MINNEAPOLIS, February 7, 2008 - The Legislative Commission on Health Care Access released its recommendations Monday for reforming the state’s health care system.

The recommendations put forward by the commission, which was chaired by Sen. Linda Berglin, DFL-Minneapolis, and Rep. Thomas Huntley, DFL-Duluth, are quite similar to the MMA’s own reform vision, “Physicians’ Plan for a Healthy Minnesota,” which was released in 2005.

The recommendations also resemble many of those made by the Health Care Transformation Task Force, a reform work group whose members were appointed by Gov. Tim Pawlenty.

A significant point of alignment between the legislative commission and the governor’s group is that they both support addressing the consequences of obesity, tobacco use, and alcohol abuse and advancing the medical home concept by providing funding for care coordination.

Here are some of the legislative commission’s key recommendations divided by topic:

Health care homes

• Work to establish health care homes for all state health care program enrollees, concentrating initially on those who have or are at risk of developing a chronic condition.
• Pay health care homes an average care coordination fee of $50 per month per enrollee. The fee amount would vary based on the care coordination needs of the patient.
• Require state health care program enrollees to complete a health assessment and select a primary care provider as a health care home.

Access

• Set the affordability guidline as individuals earning  income or below 300 percent of the federal poverty guideline should not be expected to contribute more than 6 percent of their gross income to health care in the form of premiums, deductibles, and other out of pocket costs.  For those with incomes between 300 and 400 percent, no more than 8 percent of income should be contributed.
• Increase the MinnesotaCare income limit for both families and children and adults without children to 300 percent of the federal poverty guidelines and revise the premium sliding scale.
• Provide subsidies for health coverage to Minnesotans whose income does not exceed 400 percent of the federal poverty guideline. The subsidy should equal the difference between the affordability standard and the cost of premiums and deductibles for the lowest cost policy that meets state standards.

Health insurance reform and cost containment

• Require employers to establish section 125 plans that would allow employees to pay for health care coverage with pretax dollars.
• Establish a health insurance exchange where individuals could more easily compare and purchase insurance.
• Adopt a community rating system that would only permit premium variations based on age, geography and risky behaviors, such as smoking.
• Establish an independent board to develop a cost-effective, evidence-based benefit set. The board would also identify preventive care services, diagnostic tests, chronic care coordination services, and prescription drugs that are cost effective.
• Develop an evaluation process for new procedures, medications, and technologies to ensure that coverage is only provided for those that are safe and effective.
• Institute a mandate that all Minnesotans must have health insurance, if during the next seven years the state fails to meet the universal coverage benchmarks stipulated in the report.
• Adopt a statewide health, nutrition, and physical fitness curriculum for schools, including 30 minutes of activity a day.

Public health and quality

• Work to prevent illnesses related to obesity, tobacco use, and alcohol and drug addiction.
• Require the (MDH) and the Minnesota Department of Education to start monitoring childhood obesity by using the body mass index (BMI).
• Establish a set of statewide health improvement and outcome measures for pay-for-performance programs.
• Increase tobacco taxes by 50 cents.