Minnesota's Health Insurance
Minnesota's Health Insurance Mandate Changes for 2024: Expanded Coverage and Reduced Costs
In a historic move, the Minnesota Legislature has approved sweeping changes to health insurance coverage aimed at lowering out-of-pocket expenses for essential medical services. Starting January 1, 2025, new mandates will require insurance plans to cover abortions, gender-affirming care, prosthetics, and wigs for cancer patients, among other critical services. Here’s an in-depth look at these new requirements and their implications for Minnesotans.
Expanded Coverage for Wigs
Previously, Minnesota law mandated insurance coverage for wigs only for individuals with alopecia. The new legislation, championed by former DFL Senate Majority Leader Kari Dziedzic, extends this benefit to anyone experiencing hair loss due to a health condition, including cancer patients.
High Cost of Wigs: Wigs can be extremely expensive, with prices ranging from a few hundred dollars to as much as $5,000. This high cost has made it difficult for many patients to afford them, despite their significant psychological and emotional benefits.
Advocacy and Impact: Haley Erickson, a breast cancer survivor, highlighted the importance of wigs, saying, "When it comes to something people may think is as trivial as wigs—it's not. It's very important. It's very empowering. It gives you some sense of normalcy."
Coverage Details: The new mandate provides up to $1,000 per benefit year for wigs, subject to co-pays and deductibles similar to those for other medical items. Dziedzic emphasized the patient-centric nature of the bill, stating, "If we are putting patients first, we will pass this bill to help patients move forward."
Comprehensive Abortion Services
The new statute requires insurance plans to cover abortions and related services without additional cost-sharing.
Key Provisions:
- Coverage must include pre-screenings and follow-up services.
- Prohibits any limitations on coverage, such as prior authorization or referral requirements.
Religious Exemptions: Religious organizations are exempt from providing this coverage if they object on religious grounds. However, they must inform prospective and current employees at least 30 days before they enroll in health plans.
Coverage for Gender-Affirming Care
The legislation also mandates insurance coverage for gender-affirming care, recognizing the medical necessity of these services for transgender individuals.
Scope and Definition: Gender-affirming care includes all medical, surgical, counseling, or referral services that support and affirm an individual's gender identity or expression, including telehealth services.
Religious Exemptions: Similar to abortion coverage, religious organizations may claim exemptions but must notify employees accordingly.
Orthotics and Prosthetics Coverage
Insurance plans must now cover orthotic and prosthetic devices, supplies, and services in accordance with federal standards.
Impact on Minnesotans: More than 28,000 Minnesotans live with limb loss. Without insurance coverage, the cost of prosthetics can range from $5,000 to $50,000, posing a significant financial burden on families.
Infertility Treatment Coverage: A Missed Opportunity
Despite strong advocacy, the proposal to mandate insurance coverage for infertility treatments, including in-vitro fertilization (IVF), did not pass this session.
Challenges: DFL House Speaker Melissa Hortman noted that a statewide mandate would be costly and infeasible within the current budget constraints. The legislature will revisit this issue in the next session.
Personal Impact: Miraya Gran of Bloomington shared her struggles, having spent tens of thousands of dollars and taken out a second mortgage for IVF. "The financial, emotional, and physical burden took a toll on me and my husband," she said. Gran hopes future legislation will address this critical need, joining the 21 other states and Washington, D.C., that already mandate such coverage.
Minnesota's new health insurance mandates mark a significant step towards comprehensive and equitable healthcare. By expanding coverage to include wigs for cancer patients, abortion services, gender-affirming care, and prosthetics, the state aims to alleviate financial burdens and enhance the quality of life for its residents. While the fight for infertility treatment coverage continues, these changes reflect a broader commitment to addressing the diverse healthcare needs of Minnesotans
