Medicaid, SCHIP, and Federal Authority²

SCHIP Section 1115 Waiver - In 2001, Minnesota received approval under a Section 1115 waiver to use Title XXI funds to cover parents and caretaker relatives of Medicaid and SCHIP eligible children with family incomes between 100 percent and 200 percent FPL. These individuals are subject to premiums established on a sliding scale. This is a component of the state's MinnesotaCare program.

Health Reform Demonstration - In 1995, Minnesota received approval to implement a Health Reform Demonstration. Through this initiative, children and pregnant women up to 275 percent FPL who were previously covered under the state-funded MinnesotaCare program became part of a Medicaid waiver component of the MinnesotaCare program. Under subsequent modifications of the waiver, Medicaid waiver coverage in MinnesotaCare is available to parents in families with gross incomes up to 275 percent FPL (but not above $50,000 per year). These individuals are subject to premiums based on a sliding scale. In Minnesota , individuals that are eligible for Medicaid may instead choose to join MinnesotaCare and pay a premium.

High-Risk Pool    

Minnesota Comprehensive Health Association ( MCHA ) was established in 1976 by the Minnesota legislature to offer policies of individual health insurance to Minnesota residents who have been turned down for health insurance by the private market due to pre-existing health conditions. MCHA is sometimes referred to as Minnesota 's "high-risk pool" for health insurance or health insurance of last resort. By law premiums are set at 101 percent - 125 percent of the weighted average for comparable policies. The program is funded through member premiums and an annual assessment on all health plans. At the end 2005, about 31,000 Minnesota residents are insured by MCHA throughout the state.

Limited-Benefit Plan  

In 1999, the Minnesota legislature passed SF 84 which allowed for benefit plans that may alter or eliminate coverage that is required by law, other than the requirement that care provided for covered services such as osteopaths, optometrists, and chiropractors be reimbursed on a nondiscriminatory basis. No carriers ever sold the plans and the law was allowed to expire in 2003.

In 2005, the Minnesota legislature enacted a new law that allows health plans to sell "small employer flexible benefit plans" that do not include any of the benefit mandates (except maternity).

Other

MinnesotaCare - In 1992, MinnesotaCare was established to provide health coverage to the growing number of uninsured via a risk-based managed care delivery system. It is funded through a tax on health care providers and enrollee premiums. Since 1995 a portion of MinnesotaCare has also been funded with federal Medicaid and SCHIP funds for some eligible individuals under the 1115 waivers described above. There have been several expansions in eligibility over the years. The program currently enrolls families with children up to 275 percent FPL under Medicaid and childless adults up to 175 percent of FPL without federal funding. Coverage for adults without children with incomes between 75 percent and 175 percent FPL is limited to a defined set of benefits.

	Notes and Sources

Information presented in the profile was summarized in December 2006 from a review of state Web sites and reports, and through contacts with state officials. In most cases the profiles were reviewed by state officials; however, it is possible that states have implemented strategies that are not reflected in this profile.

² The profile only includes Medicaid and SCHIP waivers intended to make comprehensive expansions to the uninsured. At this time, the profiles do not include Family Planning, Pharmacy Plus waivers, or long-term care waivers.

³ Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2005 and 2006 Current Population Survey.