Health insurance debate on tap this week
ST. PAUL — Minnesota lawmakers say they want to pass a relief package for Minnesotans facing soaring health insurance premiums by the end of this week, but lots remains to be done before policyholders know if they will get a state rebate. The next few days will determine whether that happens, or if Minnesota's leaders yet again hit delays.
The Dayton administration's top finance man said on Monday, Jan. 9, that greater Minnesota is especially looking at what happens in St. Paul. Democratic Gov. Mark Dayton and Republicans who control both houses of Legislature agree the state should provide relief to people affected by the "premium cliff:" earning too much money to qualify for federal subsidies but not enough to afford premiums as high as 30 percent of their annual income.
But they disagree on certain important details of how to do it. Those details will be sorted out Tuesday and Wednesday in committee hearings, where lawmakers, state officials, insurers and affected Minnesotans are expected to discuss proposed fixes. If a deal is struck, the House and Senate could each pass premium relief by Thursday or Friday.
That likely won't be the end.
The two chambers likely will pass different bills that would have to be reconciled in a House-Senate conference committee. Whatever solution they agree on will have to earn Dayton's support, too, or it won't become law. "We agree around this building that we need health insurance relief," Commissioner Myron Frans of Minnesota Management and Budget said. "We need it right away."
Especially looking for the aid, Frans said, are those in greater Minnesota who have just one insurance option, and it is one with high premiums and high deductibles.
Some insurance increases in greater Minnesota are "pretty intense," Frans said, and many of them are in greater Minnesota. There was more competition in the Twin Cities, but southern and western Minnesota counties, especially, had limited policies available.
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Once Medica hits its limit for new policies in much of greater Minnesota, the expensive Blue Cross Blue Shield health maintenance organization becomes the only choice.
Frans said state officials do not know just how many Minnesotans are waiting to sign up for individual health insurance policies until state officials decide what they will do to help. "We think there are thousands of people waiting on the sidelines."
The two biggest differences between Democrats and Republicans are whether the rebate should be flat or scaled by income and whether the rebates should be administered by the state or by health insurance plans. Dayton backs a flat 25 percent rebate administered by the plans, which he says would be simpler to administer and thus get money out the door much faster.
Republicans prefer the state to run the program and want to give lower subsidies to wealthier Minnesotans, which they say is fairer and would help the state's $300 million go farther. Republicans also want to include changes aimed at improving the 2018 health insurance market in the immediate relief package, while Dayton wants to save 2018 provisions for a later bill.
There's a ticking clock: Jan. 31 is the final day for Minnesotans to buy 2017 health insurance on the individual market. Lawmakers want to pass a relief package by then so that Minnesotans can buy insurance knowing whether or not they'll qualify for relief. Even if they act this week, the first relief checks wouldn't arrive for months at the earliest. That's because it will take time to build a system to administer the rebates, whether the state or health plans take the lead.
The money could have gone out sooner had Dayton and lawmakers passed a relief package in a special legislative session in November or December, but they couldn't bridge their differences. As of Monday, 103,578 Minnesotans had purchased individual health insurance through MNsure since open enrollment began Nov. 1. Of those, 62 percent qualify for federal subsidies, an average of $672 per month.
The other 38 percent, plus any Minnesotans buying health insurance directly from insurers, don't qualify for federal subsidies and may be eligible for the state relief package depending on how it's structured.
Forum News Services' Don Davis contributed to this story.