House lawmakers advance a bill creating a MinnesotaCare public option for all state residents

Minnesota House lawmakers on Wednesday advanced a bill (HF96) to expand the state’s public health insurance program called MinnesotaCare, allowing all Minnesotans to buy in to the program.

The MinnesotaCare buy-in proposal would provide affordable, government insurance for workers who need it, including the self-employed and undocumented residents, said chief author of the bill, Rep. Jamie Long, DFL-Minneapolis.

Originally designed as an insurance program for low-income working Minnesotans, MinnesotaCare is only available to U.S. citizens who live at or below 200% of the federal poverty level, or an annual household income of $27,000 or below for a single adult.  The bill proposes premiums on a sliding scale for people above that 200% cap.

About 200,000 Minnesotans do not have health insurance. While the number of uninsured people has dropped in recent years, racial disparities in coverage have widened. 

Allowing people to buy into the government system would give Minnesotans without good insurance another option beyond the individual insurance market, which in some years has seen steep premium increases. 

Gov. Tim Walz has pitched versions of the MinnesotaCare public option buy-in before, but it stalled in the GOP-controlled Senate. With the new DFL trifecta, the proposal could actually pass — and Walz recently introduced a budget that includes  MinnesotaCare expansion. Speaker of the House Melissa Hortman, DFL-Brooklyn Park, said the bill is a “very high priority.” 

“The House DFL, Senate DFL and governor are united in making health care more accessible,” Hortman said. 

Farmers, artists and small business owners testified in support of the bill, sharing stories of exorbitant costs for private health insurance or out-of-pocket care. 

Tavona Johnson, a homecare worker represented by SEIU Healthcare Minnesota, said her husband, who died last month, was a small business owner who was diagnosed with stage four colon cancer and had to drain their retirement fund to pay for chemotherapy and other medical care.

“My husband had to have this life-saving treatment. I couldn’t just let him die. If this bill would’ve been law, he would’ve had access to an affordable public plan that could’ve provided better coverage,” Johnson said. “I remember thinking: How much does a human life cost? And who put a price tag on that?” 

Minnesota Farmers Union Vice President Anne Schwargel said if she was not able to get health insurance through the union, she would not have been able to have children. 

“If we want vibrant rural communities, thriving rural schools and new farm families on the land, making health care coverage more affordable and accessible is a crucial first step,” Schwargel said. 

The Minnesota Chamber of Commerce and the Minnesota Hospital Association said the bill would not pay health care providers and hospitals enough and drive them out of business, since public programs reimburse providers less than private insurers. 

The Minnesota Hospital Association recommended expanding the income cap on MinnesotaCare to support low-income people, rather than getting rid of the cap entirely. Republicans and conservative groups said the public option would drive providers out of state. 

“It strong-arms the hospitals and clinics to lower their rates,” said Peter Nelson* of the Center of the American Experiment, a conservative think tank. 

Lobbyists for the health care insurance industry and the National Federation of Independent Businesses said they worried the public option would drive private health care insurers out of business, creating less options for small businesses. 

A companion bill has been introduced in the Senate.

Correction: A previous version misidentified Peter Nelson.