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Don Davis, Forum News Service, Published March 08 2013

MINN. LEGISLATIVE NOTEBOOK: Health marketplace a big change

ST. PAUL – Sen. Tony Lourey endured 12 hours of debate on what he called the biggest change in the Minnesota health care system in decades.

Senators voted late Thursday 37-28 to approve Lourey’s bill forming a Minnesota Insurance Marketplace, a mostly Web-based system for Minnesotans to buy health care insurance.

“Minnesotans for the first time to be able to shop on an apples-to-apples comparison for health care products,” Lourey said as the marathon debate ended.

“Individuals will get more comprehensive coverage and pay less out of pocket,” the Kerrick Democrat added.

Republicans disagreed.

“I know, Sen. Lourey, that you have the best intentions,” Sen. Julie Rosen, R-Fairmont, said.

However, she said, the bill senators passed, similar to one representatives passed earlier, would be governed by a board without people with enough expertise in health care.

The marketplace, also known as an exchange, is required by the federal law popularly known as Obamacare. If the state does not establish the marketplace, the federal government will.

“In this gamble, I am going to bet on the state of Minnesota,” Lourey said.

“I think Minnesota can do a better job,” added Sen. Rod Skoe, DFL-Clearbrook.

The Lourey bill funds the exchange, costing nearly $60 million a year to run, with existing cigarette tax proceeds. The House approved funding that would come from taking up to 3.5 percent of premiums charged in the marketplace.

The two bills head to a House-Senate conference committee in the next few days to work out differences. The goal is to get it on Gov. Mark Dayton’s desk by the end of the month.

Support of the bill split mostly along party lines in the House and Senate, with most Democrats in favor and all but one Republican voting against the bills.

Sen. Bill Weber, R-Luverne, said that Democrats did not make changes needed to improve the marketplace.

“It is the beginning of the end of the greatest health insurance system,” he said.

Because licensed insurance agents would not be allowed to be involved in the marketplace, those in charge “will not have a full comprehension of the insurance system,” Weber said.

Sen. Paul Gazelka, R-Nisswa, said he is concerned that the marketplace would mean Minnesotans will have fewer choices of insurance policies. He also questioned Lourey’s comments that insurance would cost less.

“This exchange bill establishes an extremely expensive government infrastructure that guarantees the creation of a super-agency with layers of bureaucracy between Minnesotans and their health care,” Rosen said.

Sen. Lyle Koenen, DFL-Clara City, said the marketplace would give Minnesotans some insurance competition “so we can get some lower premiums and then, secondly, that a lot of those that qualify, it will be based on income, that there will be some help to pay those premiums, and so it’s a good way, I think, to make sure that many more Minnesotans are covered by health insurance.”

Sen. Kent Eken, DFL-Twin Valley, said the type of insurance products available would expand.

“Whatever insurance (policies) offered in this exchange are going to be good-quality products ... and so we want to make sure again that people are being provided with health care coverage that is good as well as affordable,” Eken said.

Rep. Steve Green, R-Fosston, said he is troubled that a seven-person board will govern the marketplace and the plan is not really a free-market idea.

“I’m troubled by the fact that this proposal creates a seven-member unelected political board that will make decisions about what health care coverage you and your family can have,” Green said. “On top of that, there are no safeguards in place for the wealth of information that the government exchange will require of you to submit including financial records, tax records, employer-employee records and personal health information.”

Sand tax dropped

Sen. Matt Schmit, DFL-Red Wing, has dropped his proposal to allow a local tax to support provisions to regulate silica sand mining.

Schmit’s bill moves forward in the Senate, although there is no House equivalent. It would impose a statewide moratorium on new sand mines and establish a board to provide guidance to southeastern Minnesota communities considering sand mine regulation.

Silica sand is used in the production of oil and natural gas.

Methadone considered

Minnesota lawmakers will look at whether they should toughen regulations about methadone clinics.

Hearings Monday and Tuesday are set to consider the issue, which especially has gained attention in Duluth.

Methadone clinics were set up to provide the powerful drug as a pain reliever, but critics say the clinics allow patients to abuse the drug.

“Heroin and prescription drug addiction is a growing crisis in Minnesota that can lead to tragic consequences,” Human Services Commissioner Lucinda Jesson said. “That’s why the Minnesota State Substance Abuse Strategy named it a top priority. The proposals are an important first step to ensuring methadone can be used safely and responsibly as part of this effort.”

The legislative proposals authored by Sen. Julie Rosen, R-Fairmont; Sen. Tony Lourey, DFL-Kerrick; and Rep. Tom Huntley, DFL-Duluth, would require treatment programs to work with the Minnesota Prescription Monitoring Program when prescribing controlled substances and increase treatment services for clients to help them stabilize and recover.

Care union advances

The Senate State and Local Government Committee has approved a bill allowing home-based child care providers to join unions, as has the House Early Childhood and Youth Development Policy Committee.

The bills apply to providers who receive state aid from the Child Care Assistance Program.

“Family child care providers are more than babysitters,” said bill author Sen. Sandy Pappas, DFL-St. Paul. “These women deserve respect for doing one of the toughest jobs imaginable – helping raise our children.”