Senate committee hears informational testimony on county-run health plan proposal (Senate File 3149)

Senate Health and Human Services Committee members heard informational testimony April 8 on Senate File 3149, a bipartisan bill sponsored by Sen. Mark Hoffman to create a county-administered rural medical assistance model (referred to in testimony as CARMA) that would give counties a new contracting path as an alternative to existing PMAP procurement. The bill was heard post‑deadline and no committee action was taken.

Sen. Mark Hoffman told the committee the bill grew from two years of collaboration between the Department of Human Services (DHS), county-based purchasing plans and county associations and is intended to "build on the 45 years of success of county based purchasing." He described the bill as offering "direct multi‑year contracts as an alternative to existing PMAP procurement processes," and said the model emphasizes local control and closer integration of social services, public health and other county programs to address health‑related social needs such as housing, food and transportation.

County and plan representatives told the committee the approach is aimed at improving outcomes in rural Minnesota. Brad Anderson, a Goodhue County commissioner and member of the South Country Health Alliance board, described county‑run plans operating in 32 counties and said local care connectors — staff who help residents navigate services — are central to the model. "When they connect with our care connector in Goodhue County who's been in that position for 19 years, it is a voice they are very familiar with," Anderson said.

Matt Freeman, human services policy lead for the Association of Minnesota Counties, said CARMA "builds on the success of CBPs" while accounting for smaller provider networks and enrollees in rural counties. Freeman also identified data and technology as major barriers to integration, saying he served on a workgroup addressing those issues and that "one of the biggest barriers" is counties' ability to share information across systems. He thanked Sen. Lindsey Kupak for carrying a bill addressing county technology costs and said conversations between DHS and county‑based purchasing plans are ongoing.

The Minnesota Council of Health Plans, represented by Chelsea Olsen, told the committee the CARMA proposal raises concerns about enrollee choice and market competition. "This bill instead proposes to eliminate MCO managed care as offered by our nonprofit members in any county choosing CARMA," Olsen said, adding that the proposal could "eliminate the benefit of competitive bidding and natural competition to enhance services." She urged the committee to consider the results of a DHS report commissioned in 2024 before moving forward.

Committee members asked procedural and technical questions. Sen. Ruth Edke confirmed the hearing was informational and learned the bill is considered active but was heard after the legislative deadline. Members asked whether the DHS report is available; testimony indicated the report had not been provided to the committee during the hearing. Senators also pressed on data‑sharing plans and interoperability; Freeman and others said early conversations are under way but that technology and privacy issues remain unresolved.

Because this was an informational hearing held after deadline, the committee took no formal action; members were reminded that the bill remains active for the next session and that the pending DHS report may be useful to further development.

Forward look: proponents and opponents urged further work on technical, legal and enrollment details and asked DHS to provide its commissioned report to inform next steps.