For the past year the Land Stewardship Project and our allies have been organizing to make sure Minnesota moves forward, not backward, under the Affordable Care Act (ObamaCare). It’s clear that our current health care system is failing working people across the state—including urban people, rural people and farmers.
In fact, lack of access to affordable care is one of the major impediments to beginning farmers getting started. And in farm families it’s very common for one spouse to take an off-farm job to get health insurance benefits. This makes it more difficult to build an economically viable family farm—a situation that’s particularly challenging for livestock operations.
The other options are hardly better: purchasing expensive insurance on the corporate-dominated private market, which is often inadequate to meet people’s needs; or joining the 9.1 percent of Minnesotans who take the risk of going without health insurance coverage.
A Health Insurance Exchange Governed by the People
That’s why LSP has been organizing with allies across the state to win changes in our health care system that start to put the power back in the hands of the people. And we’re making progress: Last week Senator Tony Lourey (DFL-Kerrick) and Representative Joe Atkins (DFL-Inver Grove Heights) introduced a bill that would create a people-centered health exchange in Minnesota.
Under the Affordable Care Act, each state is required to have an insurance exchange, which is supposed to help people and small businesses access the private insurance market in a way that’s less complicated and offers more affordable options. But the devil’s in the details, and this kind of exchange is only going to work if it reins in the power of the corporate HMOs and puts more control in the hands of real people.
The Lourey/Atkins bill, as introduced (the Senate bill is here; House version here), does just that. It would bar HMOs and corporate representatives with a conflict of interest from the health care exchange board—making the board representative of people, not corporate “stakeholders.” The bill also makes it possible for this people’s exchange board to negotiate with the HMOs in such a way that it prevents these corporations from filling the exchange with messy, complicated policies with hidden costs and false choices. As an “active purchaser,” the exchange will be able to require the HMOs to provide clear options that are both better and easier to compare.
The corporate interests on the other side know how strong this bill is, and we’re already hearing from state legislators that the pressure is on to strip the exchange of the provisions that make it good for people. LSP is going to stay in the fight, making sure we don’t let the corporate interests get in there and weaken the exchange. There’s also room to make some parts better, including making sure the “navigators” who will help people use the exchange are folks who people can trust, not paid or commissioned representatives of the insurance industry.
Preserving and improving MinnesotaCare as a Basic Health Plan
LSP is also quite aware that this exchange is not a step forward for everyone in Minnesota. For 20 years Minnesota has been a national leader in health care policy through the legacy of our MinnesotaCare program. For people currently in MinnesotaCare, losing this effective program and going into the exchange would be a giant step backward, but that is what will happen unless the Legislature, the Governor and the federal government take appropriate action.
Last week, LSP staff and members of LSP’s Health Care Organizing Committee—Heidi Morlock and Chad Kingstrom—met with Governor Mark Dayton’s Commissioner of Human Services, Cindy Jesson, to talk about the opportunity to keep and improve MinnesotaCare under the Affordable Care Act. This could be done by moving MinnesotaCare forward as a Basic Health Plan. Commissioner Jesson committed to fighting for MinnesotaCare, saying she would “pull out all the stops” to make sure Minnesota is able to continue its legacy of providing health insurance for lower-income people below 200 percent to 275 percent of the poverty line.
The Legislature is moving the exchange bill forward, and now is the time to introduce a bill that builds on the legacy of MinnesotaCare. But Minnesota is not getting the go-ahead it needs from the Obama Administration to advance a Basic Health Plan that maintains the critical functions of MinnesotaCare for lower-income Minnesotans.
Senator Al Franken is leading the charge to get the Obama Administration’s Department of Health and Human Services to grant Minnesota the ability to keep, expand and improve MinnesotaCare. When we met with Franken, organizational allies and Minnesota state legislators on Jan. 11, the Senator made a strong case for standing up for MinnesotaCare and committed to continue his leadership on the issue. Senator Amy Klobuchar is also committed to urging the Obama Administration to allow Minnesota to move forward on this issue.
In the coming weeks, LSP will continue to push the Obama Administration to allow Minnesota to continue our state’s leadership in providing access to affordable care to lower-income people, including those in rural Minnesota.
Minnesota should be moving toward a health care system that works for everyone, no exceptions. A strong people-centered health care exchange, along with a Basic Health Plan grown out of the legacy of MinnesotaCare, are solid steps in the right direction.
Megan Buckingham and Paul Sobocinski are policy organizers who work with LSP’s Health Care Organizing Committee to advance a health care system that works for all people, no exceptions. Buckingham can be reached at 612-722-6377 and Sobocinski at 507-342-2323.