Conferees adopt commerce package with meat raffle increase, no insurance loophole fix

— UPDATED at 10:12 p.m. following House vote

The meat raffle prize increase has been added to the omnibus commerce policy bill.

But families whose health insurance coverage has been capped for their children with complex medical needs will have to wait until next session for a possible fix.

The conference committee for HF4188*/SF4365 met for the final time Saturday to adopt a report that now goes to both chambers for action. The House approved the conference committee report on a 121-13 vote Saturday night.

The committee adopted a provision from the Senate’s omnibus bill that would increase the maximum value of a meat raffle prize to $200 and a maximum ticket cost to $5. It also amended the provision to include hasenpfeffer to the list of social skill games for the purposes of tournaments or contests.

Previously, the committee defeated the provision twice, once with only the value increase and once with the addition of a ban on online sweepstakes games and revenue from illegal markets. Co-Chair Rep. Erin Koegel (DFL-Spring Lake Park) said she was “disappointed” DFLers couldn’t add the sweepstakes language to the provision.

The committee also adopted an amendment with a fuller description of the report on the health insurance problem required to be provided to lawmakers next session.

State law requires that for Minnesotans who have a commercial health plan and Medical Assistance, the commercial plan covers home care nursing services. However, two health insurance providers have recently re-evaluated their coverage and capped coverage at 120 visits.

Per the amendment, the Department of Commerce is required to evaluate health plans’ coverage of home care nursing services in accordance with state law on mandated health benefits. In consultation with the Department of Human Services, the evaluation report sent to lawmakers must include the fiscal impact to Medical Assistance.

The Department of Commerce, in consultation with the Department of Human Services, is also required to provide proposals by Jan. 15, 2027, for legislative action to support the needs of people with complex medical needs and their families using home care nursing services. The proposals are required to consider fiscal impacts to the state, families and health insurance providers, prioritize affordable health care coverage for the complex medical needs of recipients of home care nursing services and include legislative language.

[MORE: Parents fight insurance caps on home nursing care]

The House and Senate commerce chairs were only able to find out about the underlying issue that caused the problem this week after repeated attempts to discuss it with the Department of Commerce, said Co-Chair Rep. Tim O'Driscoll (R-Sartell). The chairs don’t want to come up with a fix in the final hours of session in a way that could cause more issues, angst and problems for people, he said.

O’Driscoll offered the amendment “as not the perfect solution, but a commitment from the three chairs, and hopefully the conference committee at large, to support this important issue and to get to a solution that works.”

Sen. Matt Klein (DFL-Mendota Heights) said they’re ending the conference committee on “a very disappointing note” because they failed to help the affected families.

“That is a deep regret. … I express my regrets right now to the families for our failure to produce results on that,” he said.

Sen. Liz Boldon (DFL-Rochester), the sponsor of the original bill on the issue, told the committee that she was “extremely disappointed” the Senate’s provision to ban health plans from imposing quantity limits on home care nursing services didn’t make it into the committee report.

The “pause” adopted by the committee will affect about 250 families in Minnesota, she said. The cap puts kids at risk and moves the cost the commercial plan is no longer paying onto the child’s Medical Assistance waiver budget, which is currently paying for items like equipment.

“Those costs are now being shifted onto the state in ways that aren’t contemplated in our budget,” Boldon said. “That’s going to have real ramifications for our state budget.”

Koegel said now that the commercial plans aren’t covering the home care nursing services, the families could likely forgo commercial plans and switch to the traditional Medicaid waiver in the future. Based on information provided by one health insurance provider, that could cost the state $187 million in its human services budget.

“It’s about the families, but it’s also about making prudent choices for our state moving forward. This is shameful that this is not getting fixed. It’s shameful that we have to bring legislation forward to do this. And it’s shameful that we don’t have the votes to put (the ban) forward,” she said.

Koegel added that she heard from Children’s Hospital staff who are concerned about the issue not being fixed this session. She said they’re concerned the children impacted by the change in coverage require skilled nursing at home due to severe conditions and the children will die at home without that care.

It’s also concerning, Koegel said, because the children could end up hospitalized, which will affect critical care bed availability at the hospital, especially during the season when respiratory illnesses surge and it is near capacity.