The passage of the Affordable Care Act was the most significant step forward for our health care system since the passage of Medicare and Medicaid. The advances contained within it — and the manner in which Minnesota has implemented it — have led to a record-low percentage of uninsured Minnesotans at 5.9 percent.
The Commonwealth Fund’s Scorecard on State Health System Performance selected Minnesota as having the best-performing health system in the nation, and the 2015 America’s Health Rankings ranked us the fourth-healthiest state, up from sixth in 2014.
While these are good moves forward, long-term and complex challenges remain, both with regard to the cost of health care and the financial sustainability of our delivery system. In August, I was appointed by Gov. Mark Dayton to serve on the Minnesota Health Care Financing Task Force, which brought together a wide variety of health care experts to examine options for the future of our state’s health care programs.
Last month, the task force approved a package of 33 recommendations to the entire Legislature and governor with strategies to increase affordability and improve the quality of health care for Minnesotans.
Perhaps the most notable recommendation was to continue the funding mechanism for MinnesotaCare, a program providing affordable, high-quality coverage to more than 100,000 working Minnesotans for the past 20 years. While my Republican colleagues who attempted to scrap the program during the 2015 session may disagree with the decision, keeping MinnesotaCare intact is crucial to those who are working hard to get by and for whom a private, high-deductible plan is not affordable
The task force voted to expand eligibility for MinnesotaCare to 275 percent of the federal poverty line, restoring coverage that existed in Minnesota prior to the Affordable Care Act. To address the problem of the family glitch, the task force recommended using the family premium to determine the affordability of employer-sponsored insurance rather than the individual premium for working families. The affordability of premiums was addressed by smoothing subsidies for MinnesotaCare; so a slight increase in income would not translate into a large subsidy decrease.
The task force also voted against joining the federal health care exchange by recommending keeping MNsure a state-based exchange. While the MNsure launch was bumpy, technical glitches and customer service have improved vastly. Joining the federal exchange would require additional federal fees. It also would severely limit customization of the exchange for public-program enrollment and eligibility, somewhere Minnesota should continue to improve efficiency and coverage continuity.
There were many other recommendations, such as expanding innovative health care purchasing and delivery systems, improving population health, addressing health disparities, improving patient experiences and quality, and decreasing the growth in health care costs. There are tremendous opportunities to make improvements in areas such as data-sharing that will lead to decreased costs and improved outcomes.
These recommendations do not present the final words on the topic; they will need to be considered during the 2016 legislative session. With the very productive work of the task force now completed, we should pass this package to ensure health care remains accessible and affordable with a sustainable delivery system. To do so will require bipartisan support.
Health care costs continue to be a major ongoing expense for many families. Much work remains, and I look forward to joining my colleagues to create systematic reforms and innovations to make sure our system works for all Minnesotans, whether they have public or private coverage.
(Column originally appeared in the Duluth News Tribune.)