What Minnesota Democrats and Republicans are promising about health reform
That means major changes to
"At some point, when you're in a crisis situation -- which we are -- we have to look at all options," said Rep.
But
Discussions this week with Davids; Rep.
THE PROBLEM
Health insurance premiums for the 5 percent of Minnesotans who get their plans on the individual market are shooting up by 50 percent or more for this year -- after double-digit increases last year, too.
Meanwhile,
Insurance Commissioner
The immediate reason for these problems:
A larger pool of healthy people would let insurance companies keep premiums lower for everyone.
WHAT BOTH PARTIES AGREE ON
Health policy leaders in both parties agree that
Though they don't always agree on the precise details,
The basic idea: set up a state program where the cost of expensive patients would be spread over a much larger group of people. Until the federal Affordable Care Act,
Negotiating the details could be tricky. Paying for these high-cost claims would cost millions of dollars per year and possibly much more.
Lawmakers will need to decide whether this cost should be borne by taxpayers as a whole or spread out to the broader insurance market -- and how much of their extra cost sick people should have to pay themselves.
Another idea with bipartisan support is to end "surprise billing" -- especially the practice where a patient goes to an in-network hospital but is sent to a specialist at that hospital who is out-of-network. Efforts to promote cost "transparency" draw support across the aisle.
WHAT REPUBLICANS PROPOSE
A priority for Republican lawmakers is to provide immediate relief to Minnesotans in the form of a tax break.
Benson said
In a related area, most
WHAT DEMOCRATS PROPOSE
One idea with a lot of support from legislative
Under the most popular plan, Minnesotans would be able to purchase unsubsidized MinnesotaCare insurance. This would be available throughout the state, giving another option for Minnesotans in areas with limited options.
But
OTHER IDEAS
Republican and Democratic health leaders in the
But House leaders of both parties are skeptical of this idea, thinking it could hurt and destabilize the small-group market without necessarily saving the individual market.
Lourey wants the state to explore action to get rural Minnesotans faced with narrow-network plans more affordable access to doctors of their choice.
Benson proposed converting MinnesotaCare, at least in part, from a state-run health care program into cash subsidies with which poorer Minnesotans could buy private insurance. These would be on top of existing federal subsidies for low-income Americans, which might not be enough for the working poor.
Thissen said the state needs to look beyond just stabilizing the insurance market and explore broader efforts to slow the growth of health costs in
This article has been updated and expanded, including to note that
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