The shift in control of the Minnesota Legislature from Republicans to Democrats should create a smoother path for Gov. Mark Dayton, shown with new Senate majority leader Tom Bakk, left, and new House speaker Paul Thissen, to implement his plans for a state health insurance exchange next year. (Pioneer Press: Jean Pieri)
The shift in control of the state Legislature from Republicans to Democrats should create a smoother path for Democratic Gov. Mark Dayton to implement his plans for a state health insurance exchange next year.
What's more, there's now less chance of a fight over whether to expand the Medicaid health insurance program for low-income and disabled residents.
Those are two of the clearest health care implications from election victories this week by the Democratic-Farmer-Labor Party in Minnesota.
"It's full speed ahead," Lynn Blewett, a health policy expert at the University of Minnesota, said during an interview Friday, Nov. 9. "We don't currently have exchange legislation, which we need to move forward. So, we'll get that."
As for the Medicaid expansion, which experts say could add about 57,000 people to the program, Blewett said: "It will definitely be easier."
Republicans in charge at the Legislature in 2012 were reluctant to move legislation related to health exchanges. As state Sen. David Hann, R-Eden Prairie, put it in January: "Movement on this issue is perceived by a lot of people as a way to participate in the federal government's wrong-headed behavior on health care."
Even so, some within the party urged Republicans to get involved in the debate so the health exchange might be shaped in a "government-light" way that promoted competition. That wasn't the majority view, however, so Republicans left the planning to Dayton.
The health exchange is a
central feature of the federal government's overhaul of the nation's health care system. It's intended to be a new marketplace for individuals and small businesses to shop for coverage starting late next year.The expansion of Medicaid eligibility for adults without children also was a key provision in the federal health care law, which Congress passed in 2010.
When the state Legislature adjourned this spring, it was far from certain how either plan would move forward in Minnesota. For starters, there was still a chance then that the U.S. Supreme Court might strike down the law.
When the court surprised some observers in June by upholding the law's mandate for individuals to buy coverage, while also making the Medicaid expansion optional for states, Republicans put their hopes in the election of presidential candidate Mitt Romney. Romney vowed to reverse the health law and, even without his victory, Republicans hoped to debate in the Legislature the fiscal merits of Medicaid expansion, which some described as "unsustainable."
But Romney lost, and Minnesota Republicans now find they're no longer in the majority at the state Legislature.
"The road to get to that (health exchange) destination could be a little less bumpy," said Dayton's spokesman Bob Hume during a Friday conference call with reporters.
Among the policy questions facing the new Legislature in January is whether to create a health exchange that functions like a "clearinghouse" for a wide variety of insurance policies. The alternative is for managers of the exchange to work as an "active purchaser" that would negotiate directly with insurance companies to determine which health plans could be sold.
Insurance agents and business groups prefer the clearinghouse approach, saying it would preserve more choices.
"Our clients do not want to lose their current insurance policies," said Greg Dattilo, chairman of the board with the Minnesota Association of Health Underwriters, a trade group for insurance agents. "With the purchaser model, you'll have a limited amount of policies."
But consumer advocates prefer the active purchaser model.
"One of the most important things the state can do in setting up its exchange is seek a better deal on health insurance for individuals and small businesses," said Phillip Cryan, a union organizer with SEIU Healthcare Minnesota. "It can strike a better deal ... by selectively contracting with insurers that offer the highest-value plans."
During a conference call Friday, Jim Schowalter, the commissioner of Minnesota Management and Budget, said he expects there still will be a healthy debate on the question even with DFL control of the Legislature.
But Peter Nelson of the Center for the American Experiment, a conservative think tank in Minneapolis, said the transfer of power from Republicans to Democrats in the Legislature clearly changes the debate.
"A Republican Legislature would have guaranteed that the exchange would be a clearinghouse," Nelson said. "Now, moving forward, that is an open question."
Christopher Snowbeck can be reached at 651-228-5479. Follow him at twitter.com/chrissnowbeck.
Source: http://www.twincities.com/health/ci_21968978/changes-health-care-look-likelier?source=rss
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