Dayton's State of the State speech text: Open MinnesotaCare to anyone

Updated: 9:27 p.m. | Posted: 7 p.m.

Editor's note: This story was originally based on an advance copy of Gov. Mark Dayton's Monday night State of the State address distributed to lawmakers and media. He fainted before speaking specifically on the health care propsal.

Gov. Mark Dayton on Monday called on lawmakers to open the MinnesotaCare insurance plan to anyone, introducing a government-managed option to compete against private company offerings that have left many buyers with sticker shock in recent years.

In prepared remarks he was set to deliver Monday night in his annual State of the State speech, Dayton said he would seek approval from federal regulators and state legislators to offer a first-of-its-kind shake-up in the state's individual insurance market.

Dayton distributed his remarks to the media and lawmakers in advance but fainted before he was able to deliver that part of the speech in person.

In the prepared text, however, he said a public option would require action by April 1 to make MinnesotaCare a choice for consumers for 2018 enrollments.

MinnesotaCare, which now caters to the working poor, currently provides coverage to roughly 100,000 people. Administration officials estimated that the pool could double if a current income-cap of 200 percent of federal poverty guidelines is erased as an eligibility barrier.

As it now stands, a family of four earning more than $49,000 per year can't qualify for MinnesotaCare.

The Dayton administration said the new MinnesotaCare enrollees would pay roughly $470 per month in premiums and some would still qualify for federal tax subsidies. Those rates wouldn't vary by where a person lives, unlike private plan premiums offered now.

Dayton officials said it could provide hundreds of dollars in lower premiums for people who buy the public coverage.

The state currently manages health coverage for 1 million people who either get it through MinnesotaCare or Medical Assistance, a state version of Medicaid. That heft gives state plan managers leverage in negotiating lower costs.

Dayton's plan calls for extending a tax on medical providers, currently due to expire, to help pay for the proposal. It would also require a $12 million start-up expense, primarily to help state agencies deal with a likely uptick in MinnesotaCare signups.

The DFL governor, who is in the homestretch of a final four-year term, has been scrambling to rescue an individual insurance market on the verge of collapse.

Many health plans stopped offering coverage because the amount they were paying out for care became unsustainable. Others pumped up rates and slimmed down doctor networks to limp along.

GOP lawmakers, now in control of both houses of the Minnesota Legislature, are pressing for dramatic change to the state's health insurance system.

To address concerns that people can't stay with a preferred doctor, Dayton's plan would also require health plans to let people with serious health conditions remain with their primary medical provider for 120 days into a year if that doctor is cut from a network.

It would also compel insurers to offer plans with broader doctor availability in every county.

Dayton will again seize the spotlight Tuesday when he puts out a $45 billion-plus budget. It is the starting point for a debate expected to stretch well into May or beyond.

Lawmakers must approve a new budget by June 30 to avoid a government shutdown, which happened the last time Dayton was opposite a full Republican Legislature.

Dayton urged everyone to set aside partisanship for the sake of the state's future.

"Each of us will ultimately be judged, not for the political points won in today's news cycle, but for how well we have achieved that goal, for now and for the future," Dayton said in his prepared remarks. "That is how we should judge ourselves."