‘MinnesotaCare Buy-In’ hopes to improve state healthcare

by Cori Hilsgen

news@thenewsleaders.com

Hoping to improve Minnesotans’ access to healthcare, state officials Lt. Gov. Tina Smith and Human Services Commissioner Emily Piper held a town hall meeting Nov. 6 at the St. Cloud Technical and Community College to discuss the “MinnesotaCare Buy-In” proposal.

A panel of speakers included Smith, Piper, State Rep. Clark Johnson, Senior Policy Advisor Lauren Gilchrist, Minnesota Farmers Union President Gary Wertish, St. Cloud State University Director of Student Health Services Corie Beckerman and Ralonda Mason from Mid-Minnesota Legal Aid.

“Minnesotans are concerned about the rising cost of health insurance for their families,” said Smith in a press release. “This proposal can help. For 25 years, MinnesotaCare has offered a more affordable choice for 100,000 Minnesotans. Gov. Dayton and I strongly believe all Minnesotans should be able to purchase this high-quality health insurance. I thank St. Cloud area residents for sharing their stories and input with me ahead of the 2018 legislative session.”

Smith and Dayton proposed the buy-in last year, hoping to lower prices and improve access for about 100,000 state residents.

The buy-in is not free health care but a health-insurance policy similar to those offered by commercial health plans. MinnesotaCare offers broader access to physicians and care providers, and people would have more options to choose their care providers, its advocates maintain. Currently, only certain Minnesotans at a certain income level are eligible for MinnesotaCare.

The proposal would give those who purchase their health insurance on the individual market the choice to buy into MinnesotaCare. People who choose the buy-in would pay their own way and the cost of their premiums would pay for their coverage.

Piper said MinnesotaCare has been a source of quality, affordable coverage for decades, and it’s now time to give all residents in the state the option to purchase the coverage.

By maximizing the state’s competitive bidding process, officials believe they could get a better bargain for those who buy individual insurance coverage and could offer lower health-insurance costs with little to no ongoing costs to state taxpayers.

After a one-time start-up cost, the buy-in is expected to be funded by the premiums of those who purchase the insurance coverage. Last session, the estimated start-up cost for the buy-in was about $12 million.

In the panel discussion, Wertish spoke about the decisions farmers are being forced to make regarding their expenses and the rising cost of health insurance. Even if they raise a good crop, they are not always able to pay their expenses.

Beckerman talked about how many people assume all college students are covered under their parents’ plans, but students also include parents, veterans and others. Many are forced to choose between the cost of insurance and paying their rent.

Without health-insurance coverage, many people don’t do the preventive measures that often help them stay healthy.

She said many mental-health issues surface for students during the college years. Other things such as pregnancies or illnesses such as a cancer diagnosis can also occur.

Beckerman also discussed low-cost options with the college’s student-health plan.

Area physicians Dr. Kimberly Tjaden and Dr. Patrick Zook were also part of the panel discussion. Tjaden discussed wanting all people to have access to health care but also wanting to keep clinics open.

Zook discussed the breaking point of primary care. If physicians and practitioners are squeezed too hard, they will hit a breaking point, and he believes many in the area are at that point.

Smith discussed how the costs of patients who are unable to pay their bills after receiving treatment can create issues.

Piper said Minnesota’s uninsured rate is now the second-lowest in the nation and has a $40-million reduction in uncompensated care.

Johnson gave an example of how physicians and practitioners can budget for rates but they can’t budget for the unanticipated expenses.

Mason discussed how access to providers can change when people switch insurances, and that often causes disruptions and setbacks in service for patients.

The State Legislature will have a chance to consider the proposal again in 2018. If approved, MinnesotaCare Buy-In coverage is expected to cost less than commercial health-insurance plans.

Last year’s proposal projected the buy-in would have cost about $469 per person per month for 2018 coverage. That was 13 percent less than the average projected commercial health plans.

Those who purchase from the buy-in coverage would still be eligible for federal tax credits through MNsure. More than 70 percent of MNsure enrollees are receiving tax credits this year.

If the legislature enacts the proposal by March 1, 2018, people in Minnesota could purchase the buy-in coverage by the 2019 open-enrollment period.

Creating the buy-in would require approval from the federal government. The state would also need a federal waiver to avoid any negative impact on federal basic health-plan funding and to be sure the buy-in option complies with federal law.

Republican Gov. Arne Carlson and a bipartisan coalition of legislators created MinnesotaCare in 1992.  About 100,000 eligible Minnesotans currently have this coverage.

St Cloud Technical and Community College Foundation Director Arlene M. Williams said the meeting was held at the college at the request of the governor’s office.  She said the college is a natural location choice as it has many health-related careers and adequate space and parking.

Currently, there are 338 students from the Sartell, St. Stephen and Rice areas and 99 students from the St. Joseph area enrolled at the college.