States like Minnesota willing to innovate to make health insurance more affordable should have a reliable partner in the federal government, particularly when it comes to funding new programs. Regrettably, recent developments have cast doubt on the Trump administration’s support for a pioneering Minnesota reform — the state’s “reinsurance” program that significantly lowered the cost of health insurance for those who buy plans on the individual market.
A late-November letter from federal officials, one that came to light at a Minnesota Senate hearing about a week ago, provided an unwelcome surprise with ramifications for the state budget. Instead of receiving a projected $184 million in federal aid for reinsurance in 2019, Minnesota would receive only about $85 million — a difference of roughly $100 million.
The letter contained little by way of explanation for the dramatic decline. It is important to note that the $184 million figure was an early projection of aid. But while adjustments are typically made to this calculation, it’s still a big drop and details are needed about how the new sum was tabulated. Specifically, why did Minnesota take a large hit when Alaska, another state that launched an early reinsurance program, saw its federal aid increase by about $10 million for 2019?
Thankfully, a bipartisan group of the state’s congressional delegation is stepping up to press the Trump administration for answers. In a letter sent earlier this month, both of Minnesota’s senators and four of its U.S. House members sent a strongly worded letter demanding answers from the Centers for Medicaid and Medicare Services (CMS) about the funding drop. The letter urged CMS to reconsider its decision and provide a sum closer to the original projection of $184 million.
The letter also asked several smart questions. It seeks details about the agency’s methodology for calculating Minnesota’s aid and inquires about options to appeal the decision. Perhaps the most important question: What steps can Minnesota take to mitigate future fallout from aid projections that are so far off from the original funding estimates?
“Minnesota’s reinsurance program helps more Minnesotans have access to affordable, quality health care. The estimated $100 million loss in federal funding — without explanation — would place a huge burden on our state’s budget,” said Sen. Amy Klobuchar, who spearheaded the effort. “That’s why I’m calling on the administration to restore this critical funding and make sure Minnesotans can continue to receive the care they need.”
Signatories included Sen. Tina Smith and Reps. Collin Peterson, Betty McCollum and Rick Nolan, all of whom are Democrats, as well as Rep. Tom Emmer, a Republican who represents the Sixth District.
Health reform is difficult and states at the leading edge, like Minnesota, merit support, especially when assistance has been promised. The bipartisan effort from the state’s political leadership is sending a strong, timely message to CMS: Help, don’t hinder, states willing to innovate.