It’s a shame there wasn’t room for Minnesota legislators at U.S. Rep. Tom Emmer’s Wednesday town hall in Sartell. While the event was as Minnesota Nice as it gets, with admirably civil exchanges, emotions still ran close to the edge when it was the Affordable Care Act’s turn in the spotlight.
Emmer’s fellow congressional Republicans are trying to repeal the law. Anti-ACA rhetoric also helped the state GOP win a majority in both legislative chambers last fall. But as those in the town hall crowd relayed their concerns, it became clear that many Minnesotans also have a deep, genuine fear about losing the ACA’s consumer protections and financial assistance.
“My life is in your hands,’’ said Sue O’Hara, a retired medical lab specialist from Sartell who has a type of blood cancer called multiple myeloma. O’Hara is afraid she’ll lose access to health insurance because she has a preexisting condition. Before the ACA, insurers could deny coverage if the consumer already had certain medical conditions.
O’Hara’s situation underscores the weight of the responsibility that Minnesota lawmakers must now shoulder with the ACA firmly in congressional cross hairs. The reaction in St. Paul to Washington, D.C., “reforms” — such as proposals to weaken ACA consumer protections or financial assistance — could well be determine whether Minnesotans like O’Hara can afford coverage.
Drafting state policy to protect consumers in the aftermath of whatever Congress decides to do will be a daunting assignment — and among the most important business in the remaining weeks of the current legislative session. Lawmakers in January completed an aid package in the form of 25 percent premium rebates to help individual market consumers buy coverage this year. Given the uncertainty over what will happen at the federal level, it’s imperative they take a similar approach and focus intensely on aiding consumers in the coming year.
Deadlines for action are closer than they seem. Open enrollment to buy 2018 coverage begins next fall. State insurers set rates months before then. An industry that has already had key players leave the unprofitable Minnesota individual market needs clarity by the end of March about what aid consumers will have for 2018. About 5 percent of Minnesotans buy coverage on their own instead of getting it through employers or government programs such as Medicare.
Solutions from Republican lawmakers include “reinsurance” legislation, which could help lower individual market premiums by using public dollars to offset certain high-cost enrollees’ medical care. Gov. Mark Dayton is pushing another alternative — allowing Minnesotans of all incomes to buy policies through the state’s MinnesotaCare program for low-income working families.
Significant questions remain about how these proposals would work, which is why public hearings are needed soon. It is unclear at this point how much the reinsurance proposal would drive down the cost of individual market premiums, for example.
There are also questions about the MinnesotaCare buy-in. Medical providers are worried about the lower reimbursement rates they receive for care provided to public health-insurance enrollees. There may be workable solutions to address this, but a thorough public airing is needed.
An editorial writer’s conversations during the past week with health-care policy leaders in the Legislature, such as Sen. Michelle Benson, R-Ham Lake, Sen. Tony Lourey, D-Kerrick, and Rep. Matt Dean, R-Dellwood, were reassuring. They understand the deadlines and are working hard behind the scenes on the issues. Benson merits special praise for her willingness to air Dayton’s MinnesotaCare plan in a hearing. Teamwork, along with a willingness to look at all options, is sorely needed during a time of unprecedented uncertainty for consumers.
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