State Legislators Speak Out on Affordable Care Act Repeal

As Congress considers legislation that would repeal the Affordable Care Act, it’s critical we consider what is at stake. Today the White House released a snapshot of what legislators are saying about “repeal” efforts from across the country. Here are my comments as well as those of others:

Minnesota Representative Erin Murphy:

“Repealing the Affordable Care Act means repealing affordable coverage for Minnesotans with preexisting conditions like asthma or diabetes. It means repealing consumer protections that protects an insured family from unfair premium increases. It means bringing back the prescription drug donut hole that prices seniors citizens out of the prescription drugs they need to stay healthy… Repealing the Affordable Care Act represents a fatal step backwards and the consequence is a less stable, more costly health care system for Minnesotans.”

Minnesota Representative Tom Huntley:

“Every day, Minnesotans are coming to appreciate the Affordable Care Act more and more. Adult children are being offered coverage on their parents’ policy, seniors are getting help with the costly donut hole, and small businesses are adding jobs because the tax credit is helping them provide health coverage.”

Iowa State Senator Jack Hatch:

“Before they vote, they need to think about the Iowa mother who can now get coverage for her 3-year old son who has severe asthma, a pre-existing condition; the Iowa cancer survivor who now no longer has to worry his insurance company will cut off his coverage due to an arbitrary lifetime limit; and, the tens of thousands of young Iowa men and women who now can get coverage on their parents’ health care plan.”

Texas Representative Garnet F. Coleman:

“It's telling that just weeks after taking office, Republicans in Congress have made it a priority to change current law to take away Americans' healthcare rights and allow insurance companies to drop someone from coverage if they develop a catastrophic illness like cancer. The Republican repeal would add billions to our national deficit and would have very real and drastic consequences on Texas families.”

Early MA is good deal for all Minnesotans

Last week I joined Governor Dayton in his reception room for the signing of his executive order to enroll Minnesota in early Medical Assistance (MA). It was the next step in what has been a long and ongoing journey to provide health care in a cost-effective manner for all Minnesotans.

Many people attended the signing and Governor Dayton allowed both supporters and opponents of early MA to voice their opinions. It was a refreshing display of democracy in action, which is why many news outlets spent a good deal of time discussing his remarkable decision to open his office to the people.

Along with appreciating Governor Dayton’s openness, I would like to highlight some the positive outcome for Minnesotans that his decision to enroll Minnesota in early MA. I’d also like to highlight some of the Republican myths you may have heard about early MA:

Health care for 95,000 Minnesotans
Covers 95,000 uninsured or underinsured Minnesotans who earn less than $8,000 per year with basic health care by capturing federal resources at no additional cost to the state.

Creates as many as 20,000 Minnesota Jobs
Provides more than $1 billion in additional payments to Minnesota’s health care workforce, hospitals and care providers who have been hit hard by past cuts.

Reduces the hidden tax on working families
Minnesota families pay a $1,500 hidden tax to cover the uninsured. Reducing unpaid care for 95,000 Minnesotans will significantly reduce that hidden tax for working families.

Eases strain on state budget deficit
Captures federal resources and provides care more cost effectively to SAVE the state $32 million next biennium and $233 million over five years.

Broad support from health care, businesses, and faith community
MA enrollment is supported by hospitals, nurses, seniors, business leaders, and faith organizations and more.

Dispelling Republican Myths

Don’t be fooled by “Tea Party” rhetoric
MA is not a radical form of “Obamacare.” It was created in 1965 as a federal/state partnership to provide basic health care to seniors, low-income, and the disabled.

MA enables us to move forward with cost saving reforms
MA does not “end” reform. To the contrary, MA retains innovative reforms passed in 2008 like health care homes, providing additional opportunities to reduce health care costs.

Authority to enroll Minnesota in MA passed bipartisanly
Dozens of legislative Republicans including the new Speaker of the House, Kurt Zellers, voted for the bill signed into law by Governor Pawlenty that authorized early MA enrollment.

The Work Ahead

Medical Assistance has long provided health coverage for low income seniors, disabled Minnesotans and low income families with children. The majority of the Medicaid budget is spent for the care of seniors and the disabled.

To tackle the cost trajectory in the years ahead, we must continue to pursue delivery and payment reforms across the system.

And So it Begins...

Mighty Citizens,

The 2011 legislative session began on Tuesday with my colleagues and me taking the oath of office. Raising my right hand and getting sworn in to return as your state representative was both humbling and inspiring. I am eager to get to work on the important challenges facing our community and state.

I am firmly committed to solutions that will create jobs, grow our economy for the future, and reaching a fairly balanced budget. That means protecting middle class families from steep property tax increases, college tuition hikes and damaging cuts to our schools. In the days leading up to the session new Republican leaders signaled they will put forward a budget that protects education, Minnesotans with disabilities, seniors, and public safety. I look forward to seeing the specifics of this plan and putting it through close examination so that Minnesotans know the true impact for their families and future.

I would love to see you this session, so please visit at my new office at 345 State Office Building. For those following the House committees you can also visit the three committees I will be serving on this session: Health and Human Services Finance, Health and Human Services Reform, and Rules and Legislative Administration.

Changes will mark the beginning of the legislative session. We have our first DFL Governor in about twenty years in Mark Dayton and have new Republican majorities in the Minnesota House and Senate. However, it will be how we respond to these changes that will mark the conclusion of the legislative session and ultimately the direction of our state.

It’s time to get to work.

Thank you for the opportunity to serve.

Hopeful News on Job Creation

Minnesota received hopeful economic news today about our continued recovery. In May we created 5,600 jobs according to the Department of Employment and Economic Development (DEED). This is the first time since 2008 we’ve seen two consecutive months of job growth.

Since the low point of the recession in September of 2009, we have created over 34,200 jobs. The road to recovery will be long, and not without setbacks, but it’s clear Minnesota is finally moving in the right direction.

Minnesotans are also making their way back to a full work week, an important economic indicator for a healthy economy. The average week increased to 33.1 hours. That is a boost from the 32.7 hours in January 2010.

Legislation we passed this session will help accelerate our recovery. Our bonding will put thousands of construction jobs across many different sectors. New workers will help improve our infrastructure and encourage entrepreneurship throughout Minnesota.

It will take time for our economy back to recover fully, but we’re on our way. We need to continue being proactive at the state level and pursue innovative reforms to create jobs and build our new economy for a successful future.

Learn how small businesses can take advantage of federal health care reform

The crushing cost of health insurance for small businesses was one of the driving forces for federal health care reform. Now that it’s law, it’s important for small business owners to know how they will be affected by reforms to address cost, unpredictable premiums, and lack of access to affordable choices.

The Small Business Majority (a non-partisan national non-profit organization created by small business owners) has released helpful information for small business owners to understand how federal health care reform will impact them.

They have also created a Small Business Calculator where small business owners can calculate the tax credit they will receive by offering health insurance to their employers

Here are a few of the significant ways federal health care reform will support small businesses:

Lower costs

• Small business tax credits - Creates a $40 billion tax credit from 2010 to 2019, providing approximately 4 million small businesses with a tax credit to offset employer health plan costs.

• Cost containment - Creates a small business health pool to spread risk and eliminates cost shifts that add to hidden tax passed on to everyone’s care when the uninsured seek expensive treatment in emergency rooms.

More choices

• Simplified options - Provides small businesses, including the self-employed, a new option for a simplified cafeteria plan to provide tax-free benefits to employees.

• Temporary High-Risk Pool - Creates a temporary high-risk pool in 2010, funded with $5 billion, to allow individuals who have been uninsured for six months and have a preexisting condition to buy affordable comprehensive coverage.

Insurance reforms

• Preexisting conditions - Prohibits medical screening for health conditions and makes it unlawful to deny coverage for preexisting conditions for serious health conditions.

• Oversight on premium increases - Establishes new processes for federal and state review of premium increases. Among other things, states may recommend that insurers not be allowed to participate in the exchanges due to unreasonable premium increases.

For more information visit www.smallbusinessmajority.org

GAMC: A Bridge to Comprehensive Care and System Reform

After many months of negotiation and debate, we were successful in negotiating an agreement that maintains health care coverage for current GAMC enrollees. However, there are significant problems with the compromise agreement. With the passage of the federal health care reform bill, we have the opportunity to provide comprehensive, statewide coverage to very low-income Minnesotans through an early opt-into Medical Assistance (MA). The compromise law on GAMC is a critical bridge to a better option.

Our first legislative solution, Senate File 2168, was undoubtedly the most fiscally-responsible means of restoring health care coverage to GAMC recipients, while still instituting system reforms and cost-cutting measures. Although Governor Pawlenty’s proposal to auto-enroll GAMC enrollees into Minnesota Care would have been more expensive and would have imposed additional costs and coverage caps on a population that earns less than $8,000 per year, he vetoed our bill. Our attempt to override did not garner any Republican support, even though the vast majority of them had voted for the bill.

The compromise legislation, enacted just before GAMC disenrollment commenced, preserves health care and prescription drug coverage for the GAMC population and protects the Health Care Access Fund (HCAF) for MinnesotaCare recipients. The compromise maintained the GAMC program in its current form until June 1st, at which time the program will operate by providing lump sum payments to hospitals. The hospitals will then use a managed care approach to form Coordinating Care Organizations (CCOs) to provide services to GAMC patients. Drug coverage is maintained as a fee for service—a critical component for GAMC recipients, many of who are mentally ill or suffer from chronic diseases.

While the new agreement maintains the safety net, it does come with very high expectations for hospitals, which are being asked to continue providing care despite decreased reimbursement. Initially, all but one hospital declined to become CCOs, and it was only after the Department of Human Services “reinterpreted” the new law to limit the number of patients each hospital would have to take that three additional metro-area hospitals agreed to sign on.

In the final budget agreement, we successfully negotiated the inclusion of rural hospitals in the terms established by DHS and provided an additional $10 million to their uncompensated care pool, bringing that total to $30 million for reimbursement for care provided in hospitals that do not become CCOs.

Even for the short-term, the revised GAMC program is barely sustainable. Hospitals are being asked to provide care, with less money, and enrollees have to navigate a system that asks large hospitals to coordinate their much-needed preventive care. The rudimentary reforms in GAMC will be hampered by under funding and geographic disparity.

I am monitoring closely implementation of the revised GAMC program and will be visiting providers and enrollees in Greater Minnesota to best understand the issues with implementation. Early reports suggest the concerns my colleagues and I shared with the administration prior to final passage are being realized and we will continue to pursue the transfer of GAMC patients into early MA.

A far superior option is available to us as a result of the passage of the federal health care reform bill. Because Minnesota provides coverage for very low income Minnesotans with state funds, we are one of 11 states able to transfer enrollees into Medical Assistance and earn federal matching funds.

Early MA provides stability for those getting care and predictability for providers. Most importantly, it provides us with an important opportunity to bring broad system reforms to improve care and reduce costs for everyone. Foregoing this opportunity would be a strategic failure.

We fought hard to include the early MA opt-in in the final budget agreement and it will be established in state law beginning on July 1, 2010. This option is fully funded in the budget signed by Governor Pawlenty. The Governor can now opt in by signing an executive order beginning on July 1, 2010.

By opting into early MA, a decision for Governor Pawlenty or his successor before January 15, 2011, Minnesota will earn federal matching funds. The early MA option is paid for with $1.4 billion in federal funding that is leveraged by $188 million in state dollars – a $7 to $1 ratio. After three years, the state share will disappear entirely and the federal government will pay 100 percent of the cost of coverage.

Reducing the ranks of the uninsured is a cost saver for insured Minnesota families as it eliminates the “hidden tax”, paid in the form of higher premiums to cover uncompensated care. The benefit of the state spending in this area is will create 22,000 jobs, generate $2.7 billion in business activity, and produce $984 million in salaries and wages.

With the passage of federal health insurance reform in April, I know that the GAMC compromise will have a short but important role in Minnesota. I support the early MA, along with many advocacy groups and provider organizations. I hope that you will join me in urging our current, or future, Governor to adopt this measure.

Standing With Nurses

Last Friday I joined nurses and Speaker of the House Margaret Anderson Kelliher to stand with 12,000 Twin Cities nurses who will conduct a one-day strike for patient safety on Thursday, June 10, 2010.

As a policy maker, I have always strived to reform and improve health care in Minnesota because that means a healthier population. I firmly believe a critical part of that health care delivery is strong and effective nursing workforce.

Health care in Minnesota is experiencing a lot change and is under a lot of pressure.
Reforms being implemented means change in the delivery of care. Our aging population brings a larger demand of patients. At the same time, we are seeing a shortage of nurses and other health care professionals widen. Amidst this pressure, nurses are expressing their concerns for the safety of the patients they care for everyday.

Concern for patients’ safety has always been a top concern for nurses. I know this because I’ve seen it first hand for decades. In 1984, when I was in college, nurses went on strike because of their concern for their patients. In 2001, nurses negotiated with hospitals on the number of patients that each registered nurse could care for to ensure each patient received the attention they needed. In 2008 and 2009 they came to the Legislature and worked with us to put in statute patient/provider ratios to go further to ensure patients were receiving the quality care they deserve.

I’ve worked with hundreds of nurses in many hospitals. I know how difficult a decision it is to strike, because it means leaving their patients, even for one day. But they have the courage and strength to do this in order to stand up for themselves and for the safety of their patients. I am proud to be standing with them.

To watch the entire press conferences visit http://tiny.cc/tjmfj.