St. Cloud Times
Driven by partisan ambitions, elected officials at the federal level are repeatedly failing to “repeal and replace” the Affordable Care Act.

Minnesota, meanwhile, might have a viable solution if — and, yes, that’s a big “if” — its elected officials can set aside partisanship for at least one legislative hearing and examine a proposal known as MinnesotaCare Buy-In.

Minnesota Lt. Gov. Tina Smith and Human Services Commissioner Emily Piper visited St. Cloud last week to talk about MinnesotaCare Buy-In, and especially the reasonable request for at least one legislative hearing about it.

The state’s Republican-led House and Senate, which basically denied that approach last session, should grant that request in 2018.

The proposal from DFLers sounds promising but also raises some important questions. A legislative hearing would be a good way for the public to learn whether more examination is needed.

A proven, bipartisan program

MinnesotaCare began 25 years ago as bipartisan way to provide low-income households with subsidized health coverage.

Proponents want to expand MinnesotaCare to make it available to eligible individuals who now buy insurance on the open market.

Today it covers about 100,000 Minnesotans who earn more than limits for federal programs but still are within 200 percent of the federal poverty guidelines. (Roughly a single person making between $16,000 and $24,000.)

Participants can pick from plans MinnesotaCare provides through counties. The program is funded by a state tax on Minnesota hospitals and health care providers, Basic Health Program funding via the ACA, and enrollee premiums and cost sharing.

Expensive? Well, remember …

According to the Minnesota House, in fiscal year 2015, MinnesotaCare paid $510 million for medical services provided to enrollees. Fifty-four percent was paid for by the state, 43 percent by the federal government, and 3 percent by enrollees through premium payments.

Certainly $510 million is a lot of money. Remember, though, the Legislature just this session agreed to spend more than $860 million to curb premium increases in the individual market and to keep that market viable.

Proponents of MinnesotaCare Buy-In say it will cost $12 million to set up. Citing a larger risk pool, the goal is that beyond the setup cost, the new enrollees’ premiums will pay for any additional expenses.

Please note, though, the state and federal funds now funding MinnesotaCare are in doubt. The hospital tax for the former is set to expire, and President Trump is facing a lawsuit because he wants to cut the latter.

Similarly, as Sen. Michelle Benson notes in her commentary , MinnesotaCare reimbursement rates to hospitals and doctors are lower than what private insurers provide so how will that impact the expansion?

Again, MinnesotaCare has been mostly successful for 25 years in providing coverage for low-income Minnesotans who don’t qualify for federal programs. It’s that success that makes it worthwhile to fully vet the idea of expanding it to Minnesota’s individual market.

The Republican-led Legislature should do so with a public hearing in 2018 at which key questions can be asked and answered for the public to see. Debate first, then decide.