| In addition to requiring MA beneficiaries to select a primary care clinic the Minnesota Department of Human Services would rank health care providers and place them in tiers based on quality and cost data that is currently being assembled through Minnesota’s 2008 Health Care Reform Act. Pawlenty said that MA enrollees who choose a low-cost, high quality provider would receive a deposit on an Electronic Benefit Transfer (EBT) card, which they could use for items typically not covered, such as reading glasses or over-the-counter drugs. Pawlenty suggested the incentive might be about $100. Pawlenty would also like to increase the copays and deductibles for the portion of MinnesotaCare enrollees who earn between 133 percent and 275 percent of the federal poverty guidelines. But, he also proposes, providing enrollees with a certain amount of funds in a health savings account to cover the cost of the new copays and deductibles. Those enrollees who choose a provider in a low-cost, high-quality tier would receive more money in their accounts than those MinnesotaCare enrollees choosing providers in the more costly tier. Unspent funds would rollover from year to year for both MA and MinnesotaCare enrollees. During an interview on Air America (AM 950) Tuesday, Rep. Thomas Huntley, DFL-Duluth, said that many of Pawlenty’s proposals are already advancing as a result of Minnesota’s 2008 Minnesota Health Care Reform Act. For example, the reform act calls for Minnesota’s public and private health plans to start making benefit and payment changes based on a new peer-grouping system that compares providers on cost and quality in January 2011. However, Pawlenty noted at the press conference that the reform act does not require tiering or that people on MA and MinnesotaCare choose a primary care clinic. As for the idea of giving people money on an EBT card to use toward uncovered expenses, Huntley said he did not oppose it, but he also did not think it would result in significant savings. MMA position
In September, the MMA’s House of Delegates debated whether to incorporate health savings accounts into public programs. Some MMA members support the concept, arguing that making public programs more consumer-oriented would result in enrollees making better choices, such as going to an urgent care clinic instead of an emergency room for minor problems. Opponents said administering such a program would be difficult and would result in increased costs without accruing any significant benefits. The House of Delegates ultimately rejected the idea. Insurance reform
The governor also would like to make Minnesota the first state in the nation to allow residents to purchase health insurance from other states. Under Pawelenty’s proposal, Minnesota residents would be able to buy health insurance from any one of 20 states considered by the Minnesota Department of Commerce to be good insurance regulators. Pawlenty believes that more competition would result in lower health insurance costs, since premiums in Minnesota currently run about 7 percent higher than the national average, according to a Kaiser Family Foundation study he cited. Pawlenty would also like Minnesota to help establish an interstate health insurance compact that would decide on a common regulatory standard in order to facilitate health insurance purchasing across state lines. Sen. Linda Berglin, DFL-Minneapolis, responded to the idea of allowing Minnesotans to purchase health insurance sold in other states in the Farmington Independent, by saying “the only way to save money by selling across state lines is by providing substandard policies." http://www.farmingtonindependent.com/event/article/id/20908/publisher_ID/8/ The MMA has not weighed in on this issue. “However, our concern would be that allowing patients to have health benefits from 20 different states could result in an administrative nightmare for doctors who would have to juggle all of those insurers,” said Dave Renner, MMA director of federal and state legislation. |