When politicians talk about health care, too often the discussion is more about politics than health care. The result in Congress, and the Minnesota Legislature, is that progress is halted. Meanwhile, frustrated Minnesotans look at premium increases wondering why their leaders can’t work together to solve the problem. That needs to change, and it needs to change now.
So what is the problem with the individual market?
The problem is that Minnesotans on the individual market are experiencing massive premium increases. It’s a crisis for those families and we should work as Democrats and Republicans to solve this — both in the short-term and long-term.
What is causing these increases?
House Republicans are eager to blame the Affordable Care Act and MNsure. But blaming MNsure isn’t the full story, and it doesn’t lead to a productive solution.
One of the key provisions of the Affordable Care Act forbids insurers from denying coverage to people with pre-existing conditions. This has helped dramatically reduce the number of uninsured Minnesotans, which means fewer uninsured Minnesotans are receiving care in emergency rooms — the most expensive form of health care (which is paid for by all of us).
But a consequence has been more high-cost patients in the individual market — many more than insurers anticipated. Additionally, the cost of health care continues to rise. The escalating price of prescription drugs and other procedures is driving up the cost of health care for everyone — whether they are on the individual market or receiving insurance through their employer.
As a result, the 5 percent of Minnesotans on the individual market will experience significant premium increases in 2017.
It’s not all bad news. A majority of those Minnesotans will qualify for federal tax credits on the MNsure exchange. These tax credits will reduce the premium increases significantly — and in many cases actually lower premium costs. Democrats and Republicans have a responsibility to inform their constituents about these potential savings.
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I realize that Republicans don’t like MNsure and wish the ACA never became law. But if Republicans truly believe this is a crisis for families, I hope they will inform their constituents about every possible way that they can reduce their health care costs — including purchasing their insurance through MNsure.
So what is the solution?
First, we must provide immediate relief to the Minnesotans who are being gouged by excessive premium increases. House Democrats have introduced a plan that would provide a rebate to Minnesotans who are not eligible for federal tax credits under the Affordable Care Act and ensure that no Minnesotan in the individual market would pay more than 10 percent of their annual income on health insurance.
For example, a family of four in Mankato making $120,000 per year is facing an annual premium of $18,804. That family would qualify for a rebate in 2017 of $6,804. This is the only plan to date that would provide immediate assistance to these families. It does not require a federal waiver or complex analysis. This plan simply provides relief to individuals and families who need it now.
Second, we must stabilize the individual market. Scrapping MNsure entirely, as Republicans have favored, would not solve the underlying instability of the individual market. Rather, we should consider Minnesota-driven solutions. For example, to reduce costs we could spread the cost of the sickest Minnesotans across a larger group of Minnesotans through a reinsurance fund. We could also improve competition and choice by allowing Minnesotans to purchase insurance directly through MinnesotaCare regardless of income. It would be naïve to say this is an easy problem to solve. We should work together as Democrats and Republicans to solve it.
Finally, we must pursue reforms to reduce the increasing cost of health care, which, of course, drives up the cost of health insurance.
We should get tougher with prescription drug manufacturers and demand price transparency to lower the cost of prescription drugs and get tough on insurance companies that engage in “surprise billing” practices. I was pleased to work on a bipartisan basis with Gov. Tim Pawlenty to deliver the last set of cost containment reforms in 2008, which saved Minnesota hundreds of millions of dollars. We should commit to this bipartisan work again.
Identify the problem. Work together on solutions. And keep the political blame game to the side. I think that’s what Minnesotans want us to do, and it’s time we listen.
Posted on Tue, October 18, 2016
by Paul Thissen