Minneapolis Star Tribune, June 8

Keep working on a Minnesota health care buy-in

Key questions remain about this option to improve coverage and affordability.

The fate of a popular health care reform — one with a 70% approval rating in a late 2018 Minnesota Poll — was sadly predictable.

In a state with the only politically divided legislature, a proposal to allow consumers to buy into the publicly run MinnesotaCare program in lieu of private health insurance faced an uphill battle. DFL Gov. Tim Walz made this a marquee campaign issue, while Republicans saw it as expanding government's role in health care.

Now add in the bandwidth sucked up during the recent session by another vital health measure — continuing the state's provider tax, a critical funding source for medical assistance. The time and focus simply wasn't available to fully vet a transformative change like the buy-in and create the necessary political momentum.

This week, Walz's administration told an editorial writer that the work on the buy-in and other initiatives will continue and that it remains a key strategy to ensure that Minnesotans have affordable medical and drug coverage. The reassurance is especially welcome with so many other states embracing ambitious reforms.

Maintaining the provider tax, and extending another program called "reinsurance," merely kept the status quo in Minnesota. The state needs to pick up the pace if it is to remain a leader in health care innovation.

The action in other states this year is noteworthy, according to United States of Care, a Minnesota-based organization that monitors health initiatives and provides expertise to policymakers.

Consumer advocates, lawmakers, patients and governors have a growing appetite to solve problems on their own, said Joanna Dornfeld, the organization's senior director of state affairs. They're striking out on their own as gridlock stymies Congress and the Trump administration seeks to undermine, even eradicate, the Affordable Care Act.

A recent editorial in these pages highlighted a Colorado measure to cap out-of-pocket costs for insulin, a vital medication for diabetics, at $100 a month. But Colorado and a number of other states have also made a buy-in to public medical programs, or variations on it, a focus.

Twelve states, including Minnesota, weighed buy-in legislation in 2019, according to United States of Care. One of these measures recently passed in Washington state. On May 17, Colorado's governor signed a law requiring health care officials there to develop a detailed proposal that "leverages state infrastructure" to offer a state health plan to consumers.

Connecticut policymakers also vigorously debated a public-private insurance option this year with the goal of saving consumers and small businesses 20% on insurance premiums. That effort met fierce resistance from an insurer with headquarters in the state, and policymakers ran out of time to hammer out a compromise.

The spotlight on a buy-in strategy is merited. Enrollees in publicly run medical programs, which currently restrict participation to those with low incomes, generally give good reviews to their coverage, according to United States of Care. Benefits are robust and costs per enrollee are lower than private coverage, potentially making it more affordable for buy-in customers.

Buying into these existing programs may also offer broader medical provider choices beyond the networks that private insurers have.

In health care, there are always trade-offs. A key question about a buy-in option centers on adequate reimbursement for hospitals and doctors. The main reason the public program costs are controlled is that they typically reimburse at a lower level than commercial insurance plans. Providers are concerned about their financial bottom lines if more people's care is reimbursed at these lower rates.

Are there ways a buy-in option could strike a balance offering an affordable option for consumers while adequately reimbursing providers? That's a key question yet to be answered. The debate over this reform should continue, and Minnesota should be the first to get it right.

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The Free Press of Mankato, June 7

Homeless Navigation Center a step in right direction

Why it matters: The Navigation Center in Minneapolis, set up last fall to get rid of a tent city of the homeless, closed this week.

Sometimes success is a matter of perspective, of degree, of circumstance, of incremental progress.

That would be the case with the Navigation Center in Minneapolis, set up last fall to deal with the crisis of a large and growing tent city of mostly Native American homeless in that city. The Navigation Center shut down this week, and while nobody can claim the problem of homelessness is solved, those involved in the center believe it made things better and the experience offers a path forward.

More than $3 million, much of it privately donated, was spent on the center, which involved an impressive number of governmental and nonprofit entities. The building itself is on land owned by the Red Lake Nation, and the tribe — with about 4,000 members living in the metro area — intends to build 110 units of affordable housing on the site, but also hopes to create a permanent navigation center.

Some 175 people inhabited the center this winter. Officials say about half are now in permanent housing; that is a large improvement over the usual rate of about 15 percent, according to the nonprofit that ran the shelter portion of the center.

It was a unique operation, with an emphasis on accessibility. People could stay with partners and pets. They could come and go at will. And they were not turned away for drugs or drunkenness, rare for shelters. Drug use was condoned, which is not the same as encouraged; the center was focused on preventing overdose deaths, of which there were two.

The center also had on-site social services, with culturally specific chemical dependency treatment and case managers available.

We're not sure how much of what was done in the Navigation Center is truly applicable to this area's homeless population. But we are impressed with the reported placement in permanent housing rate and with the degree of cooperation between city, county, tribe and nonprofits.

Now the partnership that created and ran the center has two challenges: First, to avoid a resurrection of the tent city. Second, to build on the accomplishments with a permanent Navigation Center.

But it was a step in the right direction, and our community may well be able to glean some best practices from it to fight our own growing problem.

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Post Bulletin, Rochester, June 6

Visit a state historic site this summer

At Jeffers Petroglyphs, a Minnesota Historical Society site near New Ulm, 5,000 ancient and sacred Native American rock carvings of bison, turtles, thunderbirds and humans can be viewed. The carvings are estimated to be up to 7,000 years old. Visitors can walk across these carvings, examining how they were made, wondering what they signify, and what messages they convey across the millennia.

And you thought history was dull!

With glorious summer weekends now lining up before us, your next getaway should include a Minnesota Historical Society site.

Minnesota is lucky to have a well-planned, well-maintained collection of buildings and landmarks that tell us the story of our past. They are accessible, educational and entertaining. Some of them also qualify as national historic landmarks.

A few are well-known. Your kids have likely taken a school field trip to the Minnesota History Center museum or Fort Snelling, for example. And it's virtually impossible to drive up the North Shore without seeing Split Rock Lighthouse.

In our region, Historic Forestville offers a 45-minute tour of the house, office, store, barn and garden of what is basically a ghost town. The site is located within Forestville/Mystery Cave State Park, so a visit to the town can be combined with a cave tour.

Also, the W.W. Mayo House, located in Le Sueur, is of particular interest locally because it is the home Dr. William W. Mayo built in 1859. It housed his family and his medical practice until the Mayos moved to Rochester in 1864. The adjacent Mayoview History Center has exhibits about the family and Mayo Clinic.

If your family is up for a slightly longer excursion, sites in the Minnesota River valley include several related to the 1862 U.S.-Dakota War: Birch Coulee Battlefield, Fort Ridgely, Lac qui Parle Mission, the Lower Sioux Agency and the Harkin Store.

The home of one of Minnesota's most famous sons, Charles Lindbergh, is preserved at Little Falls. Ojibwe culture can be explored at the Mille Lacs Indian Museum and Trading Post.

In Fiscal Year 2018, 1.1 million people — the equivalent of one in five Minnesotans — visited Minnesota Historical Society sites.

Let's join them this summer, and find out more about our state's history and our collective story as Minnesotans.

For a list of sites, including hours and admission fees, go to mnhs.org/visit .

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