EDITORIAL: Health care gets personal at Minnesota Capitol

Jan. 25--Gov. Mark Dayton wanted a new health insurance option for Minnesotans -- not his own health -- to be the headline as he sent a 2018-19 budget proposal to the Legislature. But with a fainting spell during a major address Monday and the revelation of a cancer diagnosis Tuesday, Dayton's well-being became the talk of the Capitol.

The DFL governor inadvertently underscored a reality that ought to drive this year's health policy debate: Health issues are unpredictable, and spare no one.

After presenting a $45.3 billion 2018-19 budget that includes a proposal to allow all Minnesotans to enroll in MinnesotaCare, the 25-year-old, state-subsidized insurance option for low-income people, Dayton almost casually told reporters that he was diagnosed last week with prostate cancer.

The two-term governor, who will turn 70 Thursday, said he considers himself able to continue to serve in office. "As far as I know, there are no brain cells in my prostate," he joked. The disease is one that generally responds well to treatment, he said.

The Republicans who control both chambers of the Legislature were quick to wish the governor a full recovery. But they also signaled their opposition to a number of his budget ideas. They seem particularly resistant to Dayton's proposal to turn MinnesotaCare into a full-blown "public option" that can compete with the not-for-profit health insurance plans currently on offer at the MNsure exchange. Dayton's proposal was denigrated by Sen. Michelle Benson, R-Ham Lake, as "doubling-down on government plans that will lead to fewer providers and scarcer care."

That's one view of the possible consequences of a MinnesotaCare expansion, but it's not the only one. Others see lower costs for consumers, increased competition and the assurance of at least one individual health insurance option in every corner of the state -- something not guaranteed today.

A year ago, a health care financing task force created jointly by Dayton and the 2015 Legislature recommended raising the income eligibility threshold for MinnesotaCare. Republican legislators should at least conduct hearings to examine that idea as well as Dayton's proposal to allow Minnesotans at all income levels to enroll.

They should also seriously consider Dayton's recommendation that the 2 percent provider tax that has underwritten MinnesotaCare for a quarter century be continued indefinitely. That tax is now due to disappear in 2019. If it goes, MinnesotaCare and a portion of Minnesota's Medicaid funding will be in jeopardy.

In other respects, Dayton's budget proposal contains few surprises. He seeks a substantial increase in funding for education from preschool through college, but -- in a bow to fiscal as well as political reality -- he did not renew his earlier call to require all school districts to offer preschool for 4-year-olds.

To his credit, he aims several proposals at helping low- and middle-income families afford quality child care -- an important move in a state that needs to keep as many young parents in the workforce as possible while giving more children the benefit of preschool experiences.

He allowed that in a separate message to the Legislature, he will again propose a gas tax increase to pay for highway improvements -- which Republicans said they will again oppose. That impasse and consequent inaction have been the transportation funding story throughout Dayton's governorship.

We're rooting for something to happen this year to change that narrative. Dayton offered a suggestion Tuesday: "If I'd known [fainting] would result in the Republicans not criticizing my speech, I might have tried it years ago," he quipped. We'd prefer a less drastic tactic.

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