Minnesota Lawyer
Republican Rep. Steve Gottwalt and Sen. David Hann
A pair of health care proposals — one each from key Republican and DFL lawmakers on the issue — landed at the Capitol Monday, entering a political fray that has for months pitted the Dayton administration against the GOP over how, or whether, to implement a central part of the federal health care law.
Republicans, led by Senate Health and Human Services Chairman David Hann and House Health and Human Service Reform Chairman Steve Gottwalt, introduced what they called “free market health insurance reform” that they say addresses the state’s uninsured better than the federal law they derided as “Obamacare.”
DFLers, led by key lawmakers on health care Rep. Erin Murphy and Sen. Jeff Hayden, rolled out a proposal to establish a health insurance exchange, the second such proposal this session. The other is carried by DFLers Sen. Tony Lourey and Rep. Joe Atkins. That measure has gained the backing of three House Republican chairmen: Health and Human Service Finance’s Jim Abeler, Taxes’ Greg Davids and Commerce’s Joe Hoppe.
All three have signed onto the latest Republican backed plan as well, Gottwalt said.
The Republican plan wouldn’t necessarily replace, block or implement an exchange, although Gottwalt and Hann have both been critical of the Dayton administration’s embrace of the concept and would prefer that it would.
It would establish accounts that the uninsured — mainly those who are working but aren’t provided or can’t afford insurance — would use to buy private insurance. Funds could perhaps come from employers, charitable organizations, individuals and even the state or federal government. The health law is intended to provide federal dollars to subsidize premiums, and those could be included in the funding sources for the Republicans’ plan, they said.
“This helps address a need that they have,” Gottwalt said of the uninsured, adding that it would better address the needs of Minnesota than the federal law. “We have to ask why, why are we trying to adopt a federalized approach to health care in Minnesota?”
The DFLers’ latest proposal, meanwhile, would lay out a plan to establish an exchange, which Murphy said would better address potential conflicts of interest on the governing board, health disparities and negotiating rates with providers than the one introduced earlier. Murphy did note, though, that she’s also a co-sponsor on that bill and hopes that both will be “in the mix” as the Legislature moves ahead.
“Establishing a health care exchange will finally create access to quality, affordable health coverage for individuals and small employer groups,” Murphy said.
The issue of how the state would respond to the federal health care law has been present since the Dayton administration’s early embrace of the measure. One of Gov. Mark Dayton’s first acts was to accept an early expansion of the state’s Medical Assistance program provided under the federal law.
But it was Dayton’s decision to move forward with a health insurance exchange task force, charged with studying and implementing the state’s exchange plan, that drew the strongest protest from Republicans. Hann led that charge, initially accusing the administration of overstepping its authority and threatening a lawsuit to stop it, if need be. He later backed off that threat, but has kept up his criticism of the efforts.
And those efforts have continued, while an increasingly diverse group of state interests — from health care providers and business groups to Minnesota Citizens Concerned for Life and labor — have come together to participate in the governor’s task force.
At the same, Republicans — in particular Hann and Gottwalt — have remained staunchly opposed. Both House and Senate GOP caucuses refused an invitation to join the exchange task force, and on Monday Hann wouldn’t commit to giving a Senate DFL exchange bill a full hearing.
It may be granted an “informational hearing,” he said, but adding that “it just creates a bureaucracy.” In general, both are opposed to taking any steps to implement an exchange that they see as part of an ill-advised, unconstitutional federal takeover of health care.
Every state is facing a January 2013 deadline to show the federal government that it has a plan to implement an exchange, or it faces the potential that the federal government would establish one itself. The question of whether the Legislature needs to act before that deadline to avoid such an outcome, though, remains an open one.
