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Progressive Politics in Minnesota, the Nation, and the World

Let's Fix The Health Care Problem - Without The "Dire" Rhetoric.

Category: Health Care
Posted: 10/25/16 14:14

by Dave Mindeman

I realize it is important for the MN Republicans to create a pseudo hysteria over Minnesota healthcare, but everybody needs to calm down and look at the facts.

It is unfortunate that Governor Dayton phrased his comment as if all of the ACA has become "unaffordable" - that is simply an exaggeration. He was referring to the individual market, which makes up about 5% of our citizens. And if you take away the people who participate in the exchange that get subsidies based on income, it is more like 2.5 or 3%

Essentially, about 100,000 people.

Let's remember the data here.

Using 2015 data from Kaiser Health, here is how Minnesota breaks down:

Employee benefit insurance = 56%

Medicaid recipients = 14%

Medicare eligible = 15%

Vets & Other public insurance = 1%

Non-group insurance = 8% (2015 data) - lower now

And uninsured = 6% (which is lower now) Nationally = 9% (also lower now)

Alright. So the large majority of Minnesotans are finding their insurance to be pretty stable. There are still increases across the board, just as there were prior to the ACA, but the spike in Individual plans premiums is the part we are concerned about.

Now, let's go back. During the first year of the ACA in Minnesota, we had unusually low premiums to begin with. A lot of people were scratching their heads about that, but it was a pleasant surprise.

Then it turned out that the insurance carriers misinterpreted the actual market with all of the pre-existing conditions now included. They lost money, but still went with modest increases in the 2nd year. Again, they did not get a handle on the market place and lost money again. Which led to a panic and a lot of carriers just bailing on the market altogether.

Now, I think they are being unrealistic the other way and over compensating.

But despite all of that, the current premiums with these large increases are almost exactly where the ACA data people predicted the Minnesota market would be. It just looks worse because the catch up point has required a large increase over the previous premiums.

Another caveat to keep in mind. In the original ACA bill there was a risk pool built in. It was assumed that during the transition there would be these fluctuations as the market settled out to a more predictable model. The risk pool would compensate carrier losses in certain instances where good faith premiums were grossly under valued.

However, the Republicans wiped out that risk pool - they felt is was just added on subsidizing - and put the insurance carriers at higher risk. And their reaction has been to abandon the market altogether.

So when you hear the MN Republicans go into their "death spiral" dogma, just step back and remember that this is fixable - if the legislature is willing to fix it.

As I like to point out - 11 days ago, Kurt Daudt went to the press and put together these dire talking points - asking for a special session for a health care emergency.

Gov. Dayton is willing to do that, if the leadership in the House and Senate come together with a bipartisan plan. But during the ensuing 11 days, Daudt has not negotiated anything. He has not acted on anything. And is pretty much AWOL from his declared emergency.

The Senate has a plan. The House wants the political issue.

There you go - an attempt to explain the situation.
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The Three Main Fixes To Obamacare & The Surprise Supporter

Category: Health Care
Posted: 10/24/16 12:14, Edited: 10/24/16 12:18

by Dave Mindeman

If the Republicans could quit the "repeal" rhetoric about Obamacare and actually sit down and look for solutions to the problems, the American people would be far better off.

And there are some real fixes - here are three that would secure Obamacare for the future and end the problems we are seeing presently:

1. Establish a "public option" for health insurance

This was in the original ACA proposal but Republicans and insurance companies insisted on taking it out. A public option would allow those that get caught in between the premium problems, to have a place to go. Carriers would be forced to adjust for that option as well. In Minnesota, the Senate wants MinnesotCare to be transitioned into just such a public option.

2. Increase the insurance subsidies provided to individuals and families.
From the beginning legislators knew that there would have to be adjustments along the way. But Republicans like Erik Paulsen have been too busy removing revenue from the ACA rather than allowing upward adjustments to the people who need a bridge.

3. Redesign the ACA's risk corridor program along the lines of Medicare.

Again, this was in the ACA at the beginning, but Marco Rubio successfully killed this part and that has led to the loss of the insurance carrier safety net. Which in turn has caused many of them to leave the marketplace.

These fixes are on the table. President Obama is in full support.

And you know what? Here is the real kicker about these proposals.

Speaker Paul Ryan has actually worked a version of these ideas into his new Medicare overhaul. So why wouldn't he support them in Obamacare?

That is food for thought.
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In the 8th District: Even If You Vote Trump - Nolan's Your Guy

Category: Congressional Races
Posted: 10/24/16 00:34

by Dave Mindeman

The KSTP poll for the 8th District has Stewart Mills III in the lead 45-41. And with Trump up double digits over Clinton in that area.

The 8th District has had plenty of rumblings about the Democrats. And apparently they would like to see Trump tearing up those trade deals.

But be careful what you wish for.

Let's take Trump first. There is no indication that Trump has any real understanding of trade policy. I contend that he thinks a trade deficit with another country is a monetized deficit. He thinks that a $500 billion trade deficit with China means they got that much money from us. I believe that is what he really thinks. I think that is his premise for Mexico "paying for the wall" - he's going to fix the trade deficit with Mexico and get all that "money" back. Do you really want this guy in charge of trade policy?

And although the 8th District is upset about cheap Chinese steel imports (and by the way, Trump used Chinese steel for his casinos)....there is the flip side of this, in that the 8th District does need a healthy export economy. That means we need to get some kind of trade mechanism in place and Democrats have promised to protect labor in those negotiations.

And really, do you honestly think Trump really cares about your jobs up there? He wants to go back to raping the land for minerals, and coal, and oil. Unrestricted without regulations. What would that do to the 8th District tourism industry?

And then there is Mills. Stewart is thinking he can ride that Trump train into Congress, but can you trust him as well? Mills says that he is now against the TPP and wants "fair" trade instead of free trade. This has required a full reversal on his past trade thoughts. After all, his company, Fleet Farm, needs an unencumbered ability to export. And in the past , he has embraced the establishment Republican "free trade" orthodoxy. Do you really trust him to not go back to his old ways once he establishes himself with Paul Ryan and the rest?

It is one thing to compare Trump to Clinton on trade. It is another, when comparing Mills to Rick Nolan. Nolan has established his negative view on the TPP - and he has a record of opposing deals that do not protect American workers. He is already in line with 8th District views on mining and environment. In this political climate, do you really want to be represented by a neophyte and give away a proven track record?

In the real potential event of a Clinton presidency, even Trump supporters should think twice about firing Rick Nolan. You know where he stands. You know that if President Clinton begins to waver on trade that Nolan will have the ear of the President. And you also have in Nolan, a person recognized as one the THE most effective members of Congress.

In the 8th, even if you prefer Trump - Nolan's your guy.
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