLers also worked to protect our seniors from abuse and neglect and address the opioid crisis. In the final budget agreement, House DFLers successfully prevented Republican attempts to put the care of 1.2 million Minnesotans at risk.
Protecting care for 1.2 million Minnesotans: Coming into the session, an impending sunset of the provider tax loomed as one of the most significant issues facing the Legislature. This revenue comes from health care providers and goes to the Health Care Access Fund (HCAF) to fund MinnesotaCare and Medical Assistance (MA). Letting the tax expire would have jeopardized the health care of 1.2 million Minnesotans and threatened the state’s fiscal stability. This year’s budget extends the provider tax with no future sunset.
Licensing Pharmacy Benefit Managers: A Pharmacy Benefit Manager (PBM) is a third-party administrator of prescription drug programs that develops and maintains drug formularies, contracts with pharmacies, and negotiates discounts and rebates with drug manufacturers. PBMs lack transparency, cause prescription drug prices to rise, and interfere with the doctor-patient relationship.
This session, we successfully enacted legislation to license and regulate PBMs. The bill requires PBMs operating in Minnesota to be licensed by the Department of Commerce, and it requires them to disclose significant information. The new law makes it easier for patients to synchronize prescription drug refills, and it prohibits “gagging” pharmacists (i.e., restricting disclosure about more affordable options).
Preventing abuse and neglect of vulnerable adults: After inaction last year by the then-Republican-controlled House, House DFLers worked closely with a broad coalition of advocates, including AARP Minnesota, Elder Voice Family Advocates, the Elder Justice Center, the Alzheimer’s Association, and Legal Aid to pass long-overdue reforms. The new law creates a licensure framework for assisted living facilities, more streamlined enforcement of care standards, and enhanced rights, including the use of electronic monitoring, for older and vulnerable adults and their families. Before this became law, Minnesota was the only state that did not license and regulate assisted living facilities.
Addressing the opioid crisis: The opioid crisis has devastated families across our state and nation. After being blocked last year by a then-Republican-controlled House, DFLers in the majority led the way with a comprehensive proposal to combat the opioid crisis. It holds pharmaceutical companies accountable for the crisis they helped create and from which they continue to profit. The proposal establishes a registration fee on pharmaceutical manufacturers and distributors that will raise approximately $21 million annually for an Opiate Epidemic Response Account. These funds will support important work, including prevention, treatment, child protection, and drug trafficking enforcement. This new law also convenes experts on the front lines of the opioid crisis to help policymakers examine what is working and what is needed in prevention and treatment so that funding is directed to what works.
Improving health coverage: The health and human services budget includes several provisions related to improving health coverage, including extending step therapy override procedures, and prohibiting step therapy for metastatic cancer. Step therapy is a way of controlling costs and risks associated with prescription drugs by starting with the most cost-effective drug for a condition and then moving to costlier and riskier options only if necessary. But some patients already know certain drugs are effective for them and have minimal side effects. Current law directs health plans to develop a clear and convenient process to request a step therapy override. Another change in the budget requires coverage for mammogram screening to include digital breast tomosynthesis (3-D) if an individual is at risk for breast cancer. The budget also requires coverage for Pediatric Acute-onset Neuropsychiatric Syndrome and Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANS/PANDAS).
Prescription Drugs: The health and human services bill also includes provisions related to prescription drugs. Among them, the budget includes a pathway to an emergency drug refill. It also establishes a Minnesota prescription drug and medical supply repository program to allow donation of prescription drugs and some medical supplies if certain conditions apply.
Mental and Chemical Health: Certified Community Behavioral Health Clinics (CCBHCs) make navigating mental health and substance use disorder systems easier by creating a model of community clinics that provide comprehensive, coordinated, and integrated care to individuals with complex conditions. The budget moves CCBHCs beyond a demonstration project. In addition, the bill expands school-linked mental health grants. More broadly, the budget provides the Departments of Health and Commerce with more enforcement authority to ensure health plans comply with mental health parity law.
Public Health: House DFLers also succeeded in advancing many public health initiatives. The Department of Health will administer statewide tobacco cessation services to help Minnesotans quit using tobacco products, and the bill adds e-cigarettes to the definition of smoking for the Clean Indoor Air Act. The law also requires the Department of Health to develop a grant program for the purpose of increasing public awareness and education on the health dangers associated with using skin lightening creams and products that contain mercury.
HMOs/Network Adequacy: The health and human services budget bill requires that nonprofit HMOs use their net earnings to provide comprehensive health care, and the new law toughens the process for applying for a network adequacy waiver. Under state statute, a health insurer may apply to the commissioner of health to receive a waiver if it is unable to meet statutory requirements of provider networks.
Children and Families: House DFLers defeated Republican efforts to repeal the Child Care Assistance Program (CCAP) and enacted strong program integrity measures. The budget also increases the Minnesota Family Investment Program (MFIP) monthly amount by $100 — the first increase in 33 years. The health and human services bill also includes provisions to modify the state’s child welfare training system to ensure more culturally competent trainings.
The budget also requires the Department of Health to establish community solutions for healthy child development grant program to: improve child development outcomes related to the well-being of children of color and American Indian children from prenatal to grade 3 and their families; reduce racial disparities in children’s health and development, from prenatal to grade 3; and promote racial and geographic equity.
Medical Cannabis: The budget makes several changes regarding medical cannabis, including: expanding the number of distribution facilities that a manufacturer can operate; allowing manufacturers to acquire hemp from hemp growers; allowing manufacturers to transport medical cannabis to another registered manufacturer for distribution; and allowing a medical cannabis caregiver to also be a medical cannabis patient.
Finally, there were several important bills that unfortunately did not become law this session. They include:
- The OneCare Buy-In proposed by Governor Walz
- Legislation to prevent prescription drug price-gouging
- The Alec Smith Emergency Insulin Act
- Increasing the legal age to buy tobacco to 21
- A ban on conversion therapy
- And a prescription drug price transparency bill.
We will continue working to ensure health care is affordable and accessible, keep women’s health care decisions between them and their doctors, and rein in prescription drug costs.
As always, please contact me anytime with your input. I appreciate hearing from you! You can reach me at 651-296-4280 or rep.melissa.hortman@house.mn. You can also keep up with what’s happening at the Capitol by liking my legislative Facebook page. Thank you.
Sincerely,
Melissa Hortman
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