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Serving Northern St. Louis County, Minnesota

MinnesotaCare expansion would boost rural options

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REGIONAL— Supporters of Gov. Mark Dayton’s proposal to allow any Minnesotan to buy MinnesotaCare health insurance say the expanded eligibility is critical for rural residents of the state, where insurance choices and health care provider networks are increasingly limited.

“It’s really clear that out in the countryside, having some additional options is important,” said Rep. Clark Johnson, DFL-Mankato, during a press conference held Monday at the Capitol.

Sen. Tony Lourey, DFL-Kerrick, noted that the state’s major insurers have been steadily reducing their offerings in rural Minnesota and said he’s not confident that the situation won’t continue to get worse. “I’ve asked all the carriers myself if they will be there in my district in 2018 and I can’t get one to tell me with any confidence that they will be,” he said.

At the same time, supporters of expanded eligibility for MinnesotaCare, say that the quality of private sector insurance offerings in rural Minnesota is declining, with higher deductibles and a more limited pool of in-network providers. By contrast, they say, MinnesotaCare offers a wide network of providers, minimal deductibles, and an average premium that is 12 percent lower, on average, than private offerings currently available through the state’s insurance marketplace, known as MNsure.

Christina Hujanen, recently of Tower, credits the Mayo Clinic with saving her life, when she developed stage four esophageal and stomach cancer in 2015, but she notes that the MinnesotaCare coverage that she had at the time of her diagnosis was the only insurance option in northern St. Louis County that included the Mayo Clinic in their network. “I definitely don’t know what I would have done if I wasn’t on that plan,” said Hujanen. “I never realized how limited you are on a lot of these plans until I got sick.”

Sen. Lourey also sees value in the broad network offered through MinnesotaCare.

“I really believe MinnesotaCare is a very viable option for many families in my district,” he said. “When I talk to people about the idea, they respond very favorably. It’s something that Minnesotans are looking for.”

MinnesotaCare was created in 1990s as a bipartisan effort to address the lack of health insurance access for low income Minnesotans, and access has been limited in the past to those earning 200-percent or less of the federal poverty level. The program offered heavily-subsidized insurance to those who met the income guidelines. That wouldn’t change under the governor’s proposal, but those who earn more than 200-percent of the poverty level would be able to buy MinnesotaCare coverage for the first time, at its standard, unsubsidized premium. That means that the governor’s proposal would not require state taxpayer funding, beyond an initial $12 million startup cost.

Yet Minnesotans who meet the income guidelines under the Affordable Care Act would still qualify for federal subsidies that could substantially reduce the cost of their MinnesotaCare premiums.

The prospects for the proposal in the Republican-controlled Legislature remain unclear, although DFL supporters of the proposal expressed optimism that their GOP colleagues would give it serious consideration. Rep. Johnson noted that many Republican legislators represent rural districts, where access to quality insurance coverage is a major concern.

The Timberjay did contact Sen. Michelle Benson, R- Ham Lake, who now chairs the Senate Health and Human Services Finance and Policy Committee, but her legislative assistant was unable to confirm whether the Senator planned to hold a hearing on the governor’s proposal.

The governor’s push on MinnesotaCare comes as lawmakers seek to grapple with the sharp increase in rates, and fewer options, put forward on the individual market by private insurers in the state. The rate hikes prompted the Legislature and the governor to agree on a $326 million package of rebates for those Minnesotans who don’t qualify for federal subsidies under the ACA. But lawmakers all agreed that the package is a temporary fix and both DFLers and Republicans have indicated they’ll seek additional reforms this year to provide a longer-term solution for the individual insurance market.