Committee hears emotional testimony as HF4347 seeks to block insurer limits on home care nursing

Representative Bierman urged the Commerce Policy and Finance Committee to pass House File 4347, a clarification of a 2010 mandate that he said makes commercial plans the first payer for continuous home care nursing for medically complex Minnesotans. "This is not a new mandate and does not add costs to the commercial plans or to the state budget," Bierman said as he described two plans that reinterpreted the statute and imposed severe caps in 2026.

Several parents testified that the insurer changes are already causing acute hardship. Brandon Walter of Medina told the committee his family learned that a HealthPartners approval letter promising year-long coverage was followed, weeks later, by a notice limiting the member to 120 visits for the calendar year. "This is not theoretical. It is happening right now," Walter said, urging lawmakers to pass HF4347 to keep children at home and out of hospitals.

Kit Chambers said her family depends on a mix of private insurance, medical assistance and waiver services for her son Nash; she said a cap would remove services and supports, including therapies and respite, and could force her out of paid caregiving. Provider Cameo Zender of Pediatric Home Service described home nursing as hospital-level care that requires higher commercial reimbursement to recruit and retain skilled nurses.

Representatives of insurers acknowledged changes but warned of costs. Chelsea Olsen of the Minnesota Council of Health Plans said member plans were committed to finding a solution but cautioned that removing limits could raise premiums and destabilize the individual market. Kelly Wolfe of Medica said Medica reevaluated extended home health benefits, consulted with DHS and the Department of Commerce, and provided notices to counties and families in 2025. Barbara Cox of HealthPartners said the limits dated to 2014 and that the company had stopped granting exceptions earlier this year.

Sam Smith of the Department of Commerce told the committee the department has responded to complaints and was neutral on the bill; enforcement, he said, depends on the facts of particular cases.

Several legislators described the situation as urgent and personal. Representative Hewitt, a coauthor, recounted field experience and urged members to act. Representative Finke asked explicitly whether care would be interrupted if HF4347 did not pass; testifiers warned that waiver-based funding and authorized services might not backfill arbitrarily reduced private coverage.

After debate the committee took a roll call on a motion to refer HF4347 to the Ways and Means Committee. The clerk recorded nine ayes and 10 nays, and the motion did not prevail, so HF4347 did not advance out of committee at this hearing.

The next steps for the bill were not set on the record; sponsors suggested stakeholder discussions and a summit to work toward longer-term solutions while maintaining current statutory intent.