Is Minnesota GOP Sabotaging The Individual Health Insurance Market By Rejecting MinnesotaCare-for-All Option?

Minnesota Republican legislators spent their 2016 election campaigns expressing grave concerns about whether private health insurance companies in the individual market* have sufficient competitive pressure to keep prices down, and whether Minnesotans who live outside of the Twin Cities metropolitan region will have at least one solid coverage option available to them in coming years.

Those are legitimate concerns shared by both parties. But after Republicans won control of the Minnesota House and Senate, they have been unwilling to do one very important thing that that could achieve those two goals. They have been unwilling to give those Minnesotans the option of buying into MinnesotaCare health coverage.

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Governor Dayton’s proposed “MinnesotaCare-for-All option” would allow any individual market consumer to buy into the state government-run health plan that has served over 120,000 Minnesotans since 2006. An unsubsidized version of MinnesotaCare would be an available option for all Minnesotans.

In other words, MinnesotaCare for all would be a Minnesota-specific “public option” that would always be there for Minnesotans. MinnesotaCare wouldn’t be able to abandon individual market consumers the way corporate insurance companies can and do. Moreover, MinnesotaCare’s presence in the marketplace will pressure private insurers to offer more competitive prices, because MinnesotaCare’s prices don’t have to account for corporate salaries and profits.   Representing the buying power of about a million public plan consumers, the large MinnesotaCare plan should also have leverage to negotiate consumer-friendly reimbursement rates with health care providers, which helps keep premium costs more affordable.

In fact, Governor Dayton’s office estimates that Minnesota families who purchase MinnesotaCare coverage would pay on average about $838 per person less in 2018 than they pay for private coverage in 2017.  To secure those long-term annual savings for Minnesota families, a one-time taxpayer investment of $12 million – a relatively tiny drop in the State’s $39 billion annual budget — would be required to establish the option. In subsequent years, no additional taxpayer funds would be needed to keep the lower costs flowing to Minnesotans. The MinnesotaCare-for-All option would be self-sustainable.

If you believe that government-run operations are always less efficient and customer-friendly than corporations, here’s your chance to prove it. If that’s true, comparison shopping Minnesotans will “vote with their feet” by rejecting it en masse. But if it’s not true, Minnesotans in the individual market will finally have the peace of mind that comes with knowing that at least one coverage option will always be there for them and their loved ones.

Given that 71% of Americans support having a similar Medicare-for-All option, a MinnesotaCare-for-All option is likely popular with Minnesotans.  Still, Republican state legislators killed the proposal this year.

Minnesota Republicans can’t have it both ways. They can’t reject the MinnesotaCare-for-All option and then turn around blame others if competition is insufficient in some parts of Minnesota, or if corporate insurers’ prices prove to be unaffordable to many Minnesotans. No one can know for sure if this idea will work, but if Republicans are unwilling to give things like this a try to help vulnerable consumers, then Minnesota voters should hold them accountable for their obstructionism.

*(Note: The “individual market” is made up of the 10 percent of Minnesotans who a) can’t get insurance through their employer and b) whose incomes are not low enough to quality for either of Minnesota’s two publicly subsidized health insurance plans — Medical Assistance (Minnesota’s version of Medicare) for very low-income citizens or MinnesotaCare a subsidized option for the working poor. Last year, about 250,000 consumers bought coverage in Minnesota’s individual market.)

Strib Poll Uncovers Dark Clouds For Republicans

Cursor_and_minnesota_republicans_-_Google_Search 2As the 2017 Minnesota legislative session heads into the home stretch and President Trump is creating a constitutional crisis, the news for Minnesota Republicans in the recent Star Tribune survey is not  great.

To recap, most Minnesotans are…

Digging Dayton. An overwhelming 62% of Minnesotans approve of the job being done by Minnesota Republicans’ primary antagonist, DFL Governor Mark Dayton. Less than half as many Minnesotans (29%) disapprove of the job Dayton is doing.

  • Implication:  He’s grumpy, boring, wonky, and unabashedly liberal, but Governor Eyeore remains quite popular with a strong majority Minnesotans.  Despite Republicans’ best efforts to frame Dayton as being metro-centric and out-of-touch with Greater Minnesota, a majority in every region of the state approve of the job he is doing.  As high stakes budget and policy negotiations between Dayton and legislators begin, Dayton is in a relatively strong position to push his progressive agenda.

In the Dumps About Trump. Only 40% approve of the Republicans’ national leader, President Donald Trump. This marks an all time historical low-point among Presidents, at a time that is supposed to be a President’s “honeymoon period.” For context, eight years ago, during dire economic times, the newly elected President Obama had a 62% approval rating.

  • Implication: To state the obvious, “all time low” is not good.  Republicans who remain steadfastly loyal to their party’s unpopular President could be more vulnerable in the upcoming 2018 mid-term elections. While the conventional wisdom would be for Republican incumbents to distance themselves from the toxic Trump, it’s difficult for them to do so, because Trump remains popular with the narrow band of Trump diehards.  Republican incumbents need those voters on their side in order to survive 2018 primary and general elections. With Trump this unpopular, Republican incumbents are in a political bind.

