Kathy Sheran and Vicki Jensen: Rural health care a priority for Senate Democrats

ST. PAUL--In a historically short session, the Legislature could sit on its hands, do nothing and blame inaction on time constraints and divided government. But for rural Minnesota, inaction on health care costs money.

ST. PAUL-In a historically short session, the Legislature could sit on its hands, do nothing and blame inaction on time constraints and divided government. But for rural Minnesota, inaction on health care costs money.

We have authored, co-authored or supported legislation this session aimed at fixing three rural issues: unaffordable premiums, lack of health plan options and skyrocketing prescription drug prices.

The Democrats in the Senate made rural health affordability a priority because we know rural families need relief. We debated and passed legislation that would improve rural access and affordability through the Health and Human Services policy committee that one of us (Sheran) serves on. Our counterparts in the Republican-controlled House failed to hear, much less pass, most of this legislation important for rural Minnesota. In fact, eight crucial solutions for rural Minnesota did not get a hearing, stopping their forward movement.

Under federal law, Minnesota has been split into a defined number of geographic rating areas. Premiums on the individual insurance market are set within the regions. For areas of the state with large populations, the larger risk pools lead to lower premiums.

But geographic rating has contributed to higher rates in much of rural Minnesota. To fix this, we have both co-authored a proposal by Sen. Matt Schmit, DFL- Red Wing, to seek federal approval in reducing the number of rating areas. Fewer regions could spread the risk and help reduce the price of premiums.


In addition to rising costs, many rural families face few options and often none that fit their needs. To increase choices, one of us (Sheran) introduced legislation directing Minnesota to apply for a federal waiver, making it possible for all Minnesotans to purchase MinnesotaCare. By adding a new health plan (rated statewide), all rural families win with greater choice and lower cost. We are also supporting increasing the rates paid under this programs for primary care providers.

One of us (Jensen) also asks for a federal waiver to allow families with employer-provided health care to include the premiums for family plans in their calculations when determining if they are eligible for a tax subsidy. This measure lets families that currently do not qualify for premium tax credits or cost sharing reductions reduce the cost of their plan.

Premium increases are in part due to rising prescription drug costs. To address this problem, we have supported four bills. The first would address the way pharmaceutical companies use coupons to get individuals to buy non-generic drugs. The cost appears lower at first, but the hidden share of those costs are paid by employers and individuals for their insurance.

A second bill would create a program to educate doctors on the correct use and pricing of prescription drugs, giving them a better information when prescribing. We also support a bill to require greater transparency on drug costs.

And finally, we strongly support an innovative approach in lowering costs by directing the Minnesota Department of Health to develop a plan to import safe, lower cost drugs from Canada.

One of us (Jensen) has co-authored an effort, led by Sen. Julie Rosen, R-Vernon Center, to increase the availability of critical access dental care. This proposal would benefit rural communities in finding affordable dental services.

Dentists have been pleading with us to improve funding for rural critical access dental care. The failure of the House to take any action is beyond understanding. Hopefully, the Senate will prevail in the final negotiations.

We have hope that two other rural reforms lead by the Senate will continue to advance and get funded in the House. One is the rural family residency program focused on increasing training of doctors in rural communities, where we hope they remain to practice. The other bill removes the provision that allows a lien to be placed on the assets of person who buys a MinnesotaCare product.


We want Herald readers to know that senators have introduced real, concrete actions to help reduce cost and increase choices for rural Minnesotans. Unfortunately, the GOP-controlled House has by inaction demonstrated limited concern for our problems.

Nevertheless, we have made affordable health care one of our highest priorities and will continue to push for these reforms this year and in the next session.

In the Minnesota Senate, Sheran represents Mankato, and Jensen represents Owatonna. Both senators are Democrats.

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