Committee debates expanding health care

ST. PAUL -- More Minnesotans unable to afford private health care coverage could receive subsidized insurance if a legislative proposal considered Tuesday becomes law.

ST. PAUL -- More Minnesotans unable to afford private health care coverage could receive subsidized insurance if a legislative proposal considered Tuesday becomes law.

Eligibility would be broadened for the state-supported MinnesotaCare insurance program and medical costs for lower-income citizens would be reduced in other ways under a health care finance bill supported by the Senate Health and Human Services Budget Division.

While the legislation remains far from final passage, supporters said it represents the initial step in reaching universal health care coverage in Minnesota by 2010.

Sen. Linda Berglin, DFL-Minneapolis, the bill's author and a top legislator on health care issues, said the proposal expands subsidized health insurance eligibility for people who don't qualify because they earn more than income limits or due to other restrictions.

The bill opens MinnesotaCare to more citizens. It also includes measures aimed at reaching people who are eligible for health care assistance under current guidelines but aren't using the programs.


"We believe we need to reach both sides of the equation in order for this to be successful," Berglin said.

Outreach efforts, including more advertising about health care coverage, would be expanded to a level not seen since the Legislature created MinnesotaCare in the early 1990s, she said.

The proposal also would create a state grant program for community health clinics, located throughout Minnesota, that serve a disproportionate number of uninsured clients. Treating those people is more costly, and clinics struggle to recoup their costs through government reimbursement, proponents said.

At least two medical clinic offices have closed in recent years because they couldn't afford the expenses, Jonathan Watson of the Minnesota Association of Community Health Centers told the senators.

"It overwhelms the system," added Laura Lipkin of the health center association in an interview.

Sawtooth Mountain Clinic shut its Tofte office in northeastern Minnesota, forcing 500 clients to seek treatment elsewhere, likely in Grand Marais or Duluth. On the western edge of the state, Family Healthcare Center closed its Moorhead branch, which saw 2,500 patients.

Those kinds of clinics are a "safety net" until uninsured Minnesotans can get health coverage, Berglin said.

If the legislation is passed later this session, it would face scrutiny from Republican Gov. Tim Pawlenty, who has advocated a more gradual approach to increased health care coverage and reform.


The bill moves toward universal coverage without considering whether that can be done through the private sector, Sen. Michelle Fischbach, R-Paynesville, said.

Fischbach, a health committee member who voted against the bill, said it goes further than necessary to reach people needing insurance. She predicted only portions of the legislation will remain in final negotiations over the state's next two-year budget. "This is a very expensive bill," she said, "so you're not going to see it go lock, stock and barrel."

The bill relies mostly on dollars from a reserve Health Care Access Fund and the state general fund. The health care reserve is funded partially by a tax on medical providers.

Roughly $95 million in general fund money would be spent in 2008 and 2009 under the proposal. However, Berglin said Senate leaders will give her a spending target for health care programs in the coming days. That will determine what proposals can be afforded in this budget-setting year.

The committee set the bill aside for consideration in a larger package of health and human services legislation.

The Senate bill is a good start, "but it isn't going to do everything for every person," Sen. Mary Olson said.

The Bemidji DFLer, who sits on the health care budget committee, said Minnesotans want comprehensive reforms that will reduce health care costs.

Still, Olson lauded the bill for making it easier for young adults who don't enroll in college to obtain MinnesotaCare benefits. Also, she said, small businesses would take advantage of a new MinnesotaCare program they could offer employees.


Sen. Yvonne Prettner Solon, DFL-Duluth, said expanding eligibility for MinnesotaCare is good, but she wants to see all uninsured children given coverage.

"It's just that everything is so costly and we've got limited funds," said Prettner Solon, another committee member.

Scott Wente works for Forum Communications Co., which owns the Bemidji Pioneer.

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