Reforms needed to address soaring health insurance costs

Jeremy Miller

State Senator (Rep. Winona)

One of the most enjoyable parts of serving as a member of the Minnesota Senate is communicating with constituents and doing my best to help make a difference for Minnesotans. In most cases, my office is able to provide constituents with the information they’re looking for or put them in contact with the correct expert.

Although I enjoy hearing from constituents, lately the communication has been for an undesirable reason: folks are once again seeing their health insurance premiums and deductibles skyrocket.

What’s frustrating is that significant reform cannot be done at the state level. The increases are due in large part to the Affordable Care Act (ACA), also known as Obamacare, which was passed by the federal government in 2010. It would be easy for me to say that I voted “no” for MNsure (Minnesota’s health insurance exchange) and point the finger at someone else, but that doesn’t help solve the problem thousands of Minnesotans are facing with huge premium and deductible increases and fewer options for coverage.

Before the ACA became law, Minnesota had a system in place to provide insurance options for the state’s high risk pool, in the form of the Minnesota Comprehensive Health Association

(MCHA). Ultimately, the enactment of the ACA and creation of MNsure resulted in the closure of the MCHA, which resulted in higher rates because the high risk population was mixed with the healthier population, creating a new risk pool with a poorer overall health status.

Additionally, insurers continue to drop out of MNsure and individual markets because the plans are not financially sustainable, which further increases costs and reduces choice for Minnesotans.

While the reforms needed to fix the root cause of these issues have to come from the federal government, there are things that can be done at the state level to help ease the financial burden. We can allow a tax deduction on health insurance premiums for folks who do not qualify for group insurance. We can allow agriculture co-ops to offer group health insurance for their members.

We can help increase choice by building on the MNsure reforms that achieved bipartisan support over the past two years, which included asking the federal government for permission to allow small businesses and eligible individual enrollees to receive tax credits for policies purchased both inside and outside of MNsure (the state is still waiting for a response from the federal government). We can revisit a bill I co-authored earlier this year that requested a federal waiver to modify our state’s current geographic rating areas, which would likely reduce costs for residents in southeastern Minnesota, who have been consistently paying some of the highest premiums in the state.

Federally, I encourage our elected officials to work together toward a compromise resolution. Some in Congress want to completely repeal the ACA and others won’t admit that changes need to be made, both of which are unrealistic. Posturing won’t accomplish anything; something needs to be done to help address soaring health care costs.

Often in politics there tends to be more of a focus on sound bites attempting to make the opposite party look bad rather than doing what is best for the majority of people. It’s unfortunate and it doesn’t have to be that way. One simple idea at the federal level would be for Democrats and Republicans to look at provisions in the ACA that are working and keep them, and scrap or revise those that are not. Eliminating one-size-fits-all mandates and increasing competition between health insurers would be a good start.

Wouldn’t it be great for politicians – all of us – to focus on areas where there is at least some common agreement, rather than on the areas of disagreement? A group of us are trying to accomplish this here in Minnesota with the bipartisan Purple Caucus. At the federal level, there is an organization with a similar goal called No Labels. Most folks don’t care about party affiliation, they just want us to stop bickering and deliver results. Now is the time to work together to accomplish that.