Lawmakers, families press for House File 4188 to block insurer caps on home nursing for children

Sen. Liz Boldon, who represents District 25 in the Rochester area, opened the testimony by urging the Commerce conference committee to restore clarity to a 2010 insurance mandate and include language from House File 4188 in the conference report with four days left in the session. "We are here this morning because, with just four days left in session ... there are about 250 families across the state with kids with complex medical needs who are counting on all members of the Legislature to stand up for them and ensure insurance companies are held accountable to cover the care they need," Boldon said.

Parent Kit Chambers of Plymouth described how her son Nash, a medically complex 4‑year‑old, relied on registered nurses to remain at home and attend school. Chambers said the family’s commercial plan previously covered physician‑prescribed nursing hours but "quietly decided to re‑interpret what they owe us" after open enrollment ended. "Our insurance company is now telling us they will only cover about two days per week. That is not coverage. That is abandonment," Chambers said, adding Nash has endured "over 60 surgeries" and "500+ days hospitalized."

Speakers pressed a legal distinction they said has been confused by plans and regulators: "home health" visits, which are short‑term and episodic, are different from continuous, skilled "home care nursing" that some children require around the clock. Testimony emphasized that House File 4188 would "prohibit quantity limits on home care nursing services and clarify how the services must be defined in health plans for people who have both private insurance and Medical Assistance," and that the bill would not change clinical eligibility criteria.

Sen. Matt Klein, a physician at the Mayo Clinic and a co‑chair of the Commerce Consumer Protection conference committee, said he and the other conference chairs have left the bill open and intend to try to resolve it before the end of session. "We are going to keep it open for the remaining four four days of session in the hopes that an agreement can be reached and we get this work done," Klein said.

Rep. Robert Bierman, co‑chair of the House Health Finance and Policy Committee, told lawmakers the insurers' re‑interpretation effectively shifts costs to taxpayers. "Last night we just got a budget agreement — there is no extra funding to cover additional costs from the state budget," Bierman said, and he urged passage of corrective language in the Commerce Committee. Testimony in the hearing included an estimate that the cost shift to state funds could be "roughly $75 million," though speakers did not identify an independent source for that figure.

Supporters framed the bill as restoring settled law rather than expanding coverage: multiple lawmakers said a 2010 legislative mandate required commercial plans to pay for home care nursing for people who also have Medical Assistance, and they characterized insurers’ new limits as a financial re‑interpretation rather than a legal one. Sen. Abeler of Anoka closed a round of remarks by calling the effort nonpartisan: "This is not partisan ... it's a matter of right or wrong. Let's do the right thing," he said.

The hearing did not record a formal committee vote. The Commerce conference committee remained open on the item; supporters said they would continue negotiations in the remaining days of session.