Improving Minneota’s Health Insurance Market With A “MinnesotaCare for All” Option

For Minnesotans who can’t get health insurance from an employer, Minnesota Republican legislators have been demanding improvements.

where-mn-get-insurance-donut-graphic-254x300_jpg__254×300_Out on the campaign stump, Republicans say they want more health plan options than are currently available. They want health insurance companies to feel more competitive pressure to keep a lid on premiums. They want consumers to have a broad network of health care providers available to them. They want assurances than there will always be at least one solid coverage option available to every Minnesotan, even when health insurance companies decide to pull out of the marketplace, as they have in recent years. Those are all good goals.

To achieve them, Republican state legislators should work with Governor Dayton to give Minnesotans a MinnesotaCare for All option.

Background

Currently in Minnesota, those who can’t get health insurance from an employer can get coverage from one of three sources:

  • TOP TIER. For Minnesotans who can afford premium costs, they can purchase coverage from nonprofit health plans – UCare, HealthPartners, Medica, and Blue Cross. (As part of the federal Affordable Care Act, about 60% of those buying from these companies through the MNsure online shopping tool are offsetting premium costs with federal tax credits, which this year are averaging over $7600 per year.)
  • MIDDLE TIER. For Minnesotans who can afford some, but not all, of the premium cost, they can purchase MinnesotaCare at a subsidized rate that varies depending on household income.
  • LOWER TIER. For the poorest Minnesotans who can’t afford any of the premium cost, they can get Medical Assistance at no cost to them. Medical Assistance is Minnesota’s version of the federal Medicaid program.

MinnesotaCare for All Option

Governor Dayton proposes to give those in the top tier an additional option.  He wants to give those consumers the option of buying into that middle tier — the public MinnesotaCare program.

Adding a MinnesotaCare for All option would achieve what Republicans say they want – more options for consumers, more marketplace competition to drive down prices, a guarantee that at least one plan option will always be available to Minnesotans, and consumer access to a broad network of Minnesota health care providers statewide.

A fact sheet from the Governor’s office elaborates on the consumer benefit:

Purchasing quality health coverage through MinnesotaCare is less expensive than buying coverage directly from a private insurer, because it leverages the buying power of more than 1 million Minnesotans enrolled in public plans.

Minnesotans who purchase MinnesotaCare would get high-quality health coverage for approximately $469 per month, on average. That is more than 12 percent ($69) less than the average statewide premium of $538 for private insurance in 2017.

Under the Governor’s proposal, families would spend on average $838 per person less in 2018 than in 2017 on their health insurance premiums.

After a one-time startup investment ($12 million), the cost of Governor Dayton’s plan would be funded entirely by the premiums of Minnesotans who choose to buy MinnesotaCare coverage. If the Legislature enacted this proposal by April 1, Minnesotans could purchase MinnesotaCare coverage as early as the 2018 open enrollment period.

Having this MinnesotaCare option would likely be very popular with Minnesotans.  After all, a national poll found that an overwhelming 71 percent of Americans support a similar Medicare for All option, while only 13 percent oppose the idea.

Let Consumers Choose

Why would Republicans not want this for Minnesota consumers? If the Governor’s claims about the MinnesotaCare option turn out to be accurate, many of the Republicans’ stated goals for the individual market would be achieved.

At the same time, if the Governor’s MinnesotaCare-related claims about lower prices and better health care network turn out to be inaccurate or inflated, Minnesotans will surely reject the MinnesotaCare option. If it is to their advantage, consumers will choose a nonprofit health insurance company, or a for-profit health maintenance organization (HMO), which the Governor recently agreed to authorize as part of a compromise with Republican legislators.

With the addition of the MinnesotaCare option, private, nonprofit and public options all would be available to Minnesotans who are shopping and comparing via MNsure. Then the politicians could get out of the way, and let the consumers choose the option that works best for them.

Americans Support An Actual “Government Takeover of Health Care,” And I Don’t Mean Obamacare

Government_takeover_of_health_careOn the heels of the closing of the second year of open enrollment for Obamacare coverage, expect to hear a lot of “government takeover of health care” ranting from conservatives.

That phrase is heavily used by anti-Obamacare zealots, and that is no accident.  In 2009, Republican political consultant and celebrated wordsmith Frank Luntz advised his conservative clients to portray the proposed Affordable Care Act, also known as Obamacare, as “a government takeover of health care.”

Conservatives did as they were told. If you Google those words, you’ll see that the usage of that phrase, and close variations, has been widespread among conservatives ever since.

In a 28-page strategy memo, Luntz explained why stressing a Washington “takeover” was so important:

“Takeovers are like coups.  They both lead to dictators and a loss of freedom.”

In other words, the Affordable Care Act shouldn’t be talked about as it were a legislative proposal in a representative democracy.  Instead, it should be talked about as if it were a Stalin-esque freedom grab.

