Benson: “MinnesotaCare Buy-In” supporters must answer difficult questions

Expanding MinnesotaCare raises big questions

By: Senator Michelle Benson

Thousands of Minnesota families are still struggling to recover from the Obamacare disaster, but that isn’t stopping Democrats from getting state government even more involved in health care. Toady’s version of DFL government-run health care is being called the MinnesotaCare Buy-In.

The idea is to dramatically expand eligibility for MinnesotaCare, the government-run health care program for Minnesota’s working poor.

It sounds good. It feels good. It’s comforting.

Unfortunately, last time we tried something that merely sounded good and felt good, it almost destroyed our health care market and hurt hundreds of thousands of Minnesotans.

Before we even consider their MinnesotaCare expansion approach, supporters of the plan owe it to Minnesota families to answer a few simple, but critical, questions:

1. Can you guarantee the federal government will allow federal money to pay for non-eligible people? Currently, MinnesotaCare covers people who are eligible based on income. If we expand beyond that population, there’s no guarantee the federal government will fund them. And if they won’t, working families will have to pick up the tab.

2. Can rural hospitals survive on lower reimbursement rates? Right now, hospitals receive full reimbursement from privately insured individuals and less than half for those on public programs. If we shift to a model where a small portion of hospital patients are privately insured, how can those hospitals stay afloat?

3. Will premiums increase for everyone else? Everyone knows private insurance cross-subsidizes public programs. If more people are on subsidized care paying less, then everyone else will see premium spikes to make up the difference. Will the increases be as high as 67%, like we saw last year?

4. Will doctors and nurses see significant salary and benefit cuts? The only way the math works is if those on the front lines accept pay reductions.

5. How much will we have to subsidize this program with new state taxes? We know Minnesota will receive less federal funding for state health care programs, and MinnesotaCare is funded through the health care provider tax that is set to expire. So in order to accomplish the MinnesotaCare Buy-In we’ll need a massive tax increase – but exactly how massive?

I look forward to future hearings about ideas to improve our health care system. In fact, we gave the MinnesotaCare Buy-In idea considerable committee time during a hearing on Feb. 28.

But as we debate the next steps, supporters of expanding government-run health care should be honest and realistic about what the costs will be and who will pay for it. In the last government expansion of health care, we were told “if you like your doctor, you can keep your doctor” and everyone would save $2500 a year on health care. It’s one thing for health care policy to sound good and feel good, but this time it has to work.

 

Senator Michelle Benson
Chair, Senate Health and Human Services Finance and Policy Committee