The new national health care law is expected to be a big issue this year's election, but the DFL's endorsed candidate for governor has been promising to go one step further.
Minnesota House Speaker Margaret Anderson Kelliher pledged to DFL delegates this spring that she would enact a single-payer health plan in Minnesota, but now she says she wants to study the cost first.
Kelliher announced during the DFL Convention in April that she's committed to passing a single-payer health system. She sent a letter to the plan's biggest supporter, DFL Sen. John Marty saying she would sign it within two years of becoming governor.
It helped convince Marty to throw his support to her at the convention as he dropped his own run for governor.
"I have received a personal commitment from Margaret Anderson Kelliher from her that she will do all that she can as governor to ensure its passage and sign the Minnesota Health Plan into law within two years," Marty said.
The single-payer plan has been an issue at the state Legislature for several years but has never made any major headway. Known as the Minnesota Health Plan, it would effectively end the state's current private health insurance system and replace it with a state funded plan.
But even though she continues to stress her commitment to single-payer at campaign events, Kelliher is sounding more cautious about it.
"I've always had the caveat that said that the cost study has to be done and Sen. Marty knows that as well," Kelliher said. "We need to have the cost study done to fully understand how we get it done and how quickly we get it done."
But that's a little different from the commitment Kelliher made in April. In a letter to Marty then, Kelliher wrote she was committed to signing the bill into law within two years. She now says she's committed to getting the plan done by the end of her first term.
"By the end of four years, I believe we will have universal coverage in Minnesota with all Minnesotans with health care," she said.
Kelliher said the cost study could take a year. Neither she nor other supporters know the price-tag of a single-payer system, but Kelliher says she's still committed to it. John Marty believes a single-payer system would cost less overall than the amount Minnesotans currently spend on health care. He said he's not concerned Kelliher is stressing the need for a cost study.
Kelliher's DFL primary challenger Mark Dayton said he's been a major supporter of a single-payer health system on the national level and would sign the Minnesota Health Plan. But Dayton said as governor he'll push for a bill that gives the state enough time to transition from the current HMO model to a government-run model.
"I think it's possible but it's a step-by-step basis," he said. "We're at point B and you want to get to point Z you've got to go through the various steps. I don't think you can wave a magic wand and mandate it like you can on the federal level because that would cover everybody."
While both Kelliher and Dayton are committed to single-payer, the third Democrat in the race, Matt Entenza, says he doesn't think Minnesota can afford it.
"But at a time when we have a $5-8 billion deficit, that's not a cost that's sustainable," Entenza said. "I think the goal is completely laudable, but it's not sustainable."
Entenza says the newly enacted federal health care law will help provide coverage for nearly every Minnesotan. He says he'd prefer to increase health care access through current state subsidized health insurance programs.
The other big question is what the Minnesota Health Plan would do to the state's health insurance industry. Roughly 10,000 people work for private health plans in Minnesota. Eliminating the system would put those people out of work.
Julie Brunner, with the Minnesota Council of Health Plans, said creating a government-run, single-payer system won't solve the problem of escalating health care costs.
"Every system globally, Canada, England, Germany, is struggling with the issue of covering the cost of health care," Brunner said. "So the magic bullet isn't having the government write every check. The magic bullet from my perspective is finding a way to provide quality health care at a reasonable cost."
While the Democrats are either embracing the single-payer plan or calling it a laudable goal, Republican Tom Emmer opposes it.
"Let's call it what it is. It's socialized medicine," he said at a campaign event in Moorhead last month.
"We're for universal care. But we believe that universal care that we would like to make available is universal care that allows the individual to make the choices that best fit that person and his or her family," Emmer said. "We believe that universal care is achieved by putting competition back into the marketplace."
Independence Party candidate Tom Horner also says he doesn't support the single-payer model.