Posted: 10/15/16 14:39
by Dave Mindeman
I want to go back into healthcare today. There is a lot of simplifying going on for some much more complex issues. And Republicans are only into using the issue without any intention to fix it.
The Democratic Senate put out an excellent fix for the individual market problem. For those of you who did not see it, the parts that are most relevant are:
1. Creating a compatible high risk pool.
2. Minnesota Care expansion to add people up to a certain income.
3. Full Minnesota Care option.
4. Ability to opt out of a more expensive employer based plan.
5. Insurance tax credit for taxpayers that don't fit Federal subsidies.
6. Canadian pharmacies drug import program.
7. Reducing geographic rating areas to increase rural options.
These are solid fixes. Real fixes. It would enhance the Minnesota Care program which has always been considered a national model.
But let's talk about a few more specifics.
On the risk pool. You will hear Republicans talk about going back to the Minnesota Comprehensive Health - high risk pool which Minnesota had used before the ACA. It was the program that so many people said they were not going to be able to keep when the ACA went into effect.
And there are reasons why it had to go away. It didn't cover much in the way of prescription drugs. It had a service cap - if you had a very serious illness, you could easily hit your lifetime limit quickly. It had very high deductibles. Essentially, it was catastrophic health insurance with a premium set by the state.
Many of its provisions would never meet the ACA mandated benefits. So it had to be dismantled. But what is proposed now is a new plan that would meet the ACA requirements....which would also require a much different premium and service benefit. Republicans only talk of the "old" MCHA plan. That plan gives more leverage to the insurance carriers.
Minnesota Care expansion and use as a public option are the real keys to making this work. MNSure has had a very difficult time coordinating with Minnesota Care. MNSure is supposed to find the people eligible for MNCare and then transition them over to that part of Health and Human Services. The technical glitches early on made that very frustrating. That was MNSure's fault, not MNCare's. People identified by MNSure for eligiblity should be moved out of their system and directly into Minnesota Care. Minnesota Care's administration is much better and allows for less bureaucratic snafus.
This Republican idea of dropping MNSure and going to the Federal exchange is also shortsighted. Minnesota Care can only be used as a Minnesota public option - and if the Federal Exchange is used that possibility is negated.
Check out the Minnesota Senate remedies here. They are good ones and allow us to keep our health care options local....and we have had a very good system by all accounts in the past.
The Republicans are offering old solutions. They want us to go back to the pre-ACA days. They were not good days. Not in the least. If anything, the ACA has latched on to too many of those old programs via insistence from the insurance industry.
Support the Senate plan. It is an actual fix - not a political talking point.