Senate DFL plan would extend health coverage

"MN Senate"

01/11/2007

Caps on premiums, more access to state-subsidized coverage are among highlights.


By Patricia Lopez, Star Tribune
January 10, 2007


In a sweeping plan to extend health coverage and control costs, the DFL-led Senate wants to cap all health-insurance premiums, require insurers to cover adult children under 25 through their parents' plans and allow small businesses and more farmers to buy into state-subsidized insurance.

Sen. Linda Berglin, DFL-Minneapolis, the Senate's leading force on health care, said the proposal could cover as many as 40,000 additional Minnesotans and would move the state toward universal coverage by 2010.

"We can't make people keep waiting," Berglin said, "especially when we have the resources."

Gov. Tim Pawlenty will announce a health-care proposal today.

Pawlenty's spokesman said the governor's plan has similar goals but uses somewhat different methods.

Under the Senate plan, eligibility for MinnesotaCare, the state's subsidized insurance program, would be increased for adults without children, and a four-month waiting period for children would be eliminated.

The package would also create a prescription-drug discount program for low- to middle-income earners, allowing a family of four making $60,000 to buy drugs at Medicaid-negotiated prices.

The plan has drawn support from Senate Republicans, with Sen. Paul Koering, R-Fort Ripley, co-sponsoring it.

Extending MinnesotaCare to small businesses and struggling small farmers is vital, Koering said, particularly in his rural district. "Small businesses are the backbone of our state," he said. "There's constant turnover because they can't provide health care."

Brian McClung, Pawlenty's communications director, said the Republican governor's plan will focus more on private market solutions and reforms.

McClung was most critical of the premium caps in the Senate proposal, which he called "artificial price controls," although he added that the administration was also "exploring ways to use existing authority ... to control premium growth and leverage reform." The state Commerce Department must approve rate increases. Berglin said that premium caps would have saved the average enrollee $384 in 2006 alone.

McClung said Pawlenty was more receptive to a mandate that insurers offer coverage to unmarried dependents under 25 years of age.

Health plans are wary of the Senate DFL proposal, supportive of increasing accessibility but opposed to premium caps.

Too many elements are outside a health plan's control, said Phil Stalboerger, director of legislative affairs for Blue Cross Blue Shield. "Technology, prescription drugs, utilization are driven by consumers. We'd rather focus on things that actually reduce the cost of care."

However, Stalboerger said, the Blues were interested in under-25 coverage. "Lots of states are looking at that," he said.

Mysty Shaney, 37, was at Wednesday's news conference with her 7-year-old son. She talked of her struggle to get him tested and treated for ADHD. "We had MinnesotaCare until he was 2," said the single mother from Blaine. "It was the biggest help in the world to me." Now, she said, her office job pays "just a little too much" for her to qualify. Tests for Joey would cost $115 an hour and, along with medication, remain out of her reach.

Dr. Bob Meiches, CEO of the Minnesota Medical Association, said the MMA is pushing hard for universal coverage but has not examined the details of Berglin's bill. He noted that the MMA supports Berglin's call to limit administrative costs, bring uniformity to billing and switch to electronic medical records.

Berglin said many of the elements were long overdue, including a way to cover small-business employees at affordable prices. More than half of Minnesota's 383,000 uninsured are employed by small businesses, she said.

Berglin said that costs for her proposal have not yet been determined, but funding would come from the $188 million surplus in a dedicated state health-care fund as well as from the general fund. Tax increases would not be necessary, she said.

Berglin said she also expects the plan to save some money, particularly on the $415 million spent on the uninsured in 2005 by hospitals. Such uncompensated care is recognized as a factor in driving up premiums.

The DFL-controlled House will release its proposal early next week. It is expected to be more limited in scope, focusing primarily on coverage for the 80,000 uninsured children in Minnesota.