Blue Cross wants state to require coverage

09/06/2006

Insurer joins growing call in Minnesota for universal plan to cut costs, improve health

BY JEREMY OLSON
Pioneer Press

Minnesotans would be legally required to have health insurance under a proposal unveiled Tuesday by Blue Cross and Blue Shield of Minnesota to prevent further increases in medical costs and the number of people lacking health benefits.

While it could cost the state as much as $911 million per year to extend coverage to the nearly 400,000 uninsured residents, a Blue Cross executive said, the tradeoff would be healthier Minnesotans who needed less medical care and were more productive at work.

“It’s time for Minnesota to commit to a long-term, sustainable strategy to achieve universal health coverage,” Blue Cross President Colleen Reitan said at a business luncheon at the University of Minnesota.

The Blue Cross proposal, called Unfinished Business, adds to a growing drumbeat in Minnesota for universal health coverage that will likely keep the issue atop the fall election campaigns and next year’s legislative session.

A little state pride appears to be on the line. Minnesota has long been viewed as a national leader in health reform, but Massachusetts recently took the spotlight when lawmakers there approved a mandatory insurance law. States are gradually taking on the universal coverage issue, after years of inaction at the federal level.

The state Health Department estimated this summer it would cost the public Minne-sotaCare program $663 million to extend coverage to the uninsured. Protesters at last month’s presidential visit argued universal coverage is more important than President Bush’s plan to reduce medical spending by making the public aware of the costs.

The Minnesota Medical Association, representing the state’s doctors, will consider three resolutions later this month calling for mandatory health coverage, and has already offered legislation to that effect.

“There are plenty of people who really do suffer because of their inability to access our medical system,” said Dr. Don Jacobs, who is leading a medical association group, called Healthy Minnesota, that is seeking to push health care reforms in the state.

The uninsured are less likely to obtain preventive medical care and more likely to suffer severe illnesses and need hospital care that they can’t afford. The cost of this so-called uncompensated care is expected to reach $250 million in Minnesota this year.

Critics point out that insurers such as Blue Cross have financial incentives in promoting mandated insurance, because it would guarantee them additional members and premium dollars. By taking control of the universal health care debate, insurers also discourage the idea of government taking over health care funding and putting private health plans out of business.

Blue Cross wrote the report in response to rising uninsured rates, not because of potential financial gains, said Cindy Goff, director of public policy. While Minnesota has the nation’s lowest uninsured rate, it has increased from 5.6 percent in 2000 to 7.4 percent in 2004, according to state health estimates.

“We really do believe what we say about the economic benefit of everybody having coverage and we really do believe in the peril of slipping backwards,” Goff said. “When we saw that we were starting to slip backwards, we realized we really needed to get the conversation going again.”

The state’s uninsured population includes Hispanics and rural Minnesotans. Many earn low incomes that make them eligible for public coverage, but they haven’t applied. Others are young, healthy people who are taking the chance they won’t need coverage.

Details of the Blue Cross proposal include:

• A sliding scale of subsidies to help low-income individuals who can’t afford private coverage but make too much for government health benefits.

• A state government insurance mandate that would include penalties, deducted through paychecks or tax filings, for people who didn’t gain coverage.

• An allowance to keep children on their parents’ insurance until they marry or turn 25.

• A guarantee that health plans couldn’t reject individuals seeking private health coverage, even if they are sick or having severe medical conditions.

Unaddressed by the proposal is how much coverage would be required. The state could require extensive medical coverage, but that would be unaffordable. It could require bare minimum health benefits, but they wouldn’t give people much of an advantage.

The idea of mandates brought unease to some of the small-business owners who heard Reitan speak Tuesday, because the growing burdens of health care are forcing many to drop health benefits for their employees altogether.

Reitan said the proposal is just a starting point with some admittedly “controversial” ideas. She said universal coverage can work, but only if it offered affordable options for individuals and employers.

“Solving these problems,” she said, “creates some compelling opportunities for communities that get there.”

Online

Read the report at http://www.bluecrossmn.com/public/access.

Coverage for all?

Blue Cross and Blue Shield unveiled a health plan Tuesday to insure all Minnesotans. It would:

Provide subsidies for low-income, working families.

Let children stay on their parents’ insurance until they marry or turn 25.

Require health plans to provide individual coverage, even if a person is sick.