Almost 100 years ago, a nun of the Order of St. Benedict began selling tickets to lumberjacks in the camps of northern Minnesota. Those tickets entitled the holder to full care for a year at any of the five St. Mary's hospitals. This person of faith began one of our country's first hospital prepayment plans, and, together with the Mayo brothers, launched Minnesota on the path to become the nation's most innovative state for health care.

In more recent history, Democrats and Republicans worked together to start MinnesotaCare, which made health insurance available to low-income, working families. MinnesotaCare's bipartisan creation became a model for other states, and ultimately for the federal government.

Now, 20 years after its creation, MinnesotaCare needs improvement, to make it more streamlined and affordable. But, unexpectedly, we first must ensure that this nation-leading program continues to exist.

Federal health reform means that changes are coming. The new federal model expands Medicaid for the very poor. But absent action taken at the state level to provide for something better, people making more than $15,000 a year will now largely be given a federal subsidy to buy coverage through a health insurance exchange. This would include many people currently on MinnesotaCare.

For most states, this new model is a major step forward. And while the Medicaid expansion will bring progress for Minnesota, too, a wholesale switch from MinnesotaCare would be a step backward for vulnerable, low-income people. MinnesotaCare provides more-affordable care than the high-deductible health plans that many working families would access through the federal model.

That is why we again have Minnesota Republicans and Democrats coming together to fight for the future of MinnesotaCare. Last week, U.S. Sens. Amy Klobuchar and Al Franken joined U.S. Reps. Betty McCollum, Keith Ellison, Tim Walz, Collin Peterson, Erik Paulsen, Rick Nolan and John Kline to send a letter to the Obama administration requesting federal partnership to preserve and improve MinnesotaCare. A similar bipartisan letter from state legislative leadership was issued in late January.

With this backdrop of support, Gov. Mark Dayton and I travel to Washington, D.C., today to meet with Health and Human Services Secretary Kathleen Sebelius.

We are asking the federal government to help fund the next generation of MinnesotaCare. Specifically, we ask the federal government for the dollars that otherwise would go to subsidize insurance purchases for people eligible for MinnesotaCare. (Actually, we seek 95 percent of those federal funds, which makes this proposal a cost-saving measure for the federal government.) And we ask for flexibility from federal rules to improve our state program.

As the Legislature and governor work to prepare the state budget for the coming two years, we need answers from the federal government quickly.

MinnesotaCare has served our state well. With redirected federal dollars plus some state funding, Minnesota can build upon its program to create a streamlined MinnesotaCare to better serve low-income, working families -- and help taxpayers, too. Freedom from some federal mandates would allow the state to give providers, plans and enrollees more powerful incentives to promote health and to reduce health costs and health disparities.

A next-generation MinnesotaCare could cover the same people we serve today without subjecting them to the high out-of-pocket costs most will face in the exchange. High-deductible health plans simply don't work for poor families, and they will leave providers with increased costs due to uncompensated care.

By maintaining and improving MinnesotaCare, we can make proud that nun who sold health care tickets to lumberjacks a century ago.


Lucinda Jesson is commissioner of the Minnesota Department of Human Services.