1.1    .................... moves to amend the delete everything amendment (H3391DE1) to H.
1.2F. No. 3391, as follows:
1.3Page 21, line 3, delete "Health Care Transformation Commission established" and
1.4insert "the commissioner of health"
1.5Page 21, line 4, delete everything before "shall" and delete "legislature" and insert
1.6"Legislative Commission on Health Care Access uniform"
1.7Page 21, line 6, after the period insert "The expectations of the community benefits
1.8provided and reported should be related to the statutory expectations in sections 62C.01
1.9and 62D.01 and thus focus on advocating public health, improving the art and science of
1.10medical care, and addressing the need for financial assistance to access ongoing coverage,
1.11and not related to general philanthropic endeavors. The commissioner shall seek public
1.12input regarding the range of options to be explored and the accountability measures."
1.13Page 21, line 8, after "periodically" insert "and uniformly"
1.14Page 21, line 10, delete "commission" and insert "commissioner"
1.15Page 25, line 19, delete "Health Insurance" and insert "Partnership"
1.16Page 29, lines 7, 17, 19, 23, and 29 delete "Health Insurance" and insert "Partnership"
1.17Page 29, line 30, delete "Health" and insert "Partnership"
1.18Page 29, line 31, delete "Insurance"
1.19Page 30, line 29, delete "Health Insurance" and insert "Partnership"
1.20Page 31, line 11, delete "HEALTH INSURANCE" and insert "PARTNERSHIP"
1.21Page 31, line 12 delete "Health" and insert "Partnership"
1.22Page 31, line 13, delete "Insurance"
1.23Page 31, line 14, delete "Health Insurance" and insert "Partnership"
1.24Page 31, delete line 15 and insert "is created for the purpose of assisting employers
1.25and individuals to secure affordable benefits, including health insurance. The Minnesota
1.26Partnership"
1.27Page 31, delete line 16
2.1Page 31, line 17, delete "Insurance"
2.2Page 31, line 22, delete "Health Insurance" and insert "Partnership"
2.3Page 31, line 32, after "market" insert"and that may cover either an individual or an
2.4individual and the individual's dependents"
2.5Page 32, delete lines 26 to 31 and insert:
2.6    "Subd. 5. Comparison of health plans. The exchange shall help consumers
2.7understand and compare the standardized health plan options established under section
2.862U.04. It shall also make consumers aware of eligibility for premium assistance under
2.9section 62U.09 based on the employer's contribution and the employee's income. Within
2.10each standardized plan grouping, it should provide easy ways for consumers to select
2.11among the offerings by comparing quality ratings, searching for a particular provider in its
2.12network, or by cost factors. This information shall be made available via the Internet as
2.13well as by toll-free telephone assistance and written materials."
2.14Page 33, after line 15, insert
2.15    "(d) A self-employed individual, including a partner of a partnership, a member of
2.16a limited liability company, or other owner of a business, who may not be eligible to
2.17participate in a Section 125 plan, may obtain coverage through the exchange either as an
2.18individual under paragraph (c) or as an employee covered under a small employer health
2.19benefit plan if permitted under chapter 62L."
2.20Page 33, line 21, after "individuals" insert "and small employers"
2.21Page 33, line 33, after "individuals" insert "and small employers"
2.22Page 34, line 27, after "organizations" insert ", other than those connected with
2.23Minnesota-based nonprofit health providers or health plan companies"
2.24Page 35, line 27, after "terms" insert ". These appointed members are eligible to
2.25be reappointed for one additional term"
2.26Page 36, line 2, after the period, insert "Board meetings must be open to the public,
2.27except as specified in the bylaws of the exchange."
2.28Page 36, after line 7, insert:
2.29    "Subd. 16. Investment of assets. he exchange must certify to the state board of
2.30investment that a portion of the assets of the exchange which, in the judgment of the
2.31exchange director, are not required for immediate use. Investment earnings on assets
2.32transferred to the state board of investment under this subdivision must be maintained in
2.33an account in the state treasury. Money in the account may be spent, as appropriated by
2.34law, for purposes related to assisting individuals in paying health insurance premiums,
2.35and for making health insurance products more affordable.
3.1    Subd. 17. Audit. The legislative auditor must audit the exchange, as provided in
3.2sections 3.971 and 3.972."
3.3 Renumber the subsequent subdivisions in sequence and correct internal cross references
3.4Page 36, line 25, delete "Health Insurance" and insert "Partnership"
3.5Page 37, line 9, after the headnote insert "(a)"
3.6Page 37, after line 22, insert:
3.7    "(b) Employees earning less than $30,000 per year must choose to opt-in to Section
3.8125 plan participation after being provided, by their employer, information developed by
3.9the exchange on the potential negative impact on their Social Security retirement benefits.
3.10Employers may not in any way attempt to influence those employees in their decision on
3.11whether or not to participate in the Section 125 plan pretax premium payment. Those not
3.12choosing to opt-in to Section 125 plan participation shall still remain eligible for premium
3.13collection and payment via the exchange. This also applies to anyone who may not be
3.14eligible for Section 125 plan benefits due to federal definitions of eligibility. Persons with
3.15dependents who differ in their eligibility will have their participation in the Section 125
3.16pretax benefit plan proportionately established."
3.17Page 37, line 33, delete "exclusions" and insert "limitations"
3.18Page 37, line 36, delete "health behaviors such as"
3.19Page 38, line 11, delete the colon
3.20Page 38, line 13, delete "or" and delete everything after "operations" and insert ",
3.21social services funded through Medical Assistance and property tax resources, or be an
3.22informed consumer representative."
3.23Page 38, delete line 14
3.24Page 39, line 22, after "(1)" insert "advise the commissioner of human services to"
3.25Page 39, line 25, after "system" insert ", after first presenting the general outline
3.26of the proposed changes and securing approval from the Legislative Commission on
3.27Health Care Access"
3.28Page 39, line 26, after "responsibilities" insert ", while using state employees and
3.29resources to the maximum extent possible and building state staff expertise at responding
3.30to inquiries based on the data collected. All data collected shall be the property of the state.
3.31While contracted expertise may assist with research projects, the primary responsibility
3.32for the collection, storage, data privacy protection, use, and analysis shall remain with
3.33the state agencies and state staff."
3.34Page 40, line 17, delete "Health Insurance" and insert "Partnership"
3.35Page 41, line 4, delete "Health Insurance" and insert "Partnership"
3.36Page 42, line 11, delete "Health Insurance" and insert "Partnership"
4.1Page 46, lines 7, 20, and 22, delete "Health Insurance" and insert "Partnership"
4.2Page 49, lines11 and 16, delete "Health Insurance" and insert "Partnership"
4.3Page 49, after line 24, insert

4.4    "Sec. 21. RISK SHARING.
4.5    The Risk Sharing Advisory Council shall review MCHA financing and whether the
4.6affordability needs of persons with health problems can be addressed through guaranteed
4.7issue, with no premium penalty for health history and not allowing preexisting condition
4.8limitations. This must include assessing whether stability of the insurance market could be
4.9managed through risk sharing that transfers funds between health plan companies. The
4.10goal is to discontinue MCHA assessment and replace it with a broader and fairer funding
4.11mechanism, preferably one that does not involve a fee-based mechanism. The council
4.12shall make recommendations to the Legislative Commission on Health Care Access by
4.13November 1, 2009. The Risk Sharing Advisory Council shall include representatives of
4.14insurance companies, MCHA's board of directors, safety net providers, and consumer
4.15representatives. It shall be convened by the commissioner of commerce with staffing from
4.16that agency and the Minnesota Department of Health."
4.17Amend the title accordingly