1.1.................... moves to amend S.F. No. 972, the third engrossment, as amended, as
1.2follows:
1.3Page 47, after line 26, insert:

1.4    "Sec. .... STUDY AND REPORT ON DISPARITIES BETWEEN GEOGRAPHIC
1.5RATING AREAS IN INDIVIDUAL AND SMALL GROUP MARKET HEALTH
1.6INSURANCE RATES.
1.7    Subdivision 1. Study and recommendations. (a) The commissioner of commerce must
1.8study disparities between Minnesota's nine geographic rating areas in individual and small
1.9group market health insurance rates, and recommend ways to reduce or eliminate rate
1.10disparities between the geographic rating areas and provide stability for the individual and
1.11small group health insurance markets in Minnesota. The commissioner of commerce must:
1.12(1) identify the factors that cause higher individual and small group market health
1.13insurance rates in certain geographic rating areas, and determine the extent to which each
1.14identified factor contributes to the higher rates;
1.15(2) identify the impact of referral centers on individual and small group market health
1.16insurance rates in southeastern Minnesota, and identify ways to reduce the rate disparity
1.17between southeastern Minnesota and the metropolitan area, taking into consideration the
1.18patterns of referral center usage by patients in those regions;
1.19(3) determine the extent to which individuals and small employers located in a geographic
1.20rating area with higher health insurance rates than surrounding geographic rating areas have
1.21obtained health insurance in a lower-cost geographic rating area, identify the strategies that
1.22individuals and small employers use to obtain health insurance in a lower-cost geographic
1.23rating area, and measure the effects of this practice on the rates of the individuals and small
1.24employers remaining in the geographic rating area with higher health insurance rates; and
2.1(4) develop proposals to redraw the boundaries of Minnesota's geographic rating areas
2.2and calculate the effect each proposal would have on rates in each of the proposed rating
2.3areas. The commissioner of commerce must examine at least three options for redrawing
2.4the boundaries of Minnesota's geographic rating areas, at least one of which must reduce
2.5the number of geographic rating areas. All options for redrawing Minnesota's geographic
2.6rating areas considered by the commissioner of commerce must be designed:
2.7(i) to reduce or eliminate rate disparities between geographic rating areas and providing
2.8for stability of the individual and small group health insurance markets in Minnesota;
2.9(ii) after considering the composition of existing provider networks and referral patterns
2.10in regions of Minnesota; and
2.11(iii) in compliance with the requirements for geographic rating areas in Code of Federal
2.12Regulations, title 45, section 147.102(b), and other applicable federal law and guidance.
2.13(b) Health carriers that cover Minnesota residents, health systems that provide care to
2.14Minnesota residents, and the commissioner of health must cooperate with any requests for
2.15information from the commissioner of commerce that the commissioner of commerce
2.16determines is necessary to conduct the study.
2.17(c) The commissioner of commerce may recommend one or more proposals for redrawing
2.18Minnesota's geographic rating areas if the commissioner of commerce determines that the
2.19proposal would reduce or eliminate individual and small group market health insurance rate
2.20disparities between the geographic rating areas and provide stability for the individual and
2.21small group health insurance markets in Minnesota.
2.22    Subd. 2. Contract. The commissioner of commerce may contract with another entity
2.23for technical assistance in conducting the study and developing recommendations according
2.24to subdivision 1.
2.25    Subd. 3. Report. The commissioner of commerce shall complete the study and
2.26recommendations by January 1, 2022, and submit a report on the study and recommendations
2.27by that date to the chairs and ranking minority members of the legislative committees with
2.28jurisdiction over health care and health insurance. The commissioner of commerce is to
2.29complete the study using existing appropriations."
2.30Renumber the sections in sequence
2.31Amend the title accordingly