Legislation to provide health coverage to all Minnesotans has stalled in the Minnesota House, but proponents vow to continue organizing to pass the “single payer” bill.
MORE: Minnesota Health Plan tabled in the House by Andy Birkey, Minnesota Independent
The Minnesota Health Act (HF135/SF118) would replace the existing, costly maze of private insurers and public programs with a “single payer” system to handle all administration. Everyone would be covered for all necessary care, including medical, mental health, dental, chemical dependency, medications and home health care. Individuals would pay premiums and businesses would pay taxes into a fund to run the plan, although specific dollar amounts are not spelled out in the legislation.
“We believe the program established by the Minnesota Health Act will bring order and improved health choices for all Minnesotans,” the bill’s chief author, Rep. David Bly, DFL-Northfield, told the House Health Care and Human Services Policy and Oversight Committee on Wednesday.
After hearing two hours of testimony, the committee moved to “lay over” the legislation, effectively killing the possibility of it advancing in the 2009 session. Supporters made the motion when it became clear the measure did not have enough votes to pass.
Bly said he would have liked a better outcome, but Wednesday’s hearing was a positive first step.
“This was the first hearing in the House,” he said. “We want to let people know which legislators are supporting it and we want to do the grass roots organizing” to move it forward in the future.
About 45 members of the House support the Minnesota Health Act, he said. Momentum is stronger in the Senate, where about a third of the 67 Senators back the bill and it has moved through two committees.
Bold action needed?
Everyone who testified on the bill – including opponents – said all Minnesotans need health care coverage, but they differed over whether the Minnesota Health Plan goes too far.
Dr. Ed Ehlinger was among those who told lawmakers that bold action is needed. Ehlinger, who has practiced medicine in Minnesota since 1972, said he has witnessed numerous efforts to make incremental changes to hold down costs and improve coverage.
“To me, the data and the stories I hear every day tell me our reform efforts have failed,” he said. The result, he noted, is more than 400,000 Minnesotans who lack any coverage, another 1 million who are probably “underinsured” and skyrocketing premiums, co-pays and deductibles.
The Boynton Health Service at the University of Minnesota, which he currently administers, has more staff to process paperwork than it does pharmacists, dieticians and other medical specialists, he said.
Fertile, Minn., resident Elaine Torpet moved from Canada to Minnesota 47 years ago when she married an American. “I have tried for 47 years to gain back the kind of health insurance I lost when I got married,” she told lawmakers.
In Canada, everyone is covered and health outcomes are better. Infant mortality rates are lower, life expectancy is higher and the country spends far less on health care than the United States, she said.
Bly said the Minnesota Health Act is a uniquely Minnesota solution that does not duplicate the health care system of Canada or any other country.
Unless major changes occur, small businesses will no longer be able to provide health coverage to employees, Bob Cjernia, the owner of a small publishing company based in Northfield, told lawmakers.
With costs doubling and sometimes tripling on a yearly basis, “I have been reluctant to hire additional employees,” he said. Currently, most health insurance is provided through employers. The Minnesota Health Act replaces employer-based coverage with a universal plan that residents always have – even when they change jobs or get laid off.
Reining in costs
Opponents who testified at the hearing, including the Minnesota Business Partnership, the Minnesota Chamber of Commerce and associations representing insurance companies, questioned whether the Minnesota Health Act would rein in skyrocketing health care costs.
Supporters said cost savings would be achieved by cutting out the insurers and their high administrative costs and by eliminating duplication of services. For example, a state board would have to approve major projects so that two hospitals in an area don’t both have an expensive piece of medical equipment when only one is needed.
Advocates also said huge savings could be realized by making sure everyone has access to preventive care (rather than uninsured people being forced to use costly emergency room services as their last resort) and by tracking and properly treating chronic medical conditions.
But Bly acknowledged the lack of specific information on cost savings is one reason the legislation has encountered roadblocks. He hopes a new Wilder Foundation study, tentatively scheduled for release this summer, will provide a conclusive analysis.
Opponents also said Minnesota should not make changes on its own and said some of the Minnesota Health Act may be pre-empted by current federal law.
Dr. Ehlinger argued against waiting.
“Ideally, this system should be national in scope, but Minnesotans can’t afford to wait for that to happen,” he said.
Another major piece of health care legislation, the Minnesota Health Security Act —to provide coverage for all children in the state by 2010 – is also under consideration at the Capitol.