Minnesota Hospital Association


February 27, 2017

MHA Newsline: Feb. 27, 2017

In this issue

MHA members visit Capitol on Opioid Awareness Day

Last week, care team members from CHI St. Gabriel’s Health in Little Falls visited the Minnesota State Capitol to participate in Opioid Awareness Day. Dr. Kurt Devine joined Rep. Dave Baker (R-Willmar) to testify at the Health and Human Services Reform Committee about solutions to the opioid epidemic that are working in Morrison County.

Minnesota’s hospitals and health systems believe it is time to turn the tide on opioid misuse. It will take a statewide investment and coordinated community response. Thank you to our members for speaking at the Capitol! For more information about what members are doing to address the opioid epidemic, visit the Minnesota’s Hospitals: Strengthening Healthy Communities website and Facebook page. return to top

Don’t miss the chance to earn recognition for your hospital

MHA Awards nominations due Friday, March 10

MHA wants to honor your hospital and caregivers for our 33rd annual awards program celebrating the outstanding work you do to deliver patient care and serve your communities.

MHA award categories recognize excellence including community health, best workplace and patient care. Honors for individuals recognize trustees, volunteers, hospital executives, caregivers and public officials. Additional information on the categories and judging criteria can be found on the MHA website.

Entries are due Friday, March 10; find the entry form here: Nomination Form

MHA will notify all entrants whether they have won in mid-April. A reception and dinner will take place Friday, June 2, at the Metropolitan Ballroom in suburban Minneapolis. All MHA members and associate members are invited and encouraged to attend the awards ceremony. Mark your calendars and plan to join us for this celebration of excellence in Minnesota health care.

For more information, contact Sarah Bohnet, MHA visual communications specialist, 651-603-3494. return to top

Bills on reinsurance, mental health move forward

The Senate Commerce Committee on Feb. 28 is scheduled to hold a hearing on SF 720, a bill that provides funding for a reinsurance program attempting to stabilize the individual insurance market, bringing down the costs of premiums sold in that market. The bill is authored by Sen. Gary Dahms (R-Redwood Falls), chair of the committee. MHA anticipates that the bill will be amended tomorrow. While MHA is generally supportive of the concept of reinsurance, particularly on a short-term basis, we are concerned about the potential use of the Health Care Access Fund as the source for the program.

Also on Feb. 28, the House Health and Human Services Reform Committee is scheduled to hold a hearing on a several mental health bills sponsored by NAMI Minnesota. MHA is supportive of these bills. On March 1, the House Health and Human Services Finance Committee will hold a hearing on HF 737, authored by Rep. Roz Peterson (R-Lakeville). This is the MHA-initiated bill to create a mental health innovation grant program.

With questions, contact Mary Krinkie, vice president of government relations, MHA, 651-659-1465, or Kristin Loncorich, director of state government relations, MHA, 651-603-3526.

Session bill tracker
For a complete list of 2017 legislative bills MHA is tracking, visit the MHA Member Center. For assistance accessing the Member Center, contact Emily Lowther, communications manager, MHA, 651-603-3495. return to top

House Republican ACA repeal and replace draft legislation

On Feb. 24, draft legislative language of the House Republican proposal to repeal and replace the Affordable Care Act (ACA) was leaked. The legislative text provides additional details to last week’s GOP policy brief. The House Energy and Commerce Committee and Ways and Means Committee, which have jurisdiction over the ACA, could begin marking up legislation as early as this week. The draft legislation will likely be modified based on the Congressional Budget Office’s cost estimate and concerns about individuals losing coverage from Republican Senators who represent states that expanded Medicaid.

Any legislation to repeal and replace the ACA will be approved under the reconciliation process, which allows a bill to be approved with a simple majority in the Senate, not the 60 votes needed under regular order. House Republican leadership has expressed its desire to approve ACA repeal and replace by early April, before the continuing resolution funding the government expires on April 28. Here are the proposed provisions:

Medicaid reform

Among the most significant proposed policy changes is the proposal to modify Medicaid into a per capita cap payment system. Under a per capita cap system, states would receive a set federal contribution based on each state’s average spending in fiscal year (FY) 2016 in five different enrollment categories trended forward by medical Consumer Price Index plus one percentage point, multiplied by the number of enrollees. The federal contribution would be a fixed percentage regardless of medical cost growth.

States that expanded Medicaid would continue to receive enhanced Federal Medical Assistance Percentage (FMAP) for the expansion population until Dec. 31, 2019. Beginning in 2020, states would be able to choose whether to continue covering the expansion population and receive their standard FMAP, not the enhanced rate.

The following individuals are carved out of the cap: Children’s Health Insurance Program beneficiaries, Indian Health Service beneficiaries, breast and cervical cancer treatment-eligible individuals, immigrants not otherwise Medicaid-eligible who receive Emergency Medicaid, family planning-only enrollees, dual-eligibles who only receive Medicare premiums and cost sharing, and enrollees receiving premium assistance for employer coverage.

Spending for Medicare cost-sharing, disproportionate share hospital (DSH) and administrative expenses are carved out of the cap. The cap amounts are adjusted to reflect the percentage of total Medicaid expenditures in 2016 that were attributable to non-DSH supplemental payments in 2016.

