Bill > SF1261

This bill establishes a new Family Medical Account (FMA) service delivery model for medical assistance enrollees, beginning January 1, 2026. The model requires new and reenrolling medical assistance recipients with incomes at or below 138% of the federal poverty guideline to participate, with exceptions for people with disabilities, those over 65, and individuals subject to specific federal waivers. Under this model, enrollees receive a yearly contribution amount (initially $1,500 for children, $2,500 for adults) deposited monthly into a debit account that can be used for outpatient and emergency room services, with a $300 service fee limit per occurrence. The program includes unique features like an investment account for unspent funds, ongoing education about healthcare costs, and electronic transaction requirements. Certain services like preventive care, prescription drugs for specific conditions, and inpatient hospital care remain fully covered by medical assistance. The bill requires the commissioner of human services to contract with a third-party administrator, provide enrollment counseling, publish monthly provider rates, and submit progress reports to legislative committees in 2026 and 2027. The goal appears to be encouraging more cost-conscious healthcare consumption while maintaining comprehensive medical coverage for eligible individuals.

Health and Social Services

https://www.revisor.mn.gov/bills/bill.php?b=Senate&f=SF1261&ssn=0&y=2025