MINNEAPOLIS, January 24, 2007 - The MMA’s top priorities for the 2008 Legislative Session include health care reform, reimbursement for interpreter services, and protecting the integrity of the Health Care Access Fund.

When lawmakers start the 2008 session on February 12, their main job will be passing a bonding bill for capital expenditures that are expected to total about $965 million. However, the Legislature is also expected to take up a health care reform bill that incorporates recommendations made by Gov. Tim Pawlenty’s Health Care Transformation Task Force and the Legislative Health Care Access Commission.

The two work groups met throughout 2007 to craft reform proposals for expanding access to care and making it more affordable. “We have some reports coming back,” said House Minority Leader Marty Seifert, R-Marshall during a recent press conference, “and we hope to extract some savings from the system.” 

Reform consensus
The MMA and DFL and Republican lawmakers seem to agree that health care reform should include a market-based approach, a strengthened public health system, and payment reforms that encourage disease management. Some of the health insurance reforms proposed by the governor’s group resemble those advocated by the MMA, such as requiring all Minnesotans to have health coverage, establishing an essential benefit set, and guaranteeing insurance coverage regardless of health status.

MMA concerns
However, the MMA is concerned about other proposals by the governor’s group. Particularly troubling is a recommendation that seems to suggest the creation of a capitated system that would compel physicians to join large integrated care systems. According to this recommendation, providers would be accountable for the cost and quality of a patient’s care. Providers would put forward a bid estimating how much they would charge to care for a group of patients for one year. Providers would then be paid per procedure, but payment rates would undergo quarterly adjustments up or down to ensure the providers only got paid their bid amount.

“The draft proposals have many good ideas,” said Michael Ainslie, M.D., chair of the MMA Board of Trustees, “but the MMA wants to make sure we don’t make the mistakes of the past and try to pound a square, capitated peg, into a round health care hole.”

Reform flash point
Conflict between DFL and Republican lawmakers will likely arise around the fact that the governor’s group has been more focused on controlling costs whereas the legislative group has focused both on cost and on making health care more available to low- income Minnesotans, according to Dave Renner, the MMA’s director of state and federal legislation.

DFLers are prepared to push for a constitutional amendment making health care a right if there isn’t progress on health care reform.“My sense would be that if there is not enough progress on affordable health care, then [a constitutional amendment] is something that might be in play later in the session,” said Senate Majority Leader Larry Pogemiller, DFL-Minneapolis during a press conference. The MMA opposes pursuing a constitutional amendment because it would distract lawmakers from actually reforming the health care system.

Air of optimism
Renner and others are generally optimistic progress can be made. “There seems to be momentum and bipartisan agreement that there are some reforms that are needed to improve the system,” he said.

 House Speaker Margaret Anderson Kelliher, DFL-Minneapolis, said  during a press conference. “What you can expect to realistically see this session is a lot of the building blocks will be put in place for more Minnesotans to have more affordable health care,”