SAINT PAUL, Minn. – Today, the Minnesota House Commerce Committee held a public hearing on legislation authored by House Majority Leader Jamie Long (DFL – Minneapolis) to establish a public health insurance option in Minnesota. The bill, HF 4745, would allow all Minnesotans to access comprehensive health insurance coverage – with low out-of-pocket costs and a large network of quality medical providers – by paying their own premiums on a sliding scale.
“Too many Minnesotans still don’t have access to affordable, quality health coverage and are stuck in expensive insurance that they can’t use,” Rep. Long said. “This leads to delayed care, sometimes with tragic consequences. The MinnesotaCare Public Option will remove barriers to health care for thousands more Minnesotans so they can live healthy lives, receive quality care when they need it, and avoid financial insecurity.”
Currently, MinnesotaCare coverage is limited to Minnesotans earning less than 200% of federal poverty guidelines (FPG). The MinnesotaCare Public Option would offer comprehensive health insurance coverage – including vision, dental, and more – with low out-of-pocket costs to all Minnesotans. The plan would feature $25 copays for non-preventative visits, with no copays for chemical and mental health visits. Minnesotans under 400% of FPG would have no deductibles, with deductibles limited to $1,500 for those earning more than 600% of FPG. The plan has premiums on a sliding scale for Minnesotans age 21 or older, starting at about $150 monthly for those earning 200-250% of FPG, $390 for those earning 301-400% of FPG, and $690 for those earning 501-550% of FPG. Those 20 years old or younger would be exempt from premiums.
Minnesotans would enroll on MNsure, and brokers and navigators could assist with enrollment. Providers reimbursed at least 100% of Medicare rates and the Public Option would be inclusive of undocumented immigrants.
The bill directs the Minnesota Department of Commerce to seek a federal 1332 innovation waiver through the Affordable Care Act and if approved, the Public Option would begin in 2027. 2026 would serve as a “bridge year” between the anticipated end of enhanced federal premium assistance for current MNsure plans and until implementation of the Public Option, helping avoid coverage losses and build strong enrollment. The bridge approach would include cost-sharing support for those between 200-250% of FPG, a $30 per month subsidy for silver plans on MNsure, and a premium tax credit for those earning more than 400% of FPG.
The Public Option would ramp enrollment up over time, with a cap in 2027 of 10,000 people over 400% of FPG, 15,000 people over 550% of FPG in 2028, and no cap in 2029.
The bill goes next to the House Health Committee. Video of today’s hearing will be available from House Public Information Services.