MinnesotaCares expansion proposed by lawmakers

ST. PAUL, Minnesota. On Wednesday, lawmakers began work on a proposal to allow all residents to participate in the MinnesotaCare state health insurance program, not just low-income workers who are trying to survive.

Democratic lawmakers and Gov. Tim Walz have been pushing for years to make MinnesotaCare a low-cost “public option” for health insurance available to everyone. With Democrats now in control of both houses of the Legislature and the governor’s office, expanding the program is one of their top priorities for the 2023 session.

MinnesotaCare, founded in 1992, is for low-income people who are not eligible for Medicaid and do not have access to affordable insurance coverage. The bill, which passed its first hearing on Wednesday, would remove the current 200% income cap on the federal poverty line.

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The Public Option aims to help people like home health care worker Tavona Johnson of Austin, whose husband was diagnosed with advanced colon cancer in 2020. As a small business owner, she said he didn’t have good insurance options. . The hospital then told them to be prepared to pay upfront payments of $14,000 for each chemo if they didn’t find coverage.

Johnson said at a press conference that they were finally able to find a plan through public health insurance exchange MNsure, but the premiums were “astronomical” at over $1,300 a month, with “obscenely high” deductibles and no prescription drug coverage. drugs or co-payments.

“We had to empty his pension fund to stay afloat. And we did this for a year. We had no choice,” she said. “My husband had to undergo this life-saving treatment. I couldn’t just let him die.”

Her husband died just over a month ago.

“The money he saved up and planned to use for us to retire together is gone. We had to use it to cover those medical expenses,” she said. “The money meant for me to survive after he’s gone is no longer needed.”

As of July last year, almost 108,000 Minnesota residents were enrolled in the MinnesotaCare program. The bill’s lead sponsor, House Majority Leader Jamie Long of Minneapolis, told reporters ahead of the hearing that he didn’t know how many more people would take advantage of the enhanced enrollment option, nor did he have any data on how much money the change would bring. will cost the state.

In 2017, the administration of former Gov. Mark Dayton estimated that lifting the income cap could double the number of MinnesotaCare enrollees. Walz’s proposed fiscal year 2024-25 budget includes nearly $21 million in program expansion.

Officials from business and insurance groups told the House Committee on Commerce that they are concerned about the impact on struggling hospitals in rural areas, given that payments from government programs are often much lower than those paid by commercial insurance plans and do not cover the full cost of treatment. . These commercial plans essentially help subsidize patients under government plans. And those officials have expressed fear that patients will switch from commercial plans to MinnesotaCare, further unbalancing the system.

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Rep. Tim O’Driscoll of Sartell, the leading Republican on the committee, urged his colleagues to “slow down,” adding, “We have a lot of unanswered questions.”

The committee voted to send the bill to the next of what is expected to be several committee stops.

Currently, the federal government assumes most of the cost of MinnesotaCare. The state’s share is funded by taxes on health care providers and insurers, as well as insurance premiums, which currently range from $4 per month per person to $80. Insurance is free for persons under 21 years of age. The current income limit is $29,160 per person, or $60,000 for a family of four.

Under the proposed expansion, insurance premiums will have a sliding scale, which the state will develop later. The State will also develop a participation option for businesses with fewer than 50 employees.

The change will go into effect in 2026, subject to the federal government’s approval of it, and eligibility will no longer be dependent on immigration status. During the transition, the bill will increase government subsidies for gold plans purchased through the MNsure exchange for 2024 and 2025.