Minnesota is preparing a state plan to deliver health insurance premium assistance to citizens adversely effected by premium spikes for 2017 ACA plans. This is a good thing, a response to a real problem that may impact 120,000 Minnesotans.
If one is astute and wants to actually do the work necessary to read the actual legislation, the coverage assistance looks wonderful. Very few voters have the time, energy, or motivation to spend on that pursuit, of course.
The problem is it was quietly gutted into something that is NOT wonderful.
This is manipulation that needs to be stringently monitored at every level of government,. It isn’t easy, we couldn’t find the changes quickly using our techniques that work in Arizona.
Magically Shrinking Coverage
Andy Slavitt, the former administrator of CMS (Centers for Medicare and Medicaid Services), tweeted this:
Next time an "ACA replace" package claims it allows "patient choice," understand what they intend to exclude. This just passed the MN house. pic.twitter.com/WKaK85s99w
— Andy Slavitt (@ASlavitt) January 24, 2017
The tweet is eye opening because of the list of conditions and procedures NOT covered by something with a “health care plan” label. The image alone offers no real information, it’s simply a list. So, while Andy Slavitt has a well earned reputation as a solid provider of information, there wasn’t enough to go on to investigate this further.
We tracked down the image in Slavitt’s tweet and found it on the Facebook page for Lindsey Port, a candidate for the MN House. Luckily, the comments on the above image offered a couple links with documentation of the changes listed.
Right Hand Giveth, Right Hand Taketh Away
A last minute amendment from Steve Drazkowski was offered to exclude the above list of items to be considered mandatory coverage, one of the linchpins of ACA.
Finding the documentation of the amendment and its disposition was time consuming, too much work for an average voter. So, that voter would have to rely on the suspect language from their lawmakers and possibly biased coverage from their local media outlets.
While insurers could choose to offer plans that covered, for example, prostate cancer screening and cancer care coverage, they could also choose to offer policies without that coverage.
Insurers would still be required to offer plans that covered all 68 federal mandates, but there is no stipulation of premium penalties to be paid for that complete coverage.
History indicates those plans would be prohibitively expensive. Insurance rates are calculated based upon spreading the risk around, flattening the chance of paying out too much like an investor diversifying his or her portfolio.
The Minnesota House approved the amendment 72-54, close enough to the party split in the MN House to call it a partisan vote, to repeal all the sections in the list of mandated coverage.
The GOP presented the plan as a cost saving measure for their constituents. Certainly one could save some money choosing a plan “a la carte” without some mandated items IF the insurance companies provided generous enough savings.
Everybody would win. Until a policyholder ended up sick, maybe.
Karma Offers a Clue
At about the same time Slavitt was tweeting about the Minnesota legislation, Minnesota Governor Mark Dayton was delivering his State of the State speech. Dayton’s speech included praising the creation of the public health option. Before he finished his speech, Dayton fainted after a brief episode of slurred speech.
The next day, Governor Dayton announced he has been diagnosed with prostate cancer.
Refer to the image of the excluded items and you’ll see three items NOT covered under the proposed Minnesota bill; “Diagnostic procedures for cancer”, “Cancer treatment”, and “prostate cancer screening”.
So, if he qualified for premium assistance in his state, the Governor of Minnesota could very likely be offered no help paying bills incurred for the condition that sent him to the floor during his speech. Considering the expense, it’s very conceivable he wouldn’t have even bothered with the expense of the diagnostic help finding that cancer early.
Perhaps the obvious correlation will occur to the Governor while he is deciding whether he will sign the bill.
Before that, maybe the irony will resolve into a call to action for the people of Minnesota to ensure their legislature works in their best interest to conserve tax dollars and ensure their health.
Minneapolis Star Tribune
Gov. Mark Dayton fainted near the end of his annual statewide address – 01/24/2017
Dayton reveals prostate cancer diagnosis – 01/24/2017