Counterpoint: Minnesota health care nostalgia vs. today's reality

This week, Arne Carlson and Lee Greenfield made their pitch for keeping the status quo in health care reform ("Health care solution must not be a casualty," May 12).

We should all be proud of the outstanding work Minnesota has done in providing nation-leading health care programs for the low income. Gov. Carlson and Rep. Greenfield should feel good about their legislative work, done in the early 1990s. However, that nostalgia must be updated with some facts about how Minnesota has changed in the wake of Obamacare.

After Gov. Mark Dayton was sworn in, he immediately expanded Medicaid to cover most of the folks who were on MinnesotaCare, the program Carlson and Greenfield began 23 years ago. To be fair, it was not simply Obama supporters like Dayton and Carlson leading that charge here and across the country; Medicaid expansion was supported as a boon to states.

Minnesota has two programs covering folks who would in any other state be covered by one health care exchange. MinnesotaCare, a one-size government program, covers about half of the folks who would otherwise be eligible to purchase subsidized plans on the state's insurance exchange, MNsure, which covers the other half.

MinnesotaCare no longer serves the low-income children and their parents for whom it was designed 23 years ago. Those folks are almost all on Medicaid now. The program now primarily covers low- and middle-income adults. The 2 percent provider tax that funds the program is set to expire. The program covers 60,000 families (just under 95,000 people) for about $1.4 billion per biennium. The promised federal funding didn't pan out, so Minnesota taxpayers pick up the majority of the 93 percent of costs not paid by enrollees. A family of five making $70,000 would be covered under MinnesotaCare if it expands as provided under current law.

MNsure has failed to meet enrollment numbers and has made life worse for many Minnesotans who struggle with a broken website, clogged call centers and overburdened county offices. While Hawaii and Oregon have abandoned their state-based exchanges in favor of HealthCare.gov, the federal exchange, Minnesota just approved another $90 million in spending on MNsure on top of the $200 million already spent.

That's why we think MinnesotaCare and MNsure should be combined into one program that is paid for and works better. The plan provides choices for families and better reimbursement for hospitals, and Minnesota will save over $1 billion over four years.

It's also high time we find and save the hundreds of millions of dollars Minnesota wastes on paying for services we shouldn't be paying for. We can't afford to spend money on waste or fraud. Illinois recently removed over 370,000 ineligible recipients (including 8,000 dead people) from its health care entitlement programs.

Many in the administration say Minnesota can't save a single dollar in our programs. However, just this week, we discovered that the administration has stopped verification altogether for thousands of MNsure enrollees because of a glitch. This, only weeks after the legislative auditor reported a 17 percent error rate in our eligibility determinations with thousands of backlogged files. This week, a constituent called to complain that she tried to get off Medicaid because she finally got a job but that she was turned away.

While admitting that these programs need massive reform, leaders threaten to shut down government before even discussing changes to our programs, and the only thing they will do is form more committees to study the problem. Demagoguery won't fix health care. Partisanship created much of the mess we now have, and it is too big a challenge to be solved by either party going it alone.

Every day, I talk to Minnesotans who are fed up with paying more and more, and getting less and less from a health care system they have paid into their whole lives. They sure don't have status quo. I met a man named Charlie Dunker, who lost his wife to cancer while MNsure prevented her from getting the diagnosis and treatment she would have needed to survive. Mr. Dunker doesn't have status quo.

We can look back with nostalgia on the past, but policymakers concerned about Minnesota's future need to tune out the rhetoric and decide that Minnesota should again lead, not follow, national health care reform.

Matt Dean, R-Dellwood, is a member of the Minnesota House.