DULUTH - Finally, something Republicans and Democrats agree on - health care is a big issue that needs to be dealt with.
That's not to say they agree on the solutions.
State residents have resoundingly told Democratic U.S. Sen. Tina Smith and her Republican opponent, state Sen. Karin Housley, that health care is one of their top concerns. That's not surprising, considering average health spending per person in Minnesota was $8,871 in 2014, according to the most recent data available from the Kaiser Family Foundation. That was the 15th highest per capita spending in the country.
Here is what the candidates think about the issue and what solutions they want to bring to Washington.
When Minnesotans talk about health care, what are the biggest issues they raise?
SMITH: The No. 1 issue I hear about from Minnesotans is the rising cost of health care, especially prescription drugs. That's why the first thing I did when I got to the Senate was take on the big pharmaceutical companies to lower the cost of health care.
HOUSLEY: Affordability and accessibility, particularly in Greater Minnesota where there is often only one insurer offering plans on the individual market. Many Minnesotans have seen premiums and deductibles skyrocket under Obamacare and the price has simply become unaffordable for many. Access is also a big issue, with Minnesotans being forced to travel an hour or more just to see a provider.
What are specific proposals and bills you will bring/have introduced to address these concerns?
HOUSLEY: Expanded choice goes hand-in-hand with practicality. Choice doesn't just involve your health insurance company, it also involves the doctor's office. The current system we have today makes it almost impossible for consumers to see the price of the basic health care services they are receiving. One surefire option to putting consumers in the driver's seat of price transparency is expanded Health Savings Accounts, which is a pre-tax pool of money you can use to purchase health care. Companies providing health insurance to their employees receive a tax benefit, why shouldn't you receive the same tax benefit?
In 2017, I supported reinsurance legislation that has helped to stop dramatic premium increases for individuals and families purchasing their own health insurance in the individual market. While state-based reinsurance may not be a long-term fix, it is a practical tool to help bring down premium costs for the near term.
SMITH: My first bill in the Senate helps to lower prescription drug costs by making cheaper generic drugs more available. I also recently introduced the Affordable Medications Act, a comprehensive piece of legislation to make prescription drugs more affordable, improve competition, and increase innovation. The bill would allow Medicare to negotiate for lower prescription prices and allow for the safe importation of cheaper drugs from other countries, like Canada. And it would invest billions in research for new medications, while penalizing drug companies that spike drug prices or block competition.
My opponent, on the other hand, has repeatedly sided with the pharmaceutical industry and supported giving them billions in tax cuts - all while costs rise and we pay more. That's wrong.
How do you approach partisan gridlock to deliver results - and what kind of health care reforms can get bipartisan support?
SMITH: I will work with anyone - even if we disagree - to do get things done for Minnesota. I worked with Republican Sen. Lisa Murkowski from Alaska on legislation to increase mental health services in schools and communities and also on a bill to help address sexual violence in Indian Country. I am proud that our mental health bill was included in the bipartisan bill to address the opioid crisis, which recently passed the Senate. Another provision I helped author in the opioids package will give states and tribes the financial resources they need to tackle the crisis. The package also includes measures that will increase access to medication-assisted therapy, trauma informed care and support for families affected by addiction.
HOUSLEY: The partisan gridlock so prevalent in the health care debate today actually began with Obamacare, which did not receive a single Republican vote in Congress. Right now, however, the reality is we need to put aside the partisanship and step forward with real-world solutions so individuals and families can have access to affordable and quality health care, regardless of their situation in life. We can start by meeting in the middle on two important policy aspects with bipartisan support - making sure insurance companies cannot deny people for having a pre-existing condition and making sure Americans with serious health conditions receive targeted assistance. Practicality is important, too, which is why there is bipartisan support for allowing children to remain on their parent's plans until age 26.
Do you support a Medicare-for-all buy-in and why/why not?
HOUSLEY: No. "Medicare for All" is just another name for single-payer health insurance run entirely by the government - and we've seen the detrimental effect of too many government mandates in the area of health care. When the government imposes too many controls, quality goes down and costs go up, and a government-run "solution" won't help our rural communities struggling to attract new health care providers and keep the providers they currently have. If we are going to address the accessibility and costs of health care, government is not the answer.
SMITH: I support a Medicare buy-in for Minnesotans who want that option. A Medicare buy-in would be a fast and efficient way for individuals to receive reliable coverage, which is why I've co-sponsored Sens. (Jeff) Merkley, (D-Ore.), and (Chris) Murphy's, (D-Conn.), bill to allow individuals and businesses to buy into enhanced plans under Medicare.
What parts of the Affordable care Act do you support, and which parts would you like to change?
SMITH: The Affordable Care Act put protections in place to prohibit companies from discriminating against people with pre-existing conditions. We need to keep those protections in place to ensure everyone has access to high-quality health insurance, and we must preserve protections for young people so that they can stay on their parents' health insurance plans. I'm working to make sure every Minnesota family can get high-quality health care that they can afford - that's why I'm working to expand access to health care across Minnesota with techniques like telemedicine, to keep protections for people with preexisting conditions, and to hold big pharma accountable to lower the cost of prescription medicine.
My opponent supported the Republican health care plan that failed in Congress last year, which would have gutted protections for people with pre-existing conditions, increased people's health care costs, and imposed an age tax which would have allowed insurance companies to charge older Americans up to five times more. She also opposed efforts to expand health care coverage in Minnesota, including a bipartisan effort to expand Medicaid to cover an additional 35,000 people.
HOUSLEY: While we need a new path forward for health care, I believe it is important that we protect Americans with pre-existing conditions. In Minnesota, we had a 40-year history of covering those with pre-existing conditions through our Minnesota Comprehensive Health Association (MCHA). Minnesotans with pre-existing conditions knew if they were denied health insurance coverage, they could turn to MCHA to receive reliable, affordable health insurance. Then Obamacare came along and tried to fix a problem we had already solved in Minnesota, and in the process screwed up health care for everyone resulting in skyrocketing costs and decreasing health care options.
As a mother and a small business owner, I understand the importance of affordable health care - and the necessity of having affordable health insurance to pay for that care. I will work as hard as I can for a market that provides all Minnesotans with affordable, accessible health care options.