There are two problems with conservatives parroting the Luntz-recommended phrase “government takeover of health care” to make Americans fearful about health care reform: First, It’s demonstrably false.  Second, It doesn’t scare most Americans.

False.  I’m not going to go into detail about why it is false, because it’s pretty self-evident.  But suffice it to say that ‘government takeover of health care” as a descriptor for the Affordable Care Act was named by the non-partisan editors of Politifact as their 2010 “Lie of the Year.”   In a lie-intensive election year, “government takeover of healthcare” was named by both editors and readers as the Pants on Fire of all Pants’s on Fire.  Politifact notes the obvious:

“It is inaccurate to call the plan a government takeover because it relies largely on the existing system of health coverage provided by employers.

It’s true that the law does significantly increase government regulation of health insurers. But it is, at its heart, a system that relies on private companies and the free market.”

Not Scary.  But beyond being false, the more surprising thing to me is that “government takeover of health care” is not all that scary to a  majority of Americans.

While Obamacare is not remotely close to a government takeover of health care, putting Americans into the government-run Medicare program would be exactly that.  And you know what? Most Americans are just fine with even that level of government takeover of health care.

Medicare_for_All

A January 2015 GBA Strategies survey asked Americans if they support enactment of “a national health plan in which all Americans would get their insurance through an expanded, universal form of Medicare.” By a 15-point margin, a majority of Americans (51% support, 36% oppose) supported that kind of government takeover of health care.

The same survey then asked Americans about giving people the option of having government take over their health care.   Specifically, the survey asked if respondents would support giving “all Americans the choice of buying health insurance through Medicare or private insurers, which would provide competition for insurance companies and more options for consumers.” An amazing 71% of Americans support having the option of a government takeover their health care, including 63% of Republican respondents.

So it turns out that, after six years of intensive Luntz-led vilification of “government takeover of health care,” backed by hundreds of millions of dollars of political advertising and public relations efforts, there are very few issues in America today with as much public support as there is for the federal government taking over American health care.

– Loveland

Note:  This post was republished on MinnPost.

Will Singing SD Senate Candidate Be The Next Wellstone?

Mike_Rounds_jetFormer South Dakota Governor Mike Rounds (R-Pierre), has been running for U.S. Senate the modern way.  The conservative insurance executive been  jetting around the country to raise  money from ultra-wealthy donors.  Governor Rounds also has the billionaire Koch Brothers as covert sidekicks, bringing their dark money to the state to do his dirty work.

Rick_Weiland_on_the_roadMeanwhile, Rounds’ Democratic opponent Rick Weiland has been campaigning the old fashioned way.  He is staying grounded, traveling the dusty byways in a minivan.  Weiland is the first candidate in South Dakota history to campaign face-to-face in all of the state’s 311 towns.  A couple of them are not metropolises.

Getting to all 311 towns is not just an impressive tactical feat, it’s also serves as a statement about the candidate’s values.  In a state that prides itself on hard work and personal connections, South Dakotans are noticing the hardest working man in the political business.

At one point, Weiland tried to get Rounds to join him on the gravel roads.   He challenged Rounds to reject big national money and discourage dark money, and to replace wall-to-wall campaign ads with a lengthy series of Lincoln-Douglas style debates in small towns around the state. Rounds rejected Weiland’s suggestion, and returned to the fundraising circuit.

To stress his populist “Take It Back” campaign theme on the road, Weiland sometimes belts out parody songs in an imperfect voice. When you are being badly outspent, you need to get creative to get noticed and remembered.  Weiland has long liked to relax by making music with his family and friends, so a few months back he rounded them up to videotape  a well-received parody of “I’ve Been Everywhere” to chronicle his epic campaign journey.  Today, Weiland released a parody sung to the tune of Miller’s “King of the Road.” An excerpt of the lyrics:

My vote’s not for sale or rent,
I just won’t listen to the one percent.
I’m not campaignin’ in corporate jets,
I’m meetin’ voters in luncheonettes.
I’ve been in three hundred and eleven towns.
Still lookin’ for that guy named Rounds.
I’m goin’ everywhere I can, man. Bring on the road!

Rick_Weiland_singingCorny?  You betcha.  But it’s on-message, fun and unique enough to get noticed and remembered amidst the election season media clutter.   The self-deprecating Weiland readily acknowledges he is no threat to be inducted into the Country Music Hall of Fame, but he is determined to connect with South Dakotans on a deeper level than Rounds’ formulaic political ads do. (In one of his pre-fabricated TV ads,  Rounds famously imported stock photography of faux Dakotans, including one woman from, ahem, Paris, France.)

To the surprise of many, the South Dakota U.S. Senate race is in play. A May 2014 Public Policy Polling (PPP) survey shows  Governor Rounds, a long time political institution in the state, stalled out with just 40% support, while the lesser known Weiland is already within striking distance at 28%. In a small state where only a few hundred thousand people will vote in a non-presidential election, Weiland’s hyper-local approach to campaigning could make a difference.  The Koch Brothers would not have set up shop in a deep red state if they thought their guy Rounds was safe.

