Find most efficient route for insurance relief in Minnesota

The highest-profile debates over competing plans to provide Minnesotans with health insurance rate relief are taking place at the State Capitol as the 2017 Minnesota legislative session gets underway. But the most heartbreaking discussions about it are those occurring in homes far from St. Paul — such as the southeast Minnesota farmhouse belonging to Jennifer and Michael Rupprecht.

The couple, who live near Lewiston, have a small organic farm where they raise grass-fed beef, corn, soybeans and hay. They buy their health insurance on the individual market and were hit this year with a 76 percent increase that drove their annual premium to $22,000. The well-known hazards of farming mean they cannot go without coverage, but they make slightly too much to qualify for federal financial assistance through the Affordable Care Act to pay their $1,852 monthly bill.

As with many farm families, the Rupprechts' income fluctuates through the year, and they need to know when help will arrive. The couple also has a message for state lawmakers. They're tired of the "bickering and the partisan back-and-forth."

That anger is understandable. There's widespread agreement that the state needs to pass premium relief for consumers in the state's small individual health insurance market. But the disagreement between DFL Gov. Mark Dayton and Republicans over how to do it is frustratingly stretching into its third month. An agreement is imperative before Jan. 31, the main deadline to buy 2017 coverage. Families like the Rupprechts, who have to pay monthly premiums while the political standoff continues, deserve relief as soon as possible.

In October, Dayton proposed a 25 percent rebate administered as an instant discount on consumers' monthly invoices from insurance companies. The GOP plan calls for similar levels of aid but via individual monthly checks to consumers. Republicans also want to make the aid contingent upon income after three months. They also want to link the aid's passage to other controversial reforms, such as easing access to the Minnesota market for for-profit insurers.

This page has made clear that rate relief for consumers should not be held up for other reforms, which should be considered later in the session. But even setting the reforms aside, it's clear that the political gulf remains regrettably wide over how best to deliver the aid. Dayton contends that the complexities of the GOP plan would delay relief dollars potentially through January 2018 and cost up to $20 million to administer. In fiery exchanges this week in legislative hearings, it became clear that Republicans simply don't trust cost or time-frame estimates from Myron Frans, Dayton's budget commissioner.

To help push through the stalemate, an editorial writer sought out the opinions of former state officials who had Frans' job in previous administrations. Those reached cautioned against shrugging off Frans' concerns.

Tom Hanson, who served in the administration of Republican Gov. Tim Pawlenty, noted that it's generally wise to give agencies the benefit of the doubt. He also noted that Frans' agency has long been staffed by respected professionals who would have influenced Frans' assessments and would have acted as a check on potential political overreach.

Pam Wheelock, who served in the independent Jesse Ventura administration, cautioned that she hadn't studied the situation but said her initial take was that there are "compelling reasons" to rely on insurers' existing invoice systems, as Dayton recommends. Building new systems or getting existing ones to interface, she said, can take longer than expected. "If you care about speed, cost-effectiveness and accuracy, stay within the same bucket. Don't switch horses midrace. Stay where the relationship originated and where you are more likely ready to process or reverse a payment."

GOP lawmakers said this week that their preliminary work with vendors indicated that their plan could be implemented much faster and less expensively than Frans estimates. They would not provide the vendors' names to an editorial writer who wanted to contact the firms.

The Editorial Board previously endorsed Dayton's rebate plan as the surest, swiftest way to provide relief to beleaguered Minnesotans such as the Rupprechts. That assessment has not changed. Put consumers first by passing a relief bill that delivers aid as soon as possible.