Differences over health care animate race for governor

Health care is emerging as a huge rift in Minnesota’s race for governor, with the rivals clashing over how to deliver health care coverage and what should be in the policies people buy.

It's understandable given that polls, including one by MPR News and the Star Tribune, show health care is the top concern of voters heading into November’s election. It's a major topic in television commercials of Republican Jeff Johnson and DFLer Tim Walz -- as well as outside groups spending in the race.

Johnson on Tuesday held a news conference to criticize Walz for his plan to expand the publicly subsidized MinnesotaCare insurance program so anyone could buy into it as long as they pay premiums based on their income.

Johnson, a Hennepin County commissioner, said rural hospitals ultimately would suffer because the state program reimburses clinics at a lower rate than private insurance. And he said it would put Minnesota on a path to a single-payer system in which the government would have a dominant role in offering coverage and paying insurers.

"People are scared to death about their insurance in this state, and Tim Walz and I could not be further apart in the direction we want to take health care and health insurance in Minnesota," Johnson said.

Johnson said he would work to lower health costs by inviting more competition, offering employers tax incentives to create self-insurance plans, reviving a high-risk pool to cover the sickest people and banding together with neighboring states to develop a compact that would allow cross-border sales of policies. He insisted that he would guarantee that people with prior health ailments could still get health coverage, rebutting TV ads that say he would do away with pre-existing condition protections.

But Johnson said he would consider scaling back the list of coverage requirements that govern what polices must contain. He wouldn’t say which requirements would go.

"I fully recognize how unbelievably politically difficult that is. Because if you eliminate one mandate, the attack ads come out that you don't care about people with that particular condition," Johnson said. "However, we just keep moving further in this direction, which raises the cost of insurance for everybody."

In the past two years, Minnesota individual market insurance rates have been kept in check -- or gone down for some -- after lawmakers put more than $500 million into a program using tax dollars to buy down the most expensive insurance claims. Johnson said additional subsidies might be necessary until a more-sustained solution could be put in place.

"It's a Band-Aid," Johnson said. "It's not sustainable to keep doing this year after year after year. We might have to look at doing more of it in the short term until some of these things take effect."

Walz, a six-term congressman from southern Minnesota, said in a telephone interview that Johnson's critiques of his approach to health care are off base and amount to scare tactics.

"My goal has always been and it makes good sense -- both morally and economically -- to get as many people as you can to get covered," Walz said, arguing that Republican efforts to undermine the Affordable Care Act will roil the insurance market more.

He said his aim is to reduce administrative overhead in the health care system. Walz and Johnson are both talking about price transparency so people know what procedures cost before the bill arrives.

In his campaign, Walz has said a single-payer approach is one he supports, although not something he would immediately push to enact.

Walz questioned whether Johnson's promise to elicit more private market competition is feasible.

"It's never worked anywhere in the world that there will be a magical market that will just shift this thing out," Walz said. "It's just fantasy."

Walz has taken heat in his previous campaigns for Congress for voting in favor of President Barack Obama's health care law, known as the Affordable Care Act but referred to by many as Obamacare.

Asked if he'd cast that vote again, Walz said he would -- with some caveats.

"I would insist that we not compromise with the Republicans on taking out a public option that would have strengthened the individual markets," Walz said. "I would not have let them undermine our risk corridors. ... And I think we would have demanded price transparency. And I would have held drug companies far more accountable than we had the capacity to when we compromised then."

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