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Walz pressed on nursing care law
About 250 Minnesota families are caught in a coverage gap after two major insurers capped nursing care benefits they'd provided for 15 years — and a bipartisan group of 45 lawmakers is now pressing Gov. Tim Walz to enforce a 2010 state law that requires full coverage. FOX 9's Corin Hoggard has more.
ST. PAUL, Minn. (FOX 9) - Roughly 250 Minnesota families are caught in a coverage gap after two major insurers changed how they interpret a 15-year-old state law — and a bipartisan group of lawmakers wants Gov. Tim Walz to step in.
The 2010 law at the center of the fight
A state law passed in 2010 required commercial insurance plans to cover medically necessary home nursing care for patients who also have Medicaid. For 15 years, insurers like Medica and Health Partners provided that full coverage. But last year, both companies placed new caps on how much nursing care they would cover.
What they're saying:
Kelly Wolfe, a Medica representative, said the company made that change with a specific expectation in mind.
"We did that with the understanding that Medicaid would continue to provide the nursing services that these children qualify for," said Wolfe.
But for Nick and Sam Keis, the parents of 6-year-old Guinevere, the Medicaid waiver program simply doesn't cover enough.
"We wouldn't be able to afford our nurse with the waiver program. We would only be able to cover, I believe through October before we ran out of hours to money to cover our nurse, so then we wouldn't have a nurse," said Sam Keis.
A family beating the odds — and fighting for coverage
Guinevere Keis was born three months prematurely after her mother's uterus ruptured. She spent her first 116 days in the NICU. Her father, Nick Keis, recalled the early uncertainty around her survival.
"They're 'going to be lucky to make it a week' and then after a week they're doing okay, 'maybe a month,' then after a month they said 'maybe three months,' six months and then a year," said Nick Keis.
Six years later, Guinevere is still living and growing, but she requires nursing care around the clock. Her diagnoses include hypoxic ischemic encephalopathy, bilateral brain bleeds at birth, hydrocephalus and epilepsy. Her family carries both private Medica insurance and Medicaid, and for the first five years, Medica covered a nurse on duty 18 hours a day, seven days a week.
What's next:
When the coverage changed, the Keis family filed a complaint with the state Department of Commerce, but it was closed without any action taken against Medica. Nick Keis said the family isn't asking for anything new.
"We're not asking them to pick up any additional money that they weren't for the last 16 years, since 2010 when this law went into effect. This is money that's been on the books all along. The fact that they're pulling this away, they're profiting off of the suffering of disabled children," said Nick Keis.
A bipartisan group of lawmakers tried to pass a bill in 2026 clarifying that the 2010 law requires full coverage, but Republican leadership in the House blocked it. That led 45 lawmakers – some from both parties in both chambers -- to send Walz a letter in June, asking his Department of Commerce to enforce the existing law.
A spokesperson for Walz responded: "Governor Walz shares the valid concerns of these families with complex medical needs. He believes strongly that the state legislature can and should strengthen protections for Minnesota kids with disabilities. In the meantime, he has instructed the Department of Commerce to explore any potential administrative solutions. The Governor also believes these insurance companies should not be let off the hook for trying to make an outrageous profit off the families that most urgently need assistance."
Lawmakers sound the alarm
Sen. Liz Boldon (DFL-Rochester) said the stakes go well beyond individual families.
"The ramifications of this are far reaching and again, have deep impacts on these families, and the state budget and just the precedent of insurance companies being able to ignore the law," said Boldon.
What we don't know:
Commerce is currently reviewing 2027 insurance plans. If the department does not take any administrative action, about 250 families could be left waiting until the next legislative session, hoping a clarifying bill makes it through.
The Source: FOX 9's Corin Hoggard reported from the Capitol.