Minnesota: Single-Payer Study
Upshot
S.F. 2010 and H.F. 2499 would require an analysis of the benefits and costs of a legislative proposal that would establish a single-payer health program, known as Minnesota Health Plan. The analysis would be used to compare the universal system to the current system.
The analysis would also consider how a single-payer program would impact the uninsured rate, completeness of coverage, adequacy of coverage, and quality and timeliness of care. A report of the findings would be due to the legislature by January 1, 2023.
The bill was initially taken up in 2021, but ultimately died in Committee with little action. This may be due to Minnesota exploring other options towards increased coverage and access, such as a public option and a basic health plan option.
Background
Minnesota operates a state-based Marketplace. Five insurers offered plans in 2022, with the same insurers intending to offer coverage in 2023. The state also has a reinsurance program, which was renewed in 2022 and will continue through 2027. As of 2022, 121,000 residents received coverage through the individual Marketplace. Minnesota also features a BHP, in which coverage is available to residents with incomes between 139 and 200 percent FPL.
During the most recent legislative session, Minnesota pursued several options to increase insurance affordability and coverage. This included legislation for an affordability commission, a public option, and a basic health plan buy-in, in addition to this study on the cost of a universal health care financing system.
Summary
The bill would require the Commissioner of Health to contract with the University of Minnesota School of Public Health to conduct an analysis of the benefits and costs of a legislative proposal for a single-payer financing system, known as the Minnesota Health Plan, and a similar analysis of the current health care financing system, including Medicare, Medicaid, employer-sponsored insurance, and individual Marketplace coverage, to assist the state in comparing the proposal to the current system.
The proposal for a universal health care system, known as the Minnesota Health Plan, would ensure that all state residents are covered and provided comprehensive benefits with the ability to choose any provider. The analysis would measure the performance of both the proposed Minnesota Health Plan and the current health care financing system over a ten-year period to contrast the impact on:
The number of people covered versus those who continue to lack access to care because of financial barriers;
The completeness of the coverage and the number of people lacking coverage for dental, long-term care, medical equipment or supplies, vision and hearing, or other health services that are not covered;
The adequacy of the coverage, the level of underinsured in the state;
The timeliness and appropriateness of the care received and whether people turn to inappropriate care such as emergency rooms; and
Total public and private health care spending in Minnesota under the current system versus under the legislative proposal.
The Commissioner of Health would be required to issue a final report by January 15, 2023 and would be permitted to provide interim reports to the legislative committees with jurisdiction over health and human services policy and finance.