The Minnesota House on Thursday passed a $300 million insurance premium relief bill that will provide insurance rebates to qualifying Minnesotans and institute a series of insurance market reforms.
The GOP-led bill passed 73-54 after two hours of intense debate.
It includes a 25 percent premium rebate to Minnesotans who purchase their own health insurance and who earn between $35,640 and $95,040 — too much to qualify for tax subsidies, but not enough to afford skyrocketing premiums. Families of four with incomes between $72,900 and $194,400 who purchase their own insurance also would qualify.
The Senate passed its own bill last week. That version includes a $150 million reinsurance provision intended to protect insurers from bearing the full cost of the most expensive patients. Reinsurance is not included in the House language.
The differing versions now move to conference committee where House and Senate leaders will negotiate among themselves and with Gov. Mark Dayton’s team to draft final language.
House Speaker Kurt Daudt, R-Crown, told reporters just before Thursday’s vote he expects that process to move rapidly. He wants a final bill passed and dropped onto the governor’s desk by Jan. 26.
“I think we can achieve that,” he said, “and maybe even do it sooner than that if we can get to an agreement sooner.”
The House bill included several late amendments. One adds a farmer’s insurance co-op provision. Another allows up to $20 million to be pulled from the budgets of Minnesotan Management and Budget, the Department of Revenue, or both, if administrative costs for a new electronic income-verification system run higher than Republican estimates of $8 million.
Another late addition allows insurers to offer policies that do not include the full slate of 68 benefits mandated by the federal Affordable Care Act. It was offered by Rep. Steve Drazkowski, R-Mazeppa, who called it “a cure for the regulatory disease” that infects Washington, D.C., and the Minnesota Capitol.
‘Freedom that Minnesotans need’
That amendment, which passed easily, allows insurers to offer individuals coverage that excludes some conditions. While insurers would still have to offer some plans covering all 68 federal mandates, they also could offer plans that don’t.
Such “a la carte” policies could include one or several of the mandates, none of them or all of them, Drazkowski said. “This amendment will provide the freedom that Minnesotans need and it will begin to bring down the insurance costs that are plaguing the state,” he said.
DFLers blasted the idea, saying it will encourage consumers to make unwise and uninformed health care decisions based on cost. Parents could buy plans, for instance, that don’t include psychological benefits only to learn later that their child has a mental illness, they said.
House Assistant Minority Leader Laurie Halverson, DFL-Eagan, said she found it “shocking” that a bill intended to provide relief for Minnesotans would include provisions “taking away people’s health care.”
“What Representative Drazkowski is asking Minnesotans to do with his amendment is to take gambles on their health care,” Halverson said.
Drazkowski countered by saying it is silly to make Minneapolis residents buy insurance for Lyme’s disease. “The wood ticks aren’t in Minneapolis,” he said. Throughout the chamber, Democrats shouted in unison, “Yes, they are!”
Just prior to the final vote, Rep. Tina Liebling, DFL-Rochester, tried to resurrect Gov. Mark Dayton’s plan to give qualifying Minnesotans a straightforward 25 percent rebate — she phrased it “a discount.” The money would not be sent out as checks to consumers. Instead, the state would pay insurers directly. Consumers would see the transaction only as a discount on their invoice, she said.
Liebling’s amendment offered only one of the GOP market reforms, a “transition of care” provision. Other reforms could be negotiated later, she said, after Minnesotans get help.
Liebling repeated the DFL refrain that, because of the GOP’s insistence on broad market reform and income verification, Minnesotans will be forced to cover their full insurance costs through 2017, with reimbursements delayed until at least early 2018.
“The Republican majority is saying that it is not good enough just to get people immediate relief if we don’t fix everything,” Liebling said. “We don’t have to fix everything today.” Her amendment failed.
Ghost of Christmas past
Just before the final vote, House Minority Leader Melissa Hortman, DFL-Brooklyn Park, resurrected ghosts from last year’s failed special session talks.
Attempts at scheduling a special session to deal with the health insurance crisis collapsed on Dec. 16 when Dayton and Daudt held a blisteringly contentious public “negotiation session,” where they did little more than hurl recriminations back and forth. It ended with the governor abruptly walking out and a frustrated Daudt muttering, “Whatever….”
“I know that the Republican speaker doesn’t get along with our DFL governor,” Hortman said. “But there is no reason that a personality dispute should get in the way of helping Minnesotans who need help.” Daudt listened impassively and offered no rebuttal.
Despite the fireworks, which were anticipated, Rep. Joe Hoppe, R-Chaska, said that he sees room for compromise. Hoppe, the House bill’s author, noted that Dayton, Sen. Tony Lourey, DFL-Kerrick, and other DFLers have expressed interest in meeting Republicans halfway on several reforms, including reinsurance.
While reinsurance won’t likely survive the conference committee process for the present bill, it will be part of later legislation this session after more thorough vetting, Hoppe said. Democrats are amenable to that, both Daudt and Hoppe indicated.
“I think we have good momentum,” Hoppe said.
Immediately after the floor vote Thursday, Daudt said he expects Senate leaders to appoint their conference committee members Monday morning. House leaders will follow suit Monday afternoon.
“The conference committee could then start having hearings right away, basically,” Daudt said.
These health insurance rebates are long overdue, given that the income bracket applied means there are no tax breaks for these families.