But can Weiland’s unabashedly populist message really sell in a solidly conservative state? The PPP survey says it can.  It found that South Dakotans, by a 15-point margin, prefer Weiland’s “Medicare for all” proposal to Rounds’ call to eliminate the Affordable Care Act. By a 24-point margin, South Dakota voters also reject Rounds’ embrace of the scorched earth federal budget proposed by conservative Congressman Paul Ryan (R-WI).

The wild card issue in the race could be something called EB-5.  Rounds continues to take on heavy tri-partisan criticism for his championing of the state’s scandal-plagued EB-5 program, a controversial economic development initiative that allows wealthy foreign investors to jump to the head of the citizenship line.  A steady stream of news coverage has focused on missing money, the death of a key figure, and a number of investigations.

Finally, Weiland could further close the gap as three prominent conservative candidates on the November ballot carve up South Dakota’s  conservative vote.   Former Governor Rounds,  former Republican U.S. Senator Larry Pressler (I-Sioux Falls), and former Republican State Senator Gordon Howie (I-Rapid City, Tea Party-backed) are all competing for conservative voters.  Political chameleon Pressler occasionally tries to impersonate a moderate, but with a 100% conservative rating from American Conservative Union in his last year in the Senate, the news media shouldn’t let him get away with that.  With a fragmented conservative electorate, a lone Democrat on the ballot could eke out a victory in November.

Despite all of this, some still are writing off Weiland. In the July before election day, nobody in Minnesota thought Paul Wellstone or Jesse Ventura had a chance to win either. But a populist message and an entertaining approach helped both of them sneak up on their opponents.  Could the warbling Weiland be the next upper midwestern candidate to use a similar approach to shock the world?

– Loveland

Rep. Ellison’s Ultimatum: Single Payer or Government Shutdown

SatireSaint Paul, Minn. –U.S. Rep. Keith Ellison (D-Minn.)  announced today that he is leading a progressive effort to shut down the federal government until a single payer health insurance system replaces the federal Affordable Care Act (ACA) passed in 2010, further complicating the federal budget impasse.

“The private insurance exchanges used in the ACA were never what progressives wanted, so ‘we the people’ have decided to make a principled stand against them,” said Ellison, Co-Chair of the Congressional Progressive Caucus.  The Caucus has long advocated for a single payer system in which the government would fund and operate a single insurance pool for all Americans, similar to how Medicare has long been structured for older Americans.

Rep. Ellison’s rhetoric was eerily similar to that of his fellow House Republicans, who have pushed for replacing the Affordable Care Act with the status quo system.  Under the current system, 48 million Americans are uninsured and health costs are among the highest in the industrialized world.

Rep. Ellison said his caucus is pushing legislation authored by Rep. John Conyers (D-Mich.) to essentially build on and expand the federal Medicare program.  Under the bill, all Americans would be guaranteed access to health care regardless of an ability to pay or pre-existing health conditions.

Just as Tea Party-backed House conservatives advocated in 2009 for preserving the status quo private health insurance system, House progressives pushed for a single payer approach in 2009. But neither side was able to muster sufficient votes to enact their preferred policy.

Still Ellison points to an Associated Press poll finding that 65% of Americans agree that “the United States should adopt a universal health insurance program in which everyone is covered under a program like Medicare that is run by the government and financed by taxpayers.”  Ellison also noted an NPR poll shows that 93 percent of Americans believe that the number of uninsured under the status quo system that the Republicans are fighting to preserve is a “serious problem.”

“When House Republicans finally agree to open up the government again, we’re going to shut it down if they don’t support our single payer approach,” Ellison said.  “House Republicans shut down the government to maintain a status quo insurance system that almost all Americans believe is a serious problem, so progressives can damn sure shut it down over something that two-thirds of Americans support.”

Rep. Ellison said he has offered to compromise with Republicans by offering to delay the implementation of the single payer system by a year.  Ellison has also offered to allow private insurers to sell Medigap-like supplemental health insurance plans.  However, Ellison says Republicans are refusing to even discuss compromise.

In a related development, Sen. Joe Manchin (D-W.Va.) announced that he would move to re-shut down the federal government if House Republican lawmakers didn’t pass his legislation to require background checks on people buying guns at gun shows or online.  A Washington Post/ABC News poll shows that 86% of Americans support such background checks.  Despite this overwhelming public support, Manchin’s bill was rejected by House Republicans in April 2013.  Manchin also demanded a new credenza for his office.

NOTE:  If it is not obvious to you, THIS IS SATIRE.  IT IS NOT A TRUE STORY. Representatives Ellison, Conyers, and Manchin are much too responsible to shutdown the government when they don’t get their way in the democratic process.

This post was featured in Politics in Minnesota’s Best of the Blogs and in MinnPost’s Blog Cabin.

Related post:  Bachmann Vindicated:  Industrialized Nations Continue Rush to Replicate U.S. Health Care System

– Loveland