The ACA’s DSH cuts would be restored.

Grants to states

Under the House Republican proposal, $100 billion in grant funding would be available to states over a nine-year period, FYs 2018 to 2026, to implement high-risk pools, establish premium stabilization programs, make payments to providers and assist individuals with premiums and cost-sharing, among other potential uses. Allocation of the dollars to the states would be based on “relative costs.”

Insurance market stabilization

The House bill includes provisions aimed at stabilizing the health insurance marketplaces for 2018, including increasing the permissible age-rating bands to 5-1 from 3-1 and giving states the authority to select the range for their state. The amount of the advanced premium tax credit also would be modified based on age, with younger enrollees in the same income bracket as older enrollees receiving a larger tax credit.

Also, beginning in 2018, both the federal and state-based marketplaces would be required to verify eligibility for special enrollment periods prior to enrollment.

Essential benefit requirements repealed

Beginning in 2020, the federal essential health benefit requirements would be repealed and states would be given the authority to set minimum benefit levels. 

Individual and employer insurance mandates

The individual and employer coverage mandate penalties would be eliminated. Instead, beginning in 2019, penalties for failure to maintain coverage would be implemented as the incentive to enroll in coverage. Insurers would assess a penalty on individuals who experienced 63 or more continuous days without coverage during a 12-month look-back period. The penalty would be 30 percent of the monthly price of the health plan premium and would be assessed on all monthly premium payments made during the coverage year.

Beginning in 2020, the federal government would make available age-based, advanced, refundable tax credits to individuals without another source of coverage. The value of the tax credit would start at $2,000 annually for individuals under age 30 and increase with each decade of age to a maximum of $4,000 annually for individuals over age 60. The amounts would be updated by an inflationary factor annually.

Also, beginning in 2020, advanced payment tax credits and cost-sharing reductions for individuals and health care tax credits for eligible small businesses would no longer be available.

Cadillac tax repealed

The draft legislation would repeal the “Cadillac tax” and replace it with a similar tax on employer-sponsored coverage with current premiums above the 90th percentile. Currently, employer-sponsored health coverage is not taxed. The implementation of the ACA’s “Cadillac tax” has been delayed until 2020 in response from many unions and the business community. This provision would help pay for the draft bill.

Health savings accounts

The draft bill would increase the maximum amount an individual could contribute to a health savings account (HSA) to align with limits on deductibles and co-pays.

ACA taxes repealed

The draft bill would repeal all the new taxes authorized under the ACA, including the increase in the Medicare payroll tax for high earners, fees on insurers, prescription drugs and medical device manufacturers, among others. The date of repeal varies by tax.

MHA will continue to work with hospital members and with the Minnesota congressional delegation to provide information on how the House Republican ACA repeal and replace draft legislation could impact Minnesota’s patients, hospitals and health systems. Among MHA’s priorities is to maintain insurance coverage that provides actual coverage for all essential health care services. MHA seeks to ensure Minnesota hospitals and health systems can continue to provide high-quality, low-cost health care and continue to implement innovations to further improve care and reduce costs.

With questions, contact Briana Nord Parish, policy analyst, MHA, 651-603-3498, or Ben Peltier, vice president of legal and federal affairs, MHA, 651-603-3513. return to top

Employer applications being accepted for Summer Health Care Internship Program

Deadline to apply is Friday, April 14

Employer applications are being accepted for the 2017 Summer Health Care Internship Program (SHCIP). Hospitals, clinics, nursing facilities, home care providers and adult day services facilities are encouraged to participate on behalf of qualified students in their community.

The internship program benefits students by allowing them to explore health care careers and gain experience in a health care setting. The initiative is also a great opportunity for health care employers to become more involved in their communities.

Up to half of an intern’s wages are reimbursed through a grant from the Minnesota Department of Health’s Office of Rural Health and Primary Care. The grant is administered by MHA. The employer application form is available on the MHA website. The application deadline is April 14 at 5 p.m.

For more information on the Summer Health Care Internship Program, visit the MHA website or contact Sarah Bohnet, Summer Health Care Internship Program coordinator, 651-603-3494. return to top

AHA survey sent to hospitals

MHA is coordinating the collection of the American Hospital Association survey of services, staffing, finances and EHR implementation. The cover letter, survey, walkthrough and login/password were emailed to chief executive officers on Feb. 24. The due date is April 7.

We ask for your hospital’s assistance in completing the survey. The AHA Directory of Hospitals is useful for identifying trends and the information is used for analysis in a variety of ways at the national level. Please enter your survey information online at www.ahasurvey.org. If you need your login and password, email Jenny Sanislo, division assistant, MHA. return to top

PAC golf tournament scheduled for July 31

Registration is now open for the Minnesota Hospital Political Action Committee (PAC) golf tournament. The tournament will be held on July 31 at Territory Golf Club in St. Cloud. Lunch will be served at 11:30 a.m., shotgun start at 12:30 p.m., with a dinner buffet and awards to follow at 5 p.m. Please contact Andrea Wombacher, division assistant, MHA, 651-603-3539, for information and to register. return to top