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Viewpoint: Walz/Flanagan budget is good prescription

By Johanna Rupprecht & Paul Sobocinski, Affordable Healthcare for All

The Land Stewardship Project works to address the health care crisis in rural Minnesota because we know that lack of affordable, high-quality care is a major barrier to having thriving rural communities with more farmers on the land.

As LSP organizers deeply rooted in rural Minnesota where we work, we hear stories all the time of how the health care system is failing people, including our family members, friends and neighbors. We are pleased to see that Gov. Tim Walz and Lt. Gov. Peggy Flanagan's proposed Budget for One Minnesota includes many significant steps forward toward a health care system that meets all Minnesotans' needs, including farmers, small-business owners and self-employed people.

Some key positive highlights of the budget are:

• By continuing the health care provider tax, it prevents an approximately $700-million-a-year hole in the Health Care Access Fund, which is used to fund public health programs and care for 1 million Minnesotans enrolled in Medicaid and MinnesotaCare.

The Health Care Access Fund is created by a fee providers pay on their gross revenue, which has been a dependable formula for over 20 years. The Health Care Access Fund was created with bipartisan leadership and signed into law by then-Gov. Arne Carlson in 1992. But as part of a deal to end the state government shutdown in 2011, Republican leadership of the Minnesota House and Senate struck an agreement with Gov. Mark Dayton to set a December 2019 sunset date on the provider tax. Stopping the sunset would prevent an unnecessary budget catastrophe by simply continuing what has worked well for decades to ensure stable funding for Medicaid and MinnesotaCare.

In 2017, key Republican leaders used provider tax funds for their "reinsurance initiative," which was intended to bring down premiums by giving money to insurance companies, an initiative they want to continue in 2019. But unfortunately, some of the same legislators are now trying to misrepresent what the provider tax is and what continuing it would mean. We need to stop the sunsetting of this fund to make sure this public money is available to be used for the public good.

• Using money from the Health Care Access Fund, the budget also provides direct help in two ways for Minnesotans facing unaffordable health insurance premiums on the individual market.

First, it creates a 20 percent premium subsidy for Minnesotans who don't qualify for public programs or for federal premium subsidies offered through MNsure. Up to 80,000 Minnesotans could participate in this program.

Second, it establishes a state-based health insurance tax credit by 2021 that is designed to help ensure that Minnesotans on the individual market spend no more than 10 percent of their income on health care. Up to 50,000 Minnesotans could be eligible.

• It creates a public option for health care coverage that will provide an opportunity to buy into a comprehensive program offering 90 percent actuarial value (meaning the plan pays for 90 percent of a person's health care costs), with a provider network and benefit set similar to Minnesota's popular MinnesotaCare program. This will include dental, vision and behavioral health services and is broader than what is currently available in the market.

• It proposes the creation of a uniform pharmacy benefit and dental benefit for Minnesota's public programs, including the buy-in option. It is important that our Governor is looking at using the state's purchasing power to bring down pharmaceutical and dental care costs for Minnesotans. Rising prescription drug prices are a leading driver of health care costs. Access to dental care, especially for those who get health insurance coverage through Medicaid, is a major problem in rural Minnesota, and this plan would increase the availability of these services.

Most importantly, Gov. Walz and Lt. Gov. Flanagan's health care budget proposal moves us forward toward a high-quality health care system that takes care of everyone and frees Minnesotans to pursue meaningful lives. We need health care that is comprehensive, lifelong and not tied to a person's work. Coverage must be available at a cost that each family can truly afford. We all need quality medical care to be available close to home and when we need it.

The Walz-Flanagan administration's health care proposal represents groundbreaking progress toward these shared values. We need our lawmakers in St. Paul to advance these same values.

Johanna Rupprecht and Paul Sobocinski work on Land Stewardship Project's Affordable Healthcare for All initiative. Rupprecht grew up on her family's farm and lives in Winona, and Sobocinski farms near Wabasso.