Minnesota House passes $300 million health premium rebate plan

Jan. 20--The Minnesota House has approved a $300 million health premium rebate plan that GOP lawmakers say they intend to refine and forward to DFL Gov. Mark Dayton within a week.

The bill approved Thursday in the House would provide rebates for many of the approximately 123,000 Minnesotans who buy insurance on the individual market and do not qualify for subsidies to help with their surging premiums. It includes several other provisions Republicans said were meant to expand access to health care or make it more affordable, including coverage for people with serious conditions who lose their health insurance but still require treatment, and allowing for-profit health maintenance organizations, or HMOs, to operate in the state.

Late additions to the bill included a measure to create a farmers' health care co-op and one that would allow insurance companies to offer policies that do not cover all benefits mandated under federal law.

The specifics of the House bill, passed on a vote of 73-54, differ from those in the more streamlined, $313 million rebate plan backed by Dayton and DFLers in the Legislature. But Republican lawmakers said they've been talking with Dayton and are open to changes on some of the most debated points of the bill, including who would sort out and deliver the premium rebates.

The bill will move next week into a conference committee that includes members of both the House and Senate, which passed its own health care bill last week.

House Speaker Kurt Daudt, R-Crown, told reporters that his GOP colleagues are "eager" to work with the Senate and the governor, and that they intend to get a bill to Dayton by Thursday.

"The reforms in this bill are good and important, and we hope the governor will see it that way as well," he said.

Lawmakers from both parties have spent the first few weeks of the legislative session asserting that quick premium relief is an urgent priority. Bills in both chambers raced through a series of committee hearings at an unusually fast pace, leading to objections from DFLers who said the GOP was fast-tracking complex plans without proper vetting on issues ranging from data privacy to whether rebates would be taxed.

DFL lawmakers repeated those concerns in a lengthy debate Thursday, pointing out that state budget officials had not yet been able to provide a full financial analysis of the GOP bill.

Those officials testified in legislative committees that the rebate portion of the bill, which would be administered by the state, could cost $20 million and take up to a year to process the rebates.

Both the governor's bill and the GOP bill would fund premium rebates or discounts with state reserves.

Dayton's plan would provide a 25 percent discount that would be administered by insurance companies, appearing directly on people's bills in the form of a lower monthly premium.

All individual market customers who are not eligible for subsidies would see the discounts.

Under the House and Senate bills, rebates would be distributed based on income, and by the state. The Senate bill has a more complex system, offering three tiers of rebates between 20 and 30 percent, while the House bill would provide a 25 percent rebate -- but only to people who make less than 800 percent of the federal poverty rate. That level is $95,040 for an individual or $194,000 for a family of four.

Republican House members said the reforms tucked into the premium rebate bill are essential to solving broader health care issues facing Minnesotans. But DFLers again urged support for the governor's plan, which they said would solve the most urgent problem first.

Several said they are also troubled by additions to the House bill, particularly the one that would allow insurance companies to offer plans that could exclude coverage of conditions ranging from autism to diabetes.

Rep. Debra Hilstrom, DFL-Brooklyn Center, accused Republicans of creating a "reckless situation" in the state with a bill unlikely to get the governor's approval.

"You are not dealing with it as if it's a crisis," she said. "Here we are, creating a bill that's going to go to conference, and not going to be signed."

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