Republican state lawmakers aimed Thursday to put a health insurance relief package on the fast track, promising votes soon to deliver rebates and other assurances to people struggling to keep up with changes to plans purchased on the open market.
House Speaker Kurt Daudt said a bill would be off the House floor by next week after falling short in an effort to get a vote this week. The Senate, also run by Republicans, will take more time, but leaders there said negotiations involving the House and DFL Gov. Mark Dayton would start soon.
"We're going to move fairly quickly to get this bill passed and on the governor's desk and the help in the hands of Minnesotans," said Daudt, R-Zimmerman.
Added Senate Majority Leader Paul Gazelka, R-Nisswa: "The House and Senate are on the same page. We may not move at the exact the same pace, but we know this is very important that we give some emergency aid right now."
The urgency stems from a looming sign-up deadline for people who purchase insurance through MNsure or directly from health care providers. People have until Jan. 31 to sign up for 2017 plans and meet a coverage requirement under the feature Affordable Care Act.
Some divisions were on display as House Democrats put the brakes on the plan that majority Republicans tried to get an immediate vote on, something that could happen only if both parties agreed. They said it went far beyond the agreed-upon rebate proposal.
Rep. Erin Murphy, DFL-St. Paul, argued for taking time to make sure the rebates work as intended.
"If we take the shortcut, which we're proposing to do today, we could miss that and actually delay the proper implementation of the relief that we all want together," she said
The proposal's main feature is $285 million in health insurance rebates for individual plan purchasers who aren't eligible for federal subsidies. It matches DFL Governor Mark Dayton's call for 25 percent monthly premium rebates, but the GOP proposal would place income limits on the aid.
About 125,000 Minnesotans buy their insurance that way and can't get federal subsidies.
Plan purchasers earning more than 800 percent of the federal poverty line -- about $194,000 for a family of four -- wouldn't qualify for assistance under the GOP bill. Sen. Michelle Benson, R-Ham Lake, and chair of a health committee, said the means-testing is necessary "to stretch these dollars and impact the people who are hurt the most."
Dayton’s proposal had no income cap, but he's open to the idea. Dayton cautioned that his administration could have trouble doing the income testing on the fly.
The Republican proposal also would deliver the rebates through a state agency rather than via the health care plans that sell the policies. Dayton said it's another complication.
"I thought we had an agreement that it was going to be a simple bill, straightforward premium relief because that's what we need to do now, especially before January 31st -- before people need to make their decisions about what kind of insurance policies they can afford for this year," Dayton said.
Another part of the bill creates a $15 million pool of money to offset care costs for people with serious conditions who are facing the loss of doctors due to insurance changes. People who are pregnant, in the last months of life, or in critical care would qualify for the additional help.
House Commerce Committee Chair Joe Hoppe, R-Chaska, said the continuity of care component is important.
"We don't want to leave people that through no fault of their own are all of the sudden without their local provider or somebody who is no longer in their network," he said.
The total package would be covered by $300 million from the state's rainy day fund. Votes on the bills could start soon with a goal of negotiating a deal with Dayton within weeks.
One potential landmine in the bill would allow for-profit insurance providers to enter the Minnesota market that is now limited to nonprofit health companies. Republicans said it could lead more companies to provide plans in the individual marketplace after a contraction in recent years.
"Our goal is to rescue the individual insurance market for next year and into the future," Hoppe said.
Sen. Tony Lourey, DFL-Kerrick, is skeptical.
"We should ask whether that's actually going to work. I'm not sure there are actually any for-profit providers who want to come into the state of Minnesota," he said. "They have been leaving every marketplace in the country. There may be other, more-effective levers we can use."
The Republicans said even if their proposal passes, they would be back later in the session with more changes. One possibility is to revive a high-risk insurance pool to cover people with the most severe conditions.
"This is the beginning," Benson said. "There is much work to do."