Swooning for DFL Senators. In comparison to Trump’s 40% approval rating, 58% of Minnesotans approve of DFL Senator Al Franken, and 72% approve of Senator Amy Klobuchar.

  • Implication: Franken and Klobachar remain popular as they relentlessly criticize Trump and his policies, which should embolden other DFLers to do the same. Also, Klobuchar looks difficult for Republicans to defeat in 2018, and both Franken and Klobuchar should be helpful surrogates for down ballot DFL candidates in 2018.

Cursor_and_Minnesota_mexico_wall_-_Google_SearchNot Feeling The Mandate. Trump mandate?  What mandate?  Most Minnesotans don’t like Trump’s policies any better than they like him personally. About two-thirds (65%) oppose Trump’s signature campaign issue – building a Mexico wall. Only 29% support that idea.  The survey also found that Minnesotans oppose Trump’s proposals to accelerate deportations, and his Muslim travel ban.

The only ray of hope in the survey for President Trump was that 70% of Minnesotans support his drive-by Syrian missile strike, proving once again that Americans still love military actions, as long as victory can be declared within a matter of days.

  • Implication. It turns out those “real Americans” at the Trump rallies who cheered wildly about the Mexico wall and Muslim ban are not very representative of most Minnesotans. Therefore, stressing those issues would seem to hurt Republicans more than help them, at least with moderate swing voters. However, the one thing that perhaps could make Trump more popular is a quick, easy military victory.  Don’t think for a moment that a drive-by war has not crossed Trump’s compulsively self-promotional mind.  In other words, it’s probably not a good time to plan a vacation to Grenada.

Nyet On Russiagate Coverup. Republicans steadfastly maintain that no one cares about the Russian controversy. But even prior to the disturbing Comey firing, a majority of Minnesotans (55%) indicated that they would like to see an independent investigation of the Trump campaign’s ties to the Russian interference in the U.S. presidential election, while 39% say there should be no such investigation.

  • Implication: If Republicans continue to cover up and downplay the Russia controversy, it will not pass the smell test with a majority of Minnesotans.

All Aboard On Trains. By a strong twenty-point margin (54% support to 34% oppose), Minnesotans support building two extensions of light rail transit (LRT), from Minneapolis to the southwester suburbs and Minneapolis to the northern suburbs.

  • Implication: Republicans should think twice about making LRT their poster child for wasteful spending.   Despite Republican operatives and talk radio jocks aggressively bashing LRT over many years, most Minnesotans, including plenty of voters in swing suburban districts, support LRT expansion.

Cursor_and_minnesota_tea_party_-_Google_SearchOkay With O’Care. Then there is Obamacare. Republicans seem supremely confident that Obamacare is wildly unpopular.  But a narrow plurality of Minnesotans actually is okay with it. Forty-nine percent of Minnesotans say Obamacare has been “mostly good,” while 44% say it has been “mostly bad.” This issue polled better for Republicans than most other issues, but this finding isn’t very encouraging for Republicans who are dead set on repealing Obamacare and replacing it with a Trumpcare plan that offers many fewer patient benefits.

  • Implication: As Republicans prepare to replace Obamacare with something that the nonpartisan Congressional Budget Office (CBO) says will erases all of the Obamacare coverage gains, these numbers spotlight the political risk that Republicans are taking.  Republicans are beginning to learn that the only thing many Americans hate more than Obamacare is lack of Obamacare.

Loving Local Control. By a whopping 34-point margin (60% oppose, 26% support), Minnesotans oppose the GOP-backed proposal to prevent Minnesota towns and cities from passing work-rule ordinances, such as minimum wage increases.   In every region of Minnesota, a majority oppose limiting local control.

  • Implication:  This is another loser issue for Republicans.  How in the world did the party that constantly preaches about the need for “local control” end up on this side of the issue?

Wrong Tax Cuts. Inexplicably, the Star Tribune apparently didn’t poll on what seems like the overarching question of this legislative session: What should legislators do with the state budget surplus? That is, should they spend it, cut taxes or save it for a rain day (i.e ask about “all,” “most,” “some,” or “none” for each category). Instead, the Star Tribune only asked how to cut taxes, as if tax cutting were the only thing being debated.

Even within that narrow fiscal category, the news wasn’t great for Republicans. Republicans propose tax cuts targeted to narrow constituencies — smokers, farmers, retirees, people with student loan debt, business owners and others. But most Minnesotans (45%) would rather just cut income taxes for all, perhaps because it’s simple and broad-based. Less than 20% of Minnesotans support the Republican-recommended constituency-by-constituency approach, while the rest support Jesse Ventura-style rebates (30%).

  • Implication: Tax-cutting remains the Republicans’ bread-and-butter issue, and it should be a pretty easy sell. Still, Minnesota Republicans can’t even seem to do that right.   They somehow managed to find the most unpopular way to cut taxes, which might somewhat limit the electoral benefits they stand to gain from the tax cuts.

Political tides ebb and flow, so today’s viewpoints could be very different at election time18 months from now. But as it currently stands in the dawn of the Trump era, Minnesota Republicans are not exactly winning so much they’re tired of winning.