One of the enduring lessons from the Affordable Care Act's rocky rollout is this: Health care reforms that seem simple in concept are often more difficult than expected to enact in the real world. Minnesota's experience with MNsure is a case study. A website that allows consumers to comparison-shop insurance and check if they qualify for financial aid? Sounds easy in this tech-savvy age. But it's taken several years for MNsure to work through its bugs and start living up to its promise.
Gov. Dayton's plan would most quickly address health premium hikes
Adding complexity to aid plan for 2017 creates more risk of snags.
November 24, 2016 at 12:37AM
Knowing that even good ideas can be challenging to implement is valuable as tensions escalate between Gov. Mark Dayton and GOP legislative leaders over short-term financial aid for consumers hit with massive premium increases. Given that bills for 2017 coverage kicking in Jan. 1 will start arriving in early December, any new plan must be one that can be executed with the least risk of delays or technological snags.
The consumers hit by the premium increases are the 5 percent of Minnesotans who buy coverage on the individual market, meaning they don't get it from employers or public programs such as Medicare. While many will qualify for federal aid to substantially discount premiums, some will not because their income is too high. Those are the consumers who need assistance from lawmakers.
Developments this week in negotiations over a special legislative session to approve aid have made it clear that Dayton's plan, which would provide rebates of up 25 percent of monthly premiums in 2017, would be the most straightforward to implement. The governor's proposed yearlong program, which would be funded by $300 million from the state surplus, is easy to understand. The stable sum it would provide over the entire year would also give the most certainty to consumers who are deciding right now what level of health insurance they can afford for the coming year.
The plan would also likely present the fewest headaches for state staff and insurance companies to administer. That's a major plus because those organizations would ultimately get the money to those who need it.
State Republican legislative leaders merit praise for putting forth a detailed alternative to Dayton's plan. What they've proposed goes beyond campaign-trail rhetoric. It also acknowledges a critical reality: State aid has a role to play this coming year to ensure health care access.
The GOP plan calls for a premium "cut" of 20 percent for the month of January. Then, what's dubbed "targeted assistance" would kick in for the rest of the year, with aid targeted to those with lower incomes. Details such as how much Republicans would spend on the program or how the aid would be delivered to consumers were not available this week. However, the GOP raises a fair point about giving less assistance to those with higher incomes. In addition, its proposals to broaden provider networks and allowing the state aid dollars to be used for other health costs are worthwhile.
The challenge is whether these additional details, such as adding income verification to insurers' responsibilities and designing a different state aid delivery system, could be executed in a tight time frame for 2017 relief. The answer likely is no, but GOP leadership has identified important improvements to consider during the regular legislative session for 2018 and beyond.
Now that Gov. Tim Walz’s vice presidential bid has ended, there’s important work to do at home. Reinvigorating that “One Minnesota” campaign is a must.
