Republican Rep. Kelly Fenton of Woodbury has been talking to a lot of voters this fall in her suburban Minnesota House district and one issue keeps coming up.
"As I'm knocking on doors, health care is by far an issue that I hear about over and over and over at the doors, whether it be high cost of premiums and deductibles or people fearful if we move to single payer of losing their employer coverage that they currently have," said Fenton, who's seeking a third term to the House.
Fenton and other House Republicans are touting their push last year to create a $542 million reinsurance program, which subsidizes insurance companies for expensive claims. They credit the program for recent reductions in individual market premiums.
• Full coverage: 2018 elections
Fenton's DFL opponent Steve Sandell is also hearing about health care. He says the current system is not sustainable. Sandell and other House DFL candidates are backing a proposal to expand the state's MinnesotaCare program. The plan, which Gov. Mark Dayton pushed for unsuccessfully last session, would allow anyone, regardless of income, to buy into the public coverage.
"We want to make sure health care is accessible and affordable to all Minnesotans," Sandell said. "I feel deeply about that. We want to make sure that individuals have the confidence of being able to choose their own provider. That's really important."
The stakes in the debate are high. Republicans control the House. Democrats need to pick up 11 seats in November to win the majority.
Republicans and their allies are pushing back hard on DFL candidates like Sandell. Campaign literature and TV ads accuse them of backing an expensive "government takeover" of health care.
Political action committees buying ads in some of the races and GOP candidates contend the health care switch that Democrats favor would raise taxes by $17 billion.
The estimate comes from a 2012 report titled "Analysis of a Single-Payer Plan in Minnesota," which was written by the consulting firm Lewin Group for the Minnesota nonprofit Growth and Justice.
"It's a really egregious misrepresentation of the report," said Dane Smith, senior fellow at Growth and Justice.
Republicans ignored the report's main conclusion that a single-payer system would save money, Smith said. A change to single-payer would result in a nearly 9 percent annual reduction in health care spending and average family savings would top $1,300, according to the report. Employers would also see reduced costs.
"It is true that if you have total public financing, universal health care the way most other nations do, the portion that you pay to governments would increase," Smith said. "But you completely eliminate what you pay in the private markets."
Even so, the numbers are obsolete because the report was done before the federal Affordable Care Act was fully implemented, Smith noted. It also pre-dated the MinnesotaCare buy-in proposal.
Still, Republicans, including House Speaker Kurt Daudt are using the report as a warning to voters. "If you thought Obamacare was bad, this is Obamacare on steroids," said Daudt, R-Zimmerman.
The fight over health care coverage and how to pay for it has surfaced as an issue in campaigns across the state. A September MPR News/Star Tribune Minnesota Poll showed health care as the top concern of voters heading into November's election for governor.
• APM Research Lab: Details on the MPR News/Star Tribune poll
Daudt said Republicans want to seek federal waivers to allow more state flexibility on health care. He said another round of reinsurance funding is also a possibility.
House Minority Leader Melissa Hortman said subsidies for insurance companies don't solve the problem.
"All Minnesotans need access to coverage that they can afford. Right now, not everyone has access to coverage that they can afford," said Hortman, DFL-Brooklyn Park. "The MinnesotaCare buy-in would allow us to take advantage of economies of scale, of getting more coverage to people in more parts of the state at a more affordable price."