Bill mandates health coverage for Minnesotans

03/30/2005

Patricia Lopez, Star Tribune
March 30, 2005

Every Minnesotan would be required to have at least minimal health insurance and every insurer would have to offer such a plan under a far-ranging health care overhaul bill offered by the Minnesota Medical Association on Tuesday.

The bill, which was introduced with bipartisan support in the House and Senate, also would ban smoking in the workplace—including restaurants and bars—and would increase the cigarette tax by $1 a pack.

Sen. Sheila Kiscaden, I-Rochester, the bill’s Senate sponsor, called the proposal “a major health care reform effort” that ultimately could result in lower costs and more effective health care that leans heavily toward illness prevention.

But the proposal’s scope is immense and its provisions controversial, and even supporters acknowledged that chances for passage this year are slim. The legislative session is half over, and the requirements for universal coverage and a tax increase would be expected to provoke intense and prolonged debate.

“This is a late launch,” Kiscaden said, noting that several elements of the proposal, such as the cigarette tax and smoking ban, exist in separate bills and might pass on their own.

Rep. Jim Abeler, R-Anoka, the bill’s House sponsor, said that even if the MMA proposal does not pass this year, it “puts a whole lot of ideas on the table for us to look at.”

Dr. Michael Gonzalez-Campoy, MMA president, said that the plan was the result of “months of work,” and that health providers briefed on it had been enthusiastic.

At its core, the plan would set out an as yet undefined set of “essential benefits” that would provide minimal coverage with an emphasis on prevention.

Dr. Judith Shank, a dermatologist and former MMA president who led the organization’s health reform committee, said that while no guarantee of a subsidy exists in the bill, there is a presumption that “there would have to be subsidies for people who cannot afford” even the essential benefits coverage on their own.

Some additional money would come from the thousands of young people who are uninsured either by chance or choice. Shank has argued that “it is unfair for people who assume they are young and healthy to opt out” of health insurance, as some do. By requiring them to have some type of coverage, risk would be spread as broadly as possible, she said.

Kiscaden said that under the bill Minnesotans might be required to offer proof of coverage when they filed their income taxes or applied for a driver’s license. By the same token, insurers would have to offer the essential benefits and could not reject anyone because of age, gender or health history. Preexisting health conditions, a common reason for rejection for traditional policies, could not be taken into account.

Gonzalez-Campoy said the mandatory requirement would bring another 374,000 uninsured Minnesotans into the system, resulting in earlier treatment, more prevention and more affordable care. Ultimately, he said, “health care costs will be lower.”