Facts, figures and politics of healthcare policy


 While there is considerable agreement that reform is needed, what type of reform that should be has stirred fierce debate. Former U.S. Senator Dave Durenberger, a Health Policy Fellow at the University of St. Thomas and Chair of the National Institute of Health Policy, says that, “Minnesota has been a national leader in expanding coverage to nearly all residents (although there has been a lot of slippage the eight years of the Pawlenty administration.)”

Join our June conversations on Health Care


After the federal Patient Protection and Affordable Care Act (ACA) became law, former Minnesota governor (and current presidential candidate) Tim Pawlenty made headlines for ordering state officials not to apply for “discretionary” federal healthcare money which would jump-start an insurance exchange. 

When Pawlenty’s successor, Gov. Mark Dayton took office, the White House allowed Minnesota to reapply for the $1-million planning grant that Pawlenty had declined.  A key provision of the federal law is that most Americans will be required by federal law to be insured, whether through their jobs or on their own, beginning in 2014.


Current public healthcare programs

The list below includes the major public healthcare programs, but some smaller, more targeted programs also operate at the state and federal level.

Federal programs

MEDICARE is administered by the United States government, providing health insurance coverage to people who are aged 65 and over.

MEDICAID is a means-tested program for people and families with low incomes and resources.

TRICARE is the health care program serving active duty service members, National Guard and Reserve members, retirees, families and survivors.
• The CHILDREN’S HEALTH INSURANCE PROGRAM provides matching funds to states for health insurance to families with children, for the purpose of covering uninsured children in families with incomes that are modest, but too high to qualify for Medicaid.
• The VETERANS HEALTH ADMINISTRATION provides medical assistance for veterans.


Minnesota programs

MEDICAL ASSISTANCE is Minnesota’s Medicaid program, with joint state and federal funding. (General Assistance Medical Care recipients may now be covered under this program.)
MINNESOTACARE is a publicly subsidized program designed to serve residents who do not have access to affordable health care coverage, although most are not eligible if their employer offers health insurance and pays at least half of the monthly cost. Participants pay premiums on a sliding scale. (MinnesotaCare also has some federal funding.)
• Other programs exist, such as the Minnesota Family Planning program and home and community-based waiver programs to provide assistance to help people with medical conditions remain in their own homes instead of moving to a care facility.

Rep. Steve Gottwalt (R-St. Cloud), chair of the House Health and Human Services Reform Committee, proposed legislation that would give the state greater control of insurance exchanges. An opponent of the health reform law, Gottwalt argued that if Minnesota does not establish its own exchange, and the U.S. Supreme Court allows the new federal law to stand, then the federal government will step in to run an exchange.

In April, Minnesota House Republicans introduced legislation that would bar the state of Minnesota from implementing insurance exchanges.  As reported by the Minnesota Independent, the bill, HF1552, states that, “No American Health Benefit Exchange within the meaning of that term in the federal Affordable Care Act shall be created, operate, or exist in this state.”

In championing a smaller role for government, many Republicans, led by the Tea Party faction, call for repudiating all parts of new federal healthcare legislation, which they see as a path to more government control. Activists like Twila Brace, of the Citizens Council for Health Freedom, say that any exchange set up by the state of Minnesota will be run by federal government, and that Gottwalt and others are fooling themselves by thinking that would not be the case.  Their hope is that the new law will be repealed by Congress or ruled unconstitutional by the U.S. Supreme Court. In the meantime, they call on state legislators to refuse to implement insurance exchanges that are a key element of the plan.

U.S. Health Care Facts and Figures

  • A record 50.7 million U.S. residents (16.7 percent of the population) were either uninsured or inadequately covered in 2009, according to the U.S. Census Bureau.
  • Nationally, more money is spent on health care, per person, in the U.S. than in any other nation in the world.
  • The U.S. spends twice as much as other industrialized nations on health care, $8,160 per capita.
  • The United States holds the distinction of being the only wealthy, industrialized nation that does not have a universal health care system. Source: Institute of Medicine of the National Academy of Sciences.
  • Administration of private insurance plans consumes nearly one-third (31 percent) of every health care dollar spent in the U.S.
  • In 2007, 62.1 percent of bankruptcy filings, nationally, cited high medical expenses as a cause. Since then, health costs and the numbers of uninsured and underinsured have increased.
  • By 2019, about 24 million Americans are expected to shop for coverage via insurance exchanges, choosing among health plans which offer a variety of benefits that meet basic government standards.



Come and chat with others over snacks, learn some basics about trends in health care coverage, and let us know how you think we should best expand coverage for all Minnesotans. Whether you’re a health care provider, patient, work in the insurance industry, or a concerned citizen, we want to hear your thoughts on solutions for creating good health care coverage for all Minnesotans.

We’ll be using research from the Wilder Foundation’s MN Compass project and an article from the Twin Cities Daily Planet to get this interactive conversation going. By participating in this discussion, though, you’ll provide the part that matters most. We’ll report on these conversations in the TC Daily Planet, and will share the results with policy makers.

SEIU Healthcare
June 16, 9:45 to 11:45 a.m.
345 Randolph Ave., St. Paul

Wilder Foundation
June 20, 6:00 p.m. to 8:00 p.m.
Amherst H. Wilder Foundation
Auditorium C and D
451 Lexington Parkway N., Saint Paul
R.S.V.P.  http://tinyurl.com/4263rv5

Pax Salon
June 21, 6:30 p.m. to 8:30 p.m.
Mad Hatter Café
943 W 7th, St Paul
R.S.V.P pattypax [at] earthlink.net

Mail lisa@tcdailyplanet.net to volunteer to host a community conversation.