HEALTH CARE

We must fix the ACA's marriage penalty

The unfortunate delay in the Affordable Care Act's employer mandate until 2015 gives our elected representatives in Washington an important opportunity: They can get together and remove the ACA's little-known marriage penalty.

An unfortunate exclusion in the Affordable Care Act bars access to the exchanges to otherwise eligible spouses and children of workers who are offered family coverage through their employers — even if that family coverage is not affordable by ACA standards.

Unless Congress acts soon, the ACA will leave many unsuspecting working families underinsured and medically and financially vulnerable, with high family premiums, family deductibles and family out-of-pocket limits. Furthermore, exclusion from the exchanges also bars these families from accessing the ACA's premium subsidies and tax credits. What were our representatives thinking?

As U.S. Rep. Keith Ellison told me last fall, "No law is perfect." However, the whole purpose of the ACA is to make health coverage affordable for working families. Congress needs to take advantage of this hiatus and act quickly to remove the ACA's hidden marriage penalty.

Amy Hummel, Robbinsdale

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Recent stories, letters and editorials on health insurance left out important details that would give readers a more complete picture.

With "Smart reforms on health plan costs" (July16), the Star Tribune Editorial Board continued to show its lack of understanding of the complexity of state insurance programs and its willingness to leave out important facts. For example, the report referenced in the editorial includes the fact that Minnesota's health plans lost $191 million on the state's General Assistance Medical Care Program. The editorial cites profits in one program without the balance of losses in another, even while knowing the programs came to the insurers as a package deal. A deal, by the way, the insurers are required by law to take. (A fact that is also ignored.)

A story made allegations about the financial status of Minnesota HMOs. The report completely ignored the fact that as the cost of care continues to rise, so must the amount of money in reserve. It's the law. You don't have to take my word for it — ask the state's insurance experts at the Minnesota Department of Commerce.

Profits and administrative expenses in Minnesota's nonprofit health insurance system are some of the lowest in the country. Last year, our seven members' spent $52 million every day for medical care for enrollees. Profits from their insurance business were 0.57 percent, and administrative expenses were 8.2 percent of overall revenue.

These are important conversations. And it's important that they are based on all the facts.

JULIE BRUNNER, St. Paul

The writer is executive director of the Minnesota Council of Health Plans.

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