A health care choice could disappear

Every fall we are inundated with reminders to make our “open enrollment” choices. There are indications that choice may disappear from our options without our input. That choice was made by politicians to place revision of our health care options in the 844-page legislative conference report (CCR2995, the Health and Human Services Omnibus Bill) finalized in the closing days of the legislative session and read by almost no one before the final vote along party lines and signed by the governor. The conference committee was constituted by eight DFL and two GOP members charged with reconciling the House and Senate bills, not with negotiations. "Open enrollment” may end.

Peter Nelson (Senior Policy Fellow at Center of the American Experiment) acknowledges public opinion finds health care costs too expensive but warns empowering the government to mandate lower costs will most likely hurt the most vulnerable patients, specifically the ones with chronic conditions, the disabled, and the elderly, or in other words, the high-cost patients.

According to the self-proclaimed “independent, nonprofit news organization” Minnesota Reformer, Democrats worked to address the spiraling health care costs until confronted with opposition from Minnesota’s big hospital systems. The proposed health care affordability board would have set the spending targets for health care across the state and had the ability to fine hospitals and insurance companies for non-compliance with the mandated spending targets.

The Minnesota Hospital Association wrote to the legislators in April. Following that letter, Mayo Clinic wrote to Gov. Tim Walz and threatened to cancel a multibillion-dollar investment in Minnesota if the affordability board were created.

In the omnibus bill (SF2995) signed by Walz, the name was changed to a “center” in the Department of Health to analyze the skyrocketing costs and without the power to issue $500,000 fines and penalties to hospitals or insurers for non-compliance with the state-mandated restrictions.

With paltry coverage by the traditional media outlets, I noted that Dave Racer wrote regular articles following the issue from April through August 2023. Racer is a prolific author/editor on health care.

In April, Racer reminded readers government involvement became the “new norm” with the pandemic but cautioned Minnesotans “to come together to find ways the private sector can increase health care access, restore and enhance quality, and reduce the costs.”

To find private sector solutions, let’s consider what the Democrats’ plan encompassed, what changed, and what will probably not be changed now that it is codified.

Prior to May 2023, MinnesotaCare (insurance program for people who don’t qualify for Medicaid) was available only to U.S. citizens and lawfully present noncitizens, as defined in Code of Federal Regulations, Title 8, Section 103.12, (See Section 256L.04, Subdivision 10). The DFL public option would also include dental, vision, and hearing care, and in Chapter 70, Article 16, Sec. 15, MinnesotaCare becomes available for qualifying, undocumented Minnesotans starting Jan. 1, 2025.

In the bill (now law), Racer, drawing parallels with the federal Affordable Care Act (Obamacare), writes the government will determine the reimbursement rate to providers at a rate less than the Medicare allowable payments. Taxpayers will pay more to fund the premium subsidies as well as higher personal premiums. Eventually, those taxpayers facing increasingly unaffordable premiums will also opt for the government option, driving the provider reimbursements even lower. More professionals will be forced out of practice or out of Minnesota.

On the surface, it may appear that the politicians acquiesced to external pressures, but the reality is that with the change in name, the program is only postponed a year, now scheduled to be implemented in January 2027. Government appointees began to review options in July 2023 and will report to the legislature in January 2024, per (Art. 16, Sec. 19, (b) with a final report by Jan. 15, 2026.

Delayed but not dead.

The codified charge is an “Analysis of Benefits and Costs of a Universal Health Care Financing System.” Article 16, Sec. 19, Subd. 3 requires MDH to contract one or more independent agencies to analyze the benefits and costs of a government-financed healthcare system and conduct a similar analysis of the current healthcare system before recommending the preferred option to the Legislature.

Racer projects that initially people will be satisfied by paying lower premiums under the government plan but sorely frustrated when access to medical care diminishes as providers reject the reimbursement rates lower than the Medicare allowed rate.

Even if the legislature excludes itself and other state employees, providing private insurance at taxpayer expense, it will all be equal when the politicians need to see a doctor or have surgery.

Racer solemnly states reality. “When hospitals cut staff, close buildings and clinics, when physicians and surgeons leave Minnesota to practice elsewhere, the kind of insurance you have will not matter much. You will struggle to find a primary care doctor, and specialists who find a way to survive on reduced incomes will have weeks- and months-long wait times.”

Skeptics, please read the “law” for yourself. Chapter 70 (mn.gov)

Where was there mainstream media coverage?

Where was the transparency that candidate Walz promised?

Are private sector options even possible? Maybe ... if We the People become informed and involved.

This is the opinion of Times Writers Group member Phyllis E. VanBuren, a lifelong learner and enthusiastic educator, who values family, friends, faith, honesty, liberty and integrity. Her column is published the fourth Sunday of the month.

This article originally appeared on South Bend Tribune: Thanks to law, open enrollment may end for Minnesotans