Others’ opinion: New Mexico report should serve as framework to MinnesotaCare buy-in debate

Published 8:16 am Saturday, December 15, 2018

Minneapolis Star Tribune

A recent report from New Mexico on a high-profile health reform allowing the public to buy into the government-run Medicaid program — should be required reading for Minnesota lawmakers before the Jan. 8 start of the 2019 session.

A similar reform is under consideration here allowing consumers who don’t meet MinnesotaCare financial eligibility guidelines to purchase coverage through this state-run program. The well-researched analysis from New Mexico should serve as a framework for the coming debate in St. Paul over this proposal.

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Two important points in the report: There are multiple versions of how a buy-in could work, and starting with a more targeted approach may be prudent. Understanding that this flexibility exists could help pave the way for the compromise needed to pass this reform in the state’s divided government.

Gov.-elect Tim Walz, a DFLer, made a MinnesotaCare buy-in one of his signature campaign issues and there’s wide support for it in Minnesota. Seventy percent of those surveyed in a recent Star Tribune/Minnesota Public Radio poll generally approved of the concept. The MinnesotaCare buy-in’s appeal lies in the potential to offer less-expensive health care plans with better benefits to those on the individual health insurance market, meaning they don’t get coverage through an employer or through another government-run plan such as Medicare, which primarily serves those 65 and up.

Coverage for consumers who buy in would not be subsidized by tax dollars as it is for traditional MinnesotaCare enrollees, whose income must be between 133 percent and 200 percent of federal poverty guidelines. Still, the program’s administrative efficiencies and lower reimbursements for medical providers could deliver savings and make this option more affordable than private insurance plans.

State lawmakers have already heard from a large insurer, with a Minnesota Senate hearing earlier this month focused on a critical analysis commissioned by Blue Cross and Blue Shield of Minnesota. The New Mexico report pulls no punches but more helpfully relies on input from a broader array of stakeholders — consumers, caregivers, businesses, labor groups, medical providers and insurers — to offer a clear-eyed view of a buy-in’s advantages, disadvantages and unknowns.