Minnesota Measure Extends Health-Insurance Coverage
In a move that will make health insurance available to thousands of uninsured children and their families, Minnesota lawmakers have adopted a sweeping health-insurance-reform bill.
The measure, signed last week by Gov. Arne Carlson, will enable uninsured state residents who earn up to 275 percent of the federally defined poverty level, or about $37,536 for a family of four, to buy subsidized health insurance from the state.
The program, which will be fully implemented over the next two years, is aimed at the approximately 370,000 Minnesotans, including almost 70,000 children, who lack health insurance.
Besides Minnesota, only Hawaii has enacted laws that ensure that virtually all its residents have health-care coverage.
Since 1975, Hawaii has required employers to provide health insurance to their employees. In addition, the state for the past two years has had a program under which uninsured residents who earn less than 300 percent of the federal poverty level can buy coverage from the state.
Oregon and Florida have also passed health-insurance reforms, but their planned programs are awaiting approval from federal officials before they can be implemented.
Focus on Prevention
Minnesota's new HealthRight plan, which does not require federal approval, will provide children and families with a wide range of preventive and primary health-care services at no cost beyond the premium.
Hospital benefits for adults will be limited to $10,000 a year, but no co-payments will be required for any health-care services for children.
Premiums will range from $16 to $253 a month for four-member families.
"The gist of the program is to encourage more visits to the doctor and less visits to the hospital,'' said Representative Paul Anders Ogren, a chief sponsor of the measure. "I think it will make a huge difference for hundreds of thousands of people.''
The program will be financed by a 5-cent-a-pack increase in the cigarette tax, a 2 percent tax on the revenues of health-care providers and physicians, and a 1 percent tax on nonprofit health-insurer and health-maintenance organizations.
The legislation had been opposed by many segments of the state's medical community, which feared it would impose too great a financial burden.
The Minnesota chapter of the American Academy of Pediatrics, however, lobbied for the new program. "This would do more for kids, and we had to put that in front of us,'' said Peggy Specktor, a public-policy consultant for the group.
Ms. Specktor said one concern of the pediatricians was how the new program would be coordinated with the state's Children's Health Plan, a 4-year-old program that provides preventive-care services, but not hospital care, to all children under age 18 from families with incomes of less than 185 percent of poverty. (See Education Week, Dec. 14, 1988.)
About 26,600 children are enrolled in that plan, which requires a $25 yearly fee.
In the conference committee on the HealthRight bill, lawmakers decided to allow children to be covered by the existing program through July 1994. The legislature is to receive recommendations next year on how the two programs should be blended.
Many of the children who would have benefited under the old plan are also likely to receive health services under HealthRight, Ms. Specktor and others said.
Starting in October, families with children that have not had health insurance for at least four months and have incomes below 185 percent of the federal poverty level will be able to enroll in the plan.
In January of next year, uninsured families with children with incomes up to 275 percent of the poverty level will be eligible to enroll. Beginning in 1994, single adults and households without children will be able to purchase health coverage.
The HealthRight package also calls for creation of state and regional boards to recommend limits on growth in health-care spending.
The measure also boosts by 25 percent reimbursements to primary-care physicians who treat those enrolled in Medicaid, the Children's Health Plan, and HealthRight.