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Work Together to Make the Health Care Overhaul Work for Minnesotans

September 08, 2010 By Marla Becker, Undergraduate Research Fellow

For decades, Minnesotans have paved the way for an effective health care system, becoming one of the nation's most insured states with only about a 9 percent uninsured rate, compared to the nation's 14 percent uninsured average.  Public health care programs such as General Assistance Medical Care (GAMC), Minnesota Family Planning System and State Children's Health Insurance Program (SHCIP) help widen access to almost 30 percent of Minnesotans.   Still an inevitable question remains: Why are there 480,000 people in Minnesota without health insurance?

Among the 480,000 uninsured Minnesotans, those between 18 and 24 years old have the highest probability of being uninsured (22%).  While Minnesota is one of 10 states and the District of Columbia that offers low-income adults without children health care, few meet the income guidelines of 175 percent of the Federal Poverty Rate or $18,953 by 2010 Federal Poverty Guidelines.
How will the Health Care Reform affect these people?

In short, President Obama's reform package will potentially expand coverage to 32 million presently uninsured Americans by establishing Health-Insurance Exchanges, also called state based exchanges--where individuals who earn between 100% and 400% of the Federal Poverty Line can purchase subsidized health insurance from a competitive pool of private insurers. According to the 2010 Federal Poverty Guidelines, this equates to a family of one who earns between $10,830 and $43,320. In Minnesota, many of those previously uninsured making more than 175 percent of the FPL, will now be able to obtain health care coverage from the public exchange market.

To pay for expanding health care coverage there will be some cost shifts. Individuals earning more than $200,000, couples earning more than $250,000, insurers of employee sponsored health plans, the health care industry, and some Medicare recipients will bear parts of the expense.  As with any massive reform, tax increases are to be expected but the Medicare cuts have been more contentious.

Medicare has been a sustainable program for the last forty-five years, but recent studies argue that this advantageous program may not be able to continue given the magnitude of the health care reform and baby boomer retirees. Economists estimate that in 2030 Americans will experience the peak of baby boomer retirement. In hindsight, to compensate for the overwhelming increase in Medicare beneficiaries, Congress should have started saving more than 30 years ago. In order to ensure that we will be able to afford Medicare for Baby Boomers, cost controls that improve quality and shifts to more efficient care must be achieved. 

According to the Congressional Budget Office (CBO), the net reduction in Medicare Spending from 2010-2019 is 117 billion dollars. The 12.1 percent of Minnesotans currently on Medicare will most likely not notice a change in their guaranteed benefits but the 206,578 Minnesotans on Medicare Advantage (MA) will be affected. MA contracts Medicare through a private insurer and provides enrollees with additional services in combination with the standard Medicare Part A and B benefits. This program has been targeted for cuts because it's susceptible to waste and fraud. The Obama administration assures we can achieve cuts without decreasing the quality of care for seniors in the MA program.

Health care overhaul has been a monumental step toward a more efficient and impartial version of our flawed health care system, but there are still fundamental issues that need resolving. How do we expand access and keep costs down?  How can we get the rest of the nation to adopt a fee system that rewards prevention and wellness not just procedures?

For decades, Minnesota public health policy has provided the nation a model for achieving high-quality health care with wide access.  To maintain that reputation, state lawmakers must use this opportunity to work with federal officials in implementing a health system that works for all Minnesotans. The governor's continued criticism and resistance to the overhaul and consistent refusal to accept certain federal health care dollars hurts the average Minnesotan, helping concentrate more of government's services to a select few. No, the overhaul isn't perfect, even progressives will admit that, but refusing to adopt its meaningful changes to advance conservative public policy won't move our state's health care system forward either.

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