Health insurance rebates get complicated

with Brian Bakst

The push to provide quick relief to Minnesotans facing huge health insurance premium spikes grew more complicated Tuesday at the state Capitol,and fueled partisan tensions in the process.

During a hearing before the Senate commerce committee, Sen. Michelle Benson, R-Ham Lake, presented a revised version of her bill that will likely add significantly to its $300 million price tag.

Her changes include a reinsurance provision to cushion the market impact of people with serious health problems. Benson said she had not yet received a cost estimate on the provision, but she stressed the importance of reform along with financial help.

“As we’re working on relief for 2017, we also have to be working on the underlying problem for the 2018 market,” Benson said. “Or, we’re going to end up in the same place next year, with very high premiums and having taken no action to solve the underlying problem.”

DFL Gov. Mark Dayton said last week that he won’t sign a relief bill that includes reinsurance. Dayton said it would add an estimated $500 million to the cost.

There are also disagreements over the best way to deliver rebates to the 125,000 people who buy health coverage through the individual market but aren’t eligible for federal subsidies.

Republicans want a state agency to send out the 25 percent rebate checks. Dayton says insurance companies are better equipped to deliver state aid quickly.

In a House hearing, Rep. Duane Quam, R-Byron, questioned the administration’s estimate that it would take the state many months and millions of dollars to directly deliver relief.

“Frankly in the real world, outside where our citizens work they get stuff done in a timely fashion,” Quam said

Dayton’s budget commissioner Myron Frans was firm in his response.

“If the House GOP plan is to develop an administrative nightmare and then make us responsible for it, then I’m going to tell you how long it’s going to take to develop that system, how much it’s going to take so it runs and runs exactly correctly,” Frans said.

Karen Laumb, a public health consultant with her own business in St. Paul, told lawmakers a fix is urgent for her.

The cancer survivor says her 2017 premiums increased 50 percent to more than $540 per month. And she said her new plan’s slimmer network has left her without most of her regular doctors.

“I am not naive and I know that health care is not free,” Laumb said. “But it is frustrating for me to be paying this much for health coverage that is greatly inferior to what was available to me as an employed person just two years ago.”

Meanwhile, Republican Rep. Matt Dean of Dellwood said the state’s top insurance regulator should be fired over the problems in Minnesota’s individual insurance market.

Dean, who is chairman of a House health budget committee, said Tuesday that Commerce Commissioner Mike Rothman should be fired amid rising rates and how he’s handled the crisis in the health insurance market.

Just a few years ago, Minnesota had some of the nation’s best rates for individual plans, which Rothman touted. Now consumers are dealing with huge premium increases.

Dean criticized Rothman in a House committee hearing and later on an MPR News program.

“If he is going to take credit for the lowest insurance prices in the country, he needs to be held personally responsible for this mess on this day. And that has not yet happened, and it needs to happen,” Dean said, clarifying later that he wanted Rothman to be let go.

Dean said Rothman didn’t do enough to keep lawmakers apprised of how bad things were until it was too late.

Rothman testified to a House committee that his taken steps to stabilize a market in dire shape as and is working on others.

“The governor and us as commissioners are very eager to work with the Legislature,” Rothman said. But the commissioner said a rebate plan must come first and fast.

He compared the market situation to a patient with no pulse. “We are still in the emergency room. And before we can talk about how the market is going to walk again in 2018 up in the operating room, we need to finish stabilizing the patient by infusing premium relief to consumers,” Rothman said.

Rothman reports to Governor Mark Dayton, who said he stands by his commissioner. Dayton said he disagrees with Dean’s assessment.

“The rate increases are not Commissioner Rothman’s fault. They were decided by the health plans,” Dayton said in a statement. “The commissioner did an outstanding job negotiating with insurers to remain in the marketplace, after Blue Cross Blue Shield pulled out.”