Minn. lawmakers reach negotiation stage on health premium relief

The Republican-led state House approved its version of a health care relief package Thursday that mixes hundreds of millions of dollars of health insurance rebates with some changes aimed at expanding coverage networks, particularly in greater Minnesota. The 73-54 vote sets up negotiations on a final relief package.

The proposals from all sides would provide 25 percent premium breaks to people in the individual insurance market who don't qualify for federal assistance.

The disagreement is over who gets the state breaks, who administers the aid and how fast it gets out to people.

State Rep. Joe Hoppe, R-Chaska, said a deal isn't as far off as it might seem.

"We're just trying to get to a point where we can get enough reform in the bill that satisfies the Legislature and enough rebate quickly enough to satisfy the governor. I think we're working towards it," Hoppe said.

The bills passed by the House and Senate would have the state write rebate checks. But they would rule out anyone who makes more than eight times the federal poverty limit, or above $194,000 a year for a family of four. Dayton's administration says that would take several months.

Dayton's plan would route the aid through insurance companies without an income test.

DFL House Minority Leader Melissa Hortman of Brooklyn Park said that proposal "is quick and easy. The Republican plan is slow and complicated."

Dayton's finance chief, Myron Frans favors authorizing insurance companies to patient costs by 25 percent, as the quickest turnaround.

"There's no need for a check. There's no need for an application. There's a relationship between the insured and the insurance company and that method and only that method is not taxable to the insured," Frans said.

The debate in Minnesota comes at a time of uncertainty.

President-elect Donald Trump and a Republican Congress aim to ditch Obamacare for something else. But state lawmakers have to proceed as though what's in place now will drive the 2018 insurance market.

The proposal from majority legislative Republicans would allow for-profit carriers to offer plans in the Minnesota market, something they can't do under current law.

They also would give medical providers more avenues to get into health insurance networks to address complaints that people can't get care close enough to home.

And, in the Senate Republicans' bill, there would be a way to shield insurance companies from extremely costly claims by creating state-funded fallback insurance.

Health insurers must finalize plans this spring to submit to state regulators on the scope of offerings for the fall's open enrollment.

"There is so much uncertainty for individuals in Minnesota, to know whether they are going to get a premium subsidy for 2017 or if their plan is going to be available for 2018," said Jim Schowalter, president of the Minnesota Council of Health Plans, the trade group for state insurance companies. "So obviously the more quickly and creatively we can get going, Minnesotans are going to have more options and more understanding of what's going to be coming."

Without dramatic market changes, Republicans argue the state will be back in the same predicament it is now. Insurers have reduced options and the cost of providing care to more people shot up. Individual plan premiums climbed this year as much as 67 percent. That's meant hundreds more dollars a month for some shoppers, especially those who earn too much to qualify for federal tax credits.

Hoppe, who is sponsoring the House bill, says the challenge is to lure more companies into the marketplace.

"What we're trying to do is set things up to have a more robust market next year so that the individual health plans will go to more providers and will have wider, deeper networks and have more access for people."

Hoppe says negotiators are prepared to work through the weekend in search of a compromise that can be adopted by the end of next week.