PUBLISHER'S NOTEBOOK: Birth of MinnesotaCare in '92 now appears to be remarkable
Tuesday, December 04, 2012 3:57 AM
Current and former lawmakers met last week at the Minnesota History Center for a celebration of the 20th anniversary of MinnesotaCare, a state-funded program that provides health benefits to children and low- and moderate-income families who don't get affordable insurance through their employees and earn too much to qualify for Medicaid.
The program serves an average of 148,000 people a month, 35 percent of them children. Funding comes from a state tax on Minnesota hospitals and health-care providers, federal Medicaid matching funds and premiums paid by the people enrolled.
To qualify, Minnesotans must have been without health insurance coverage for four months or be working for an employer who pays less than half of the monthly premium costs.
MinnesotaCare was considered a "landmark piece of legislation" that provided critical health care coverage for Minnesotans caught in "the health care insurance dilemma" of earning too much for Medical Assistance, but not being able to afford the private market, said Amy Crawford, regional director of the Children's Defense Fund - Minnesota, which sponsored the celebration.
The anniversary shows just how much things have changed since 1992 when this legislation passed. Although there were bitter battles, the two sides did end up with a bipartisan belief that Minnesota families shouldn't have to be on welfare to get affordable health care.
Now, just 20 years later, it seems hard to imagine that this process could have ever taken place.
Even the name seems quaint. Today, the national Affordable Care Act passed by Congress and signed by the president is nicknamed Obamacare as a partisan strategy to pin the change on one individual.
Although the bipartisanship that somehow satisfied both free-market advocates and supporters of a government safety net may bring back fond memories, the process was not easy.
There were bitter battles at the Capitol, groups representing hospitals and physicians staged protests over the tax and insurers were fearful that people would leave the private market.
The issue had even more interest in our area as Duane Benson, a Republican state senator from Lanesboro at the time, was a member of the "Gang of 7," a bipartisan group of legislators that barricaded themselves in a Capitol meeting room to reach a consensus on a bill that would improve care, focus on prevention and be self-funding to remove itself from the variables of state budgets.
"It was one of the most grueling, long-suffering events I've ever been through," Benson told the Star Tribune recently.
Although it would seem unlikely that Republicans today would ever engage in the same process, Arne Carlson, the Republican who was governor at the time, still feels that it was a good move.
MinnesotaCare may have fallen a bit short of some of its lofty goals, significantly more people in Minnesota have health insurance compared to most states.
Health care is facing many changes again, notably due to the provisions of the Affordable Care Act, or Obamacare. The future of MinnesotaCare will be one of several health care issues legislators will tackle when they meet again in January.
Times are different in more ways than the prominence of partisanship over finding solutions. Back then, there was a feeling that universal health care was on the horizon. Today, merely meeting the requirements of the federal Affordable Care Act may mean a step backward for the state.
However, the most interesting component will be getting a sense of the process of working out differences in ideology of lawmakers as they set the course for the state.
We'll get to see if the politicians can turn back the clock and work out a bipartisan agreement that continues Minnesota's progressive tradition or continue the recent history of partisan maneuvering that leaves no room for compromise or shared solutions.