Talks over new bill could allow anyone to sign up for MinnesotaCare

[MUSIC PLAYING] CATHY WURZER: Leading the program, DFL lawmakers are just wrapping up a news conference on proposed changes to Minnesota's health care insurance program that covers low-income residents. The bill, which will be heard today in the House Commerce Committee, would create a public option through MinnesotaCare, which would allow anyone to enroll.

DFL representative and House Majority Leader, Jamie Long, is the lead author on the bill. He's here to talk it through with us. Welcome, Mr. Leader.

JAMIE LONG: Thank you, Cathy. Thanks for having me.

CATHY WURZER: MinnesotaCare has been around for a while now, so is the idea of a public option. How would this work?

JAMIE LONG: Well, MinnesotaCare has been a real success story for our state. It started out in 1992 on a bipartisan basis and is now recognized nationally as a model. And so the idea is pretty simple, which is just we would give folks the option of buying into MinnesotaCare so that they have more choices, more affordable insurance options that they can choose for their families or for their small businesses.

CATHY WURZER: So anyone would be eligible?

JAMIE LONG: That's right. If you are right now under our bill, you would be eligible if you are an individual. And so we would remove the current income cap. Right now, it's set at 200% of the federal poverty line. And you would also be able to purchase the MinnesotaCare option for your small businesses if you're running a small business.

I've heard from many folks in my community who are small business owners or who are self-employed and are struggling with trying to find affordable health insurance options, it often walks them into jobs that they might not otherwise choose to have or puts them on plans that are far too expensive for them and their families.

CATHY WURZER: Governor Walz included a public option in his budget proposal. How does your bill compare to with what he's proposing?

JAMIE LONG: They're very similar. They both take care of some of the core challenges that we're seeing in the insurance market. So we know that a lot of individuals don't have affordable health insurance options, and so we're trying to take care of that by allowing them to buy into this really successful program of MinnesotaCare.

We go a little further than the governor on small businesses, but we're working together on trying to find some options there. And then we both allow coverage for undocumented Minnesotans as well. Right now, undocumented Minnesotans really can only pursue emergency care, and that is not a good model for our health care system as a whole. Means there's a lot of uncompensated care and means people are waiting until they get really sick before they get help.

CATHY WURZER: A public option would come with a hefty price tag. What are you looking at?

JAMIE LONG: Well, we don't know exactly yet. We're still working on getting our estimates and we're refining the bill as we go. But we know that there's a lot of uncompensated care out there and there's a lot of folks who are uninsured.

So when you look at, I think, the overall cost to society of having a health care system that's broken. That still continues to have large numbers of Minnesotans who don't have adequate coverage or have coverage that's too expensive. That's not good for anybody. That results in more expensive care at the end of the day. When you have people who are waiting to get treatment, waiting to get help. And that's not what we should be encouraging.

So having people be able to get preventative help, be able to make sure that they have good health insurance, and are seeking care when they need it is going to save money in the long run.

CATHY WURZER: If this passes in Minnesota, the state will join just a handful of other states, of three states. Colorado, Nevada and Washington have already enacted legislation to create some form of a public option. All have run into political, legal, and fiscal challenges.

I'm thinking Washington state's program is an example. Ran into severe opposition from doctors, hospitals, and private insurers so much so that the Washington State plans viabilities in question. What can be learned, say, from the Washington State experience that could translate to Minnesota?

JAMIE LONG: Well, I think Minnesota's going to do it its own way. We're not going to try to follow the models that other states have pursued, but we'll certainly learn from some of their mistakes.

And I think the reason that it's going to succeed here is MinnesotaCare. It's been in our state since 1992. It's worked well for low-income individuals. We have a track record of a program that's been successful, and we're building on that program.

There's only really one other program like it in the country. And so I think we do have the ability to continue to be a nationwide leader in health care and continue to build on our past success to make sure that we are covering everybody in the state with affordable insurance options.

CATHY WURZER: But adding more people to MinnesotaCare adds another level of administrative complexity that could lead to dysfunction. I'm thinking about other large scale programs run into administrative quicksand. MNsure had a rocky rollout. MNLARS didn't work. I mean, this would be a bigger expansion of MinnesotaCare. Do you have any concerns over creating such a large bureaucracy?

JAMIE LONG: Well, it wouldn't really be a large bureaucracy. It would take some additional capacity to manage. But the way we structure it right now, there is a public requirements for what is offered on the plans. But the plans are provided by private insurers, and so we would keep that framework.

We do have a proposal to study, whether we would look at building out a more public implementation system in the future. But right now, the way the bill is structured, we would be keeping the current existing model and we would build in time enough to make sure we get this right.

It probably will take a couple of years to implement it and make sure we're building it out so that we have the options for more Minnesotans to buy in, but this is something that Minnesotans are asking us for.

Health care comes out when I talk to my constituents all the time, whether it's somebody who is in between jobs and isn't able to come up with a good option or is juggling multiple jobs or a self-employed. We know that this is going to be a good option for a lot of folks in a lot of different situations to get more affordable health care.

CATHY WURZER: I know you're building this as you're going along here. Have you had an opportunity to get any buy-in, any conversations from insurers, from physicians? Who's on board so far?

JAMIE LONG: Sure. Well, we have a really broad coalition of support that includes farmers, small businesses, folks who are currently struggling with health care coverage right now, and also a broad coalition of faith leaders and community leaders, labor advocates.

We are continuing conversations with health insurers and with providers. And we're at the start of this process, not the end. So we do have a lot of conversation to have to make sure that we're getting this right. And we want to make sure that this is a workable system. It's too important not to get right.

But there's a real need here. And I think everybody understands and admits that there's a problem and that we need to solve it. So I think if we can get all our heads together, we can make it work for everybody.

CATHY WURZER: I'm going to go back to the fiscal part of this for just a moment. I know you don't have a price tag at this point. But when you look in the out-years, people always worry about fiscal tails to programs. What's your concern about that? How do you think this might be funded, the mechanisms for it? Do you have any idea at this point?

JAMIE LONG: Sure. Well, the bulk of this is going to be paid for by premiums. So it's individual members who are going to be buying into MinnesotaCare. We also have the option of trying to make sure we're maximizing our federal benefits under the Affordable Care Act. And so there probably will be a need to work closely with the federal government on how we're structuring this, but they've been very flexible with our state and accommodating in the past when we've set up MinnesotaCare, for example, as a basic health plan under the Affordable Care Act.

So we know that most of this program is going to be covered. There will be some costs, but I'm not-- as I mentioned, I think that when we're looking at health care costs, we have to take a holistic look at what are the costs to society of uncompensated care? What are the costs to individual health decisions when people aren't able to get their coverage they need or can't afford it?

These are real, big societal problems. And that's-- the role of the state is to try to help make sure we're caring for our neighbors and our family members in Minnesota and making sure that they have good health insurance options.

CATHY WURZER: I know you have to run. Representative, thank you for your time.

JAMIE LONG: Thank you, Cathy. Appreciate it.

CATHY WURZER: Jamie Long is the House Majority Leader. He represents part of South Minneapolis and is sponsoring the bill to create a public option for health care in Minnesota. The House conference committee-- excuse me, the house Commerce Committee is scheduled to discuss that bill at 1 o'clock this afternoon.