ST. PAUL -- The MinnesotaCare health program needs to be re-examined, officials in both major political parties agreed late this past week. The big debate: whether change should happen right away, or years down the road after further study.
The fate of the program, which provides health care for the state’s working poor, is up in the air as lawmakers hammer out the state’s budget over this week. MinnesotaCare provides better coverage than low-income people would get if the state instead sent them to buy private plans on the MNsure insurance exchange, but this costs hundreds of millions of dollars each year.
Republicans have been leading the charge for immediate and drastic changes to MinnesotaCare. They want to abolish the program and use part of the savings to subsidize its former members’ MNsure plans.
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“Our reimbursement level from the federal government is lower than what we had expected,” said Rep. Matt Dean, R-Dellwood, at a Friday hearing discussing the issue. “In fact, it’s a pretty bad deal. … That is not a sustainable position.”
Although DFL lawmakers and state officials have fiercely defended MinnesotaCare, on Friday both groups were fighting for time instead of defending the status quo.
“There isn’t this big rush in the next couple weeks to dismantle something that has been so valuable,” said Sen. Tony Lourey, DFL-Kerrick. “We can agree to have a task force over the interim and agree to look at sustainability issues.”
Republican Rep. Nick Zerwas of Elk River said a new task force isn’t necessary. Far from being rushed, he said, the health and human services committee in the Republican-led House has studied the issue thoroughly and is ready to act.
“We’ve been having these discussions for months,” he said.
Another divisive issue as lawmakers debate the final health and human services budget: the future of MNsure, which is still struggling with technical problems and lower-than-projected enrollment almost two years after a botched launch.
MNsure is a quasi-governmental agency, governed by an independent board appointed by the governor.
The Senate DFL majority wants to change that and make MNsure a normal government department, abolishing its board. House Republicans passed a bill keeping MNsure’s board but expanding it and giving its ability to appoint an executive director to the governor. And the Senate Republican minority endorses an alternative plan: putting MNsure under the Department of Human Services for the time being while studying what to do with it.
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On Friday, Human Services Commissioner Lucinda Jesson - a member of the MNsure board - endorsed the Senate plan and said she didn’t want MNsure under her department.
“Instead of having MNsure run by a board that’s somewhat independent … let’s just have that … be an agency,” said Jesson, who added that she “frankly” doesn’t believe MNsure’s board is “as accountable as it should be to both the Legislature and the governor.”
MNsure’s board has not taken any position on potential governance reforms. Nor, outgoing executive director Scott Leitz said, has it had “a lot of robust discussion” of the subject.
House Republicans at Friday’s hearing focused their remarks on MNsure’s enduring technological problems.
“We’ve been … told time and time again, quite frankly, that these fixes were in hand, that they were months away - and sometimes we were told that they were weeks away,” Zerwas said. “It turns out they were years away, and not yet realized.”
Leitz told lawmakers that despite missed projections in the past, he’s confident their current timeline for technical fixes is “extraordinarily realistic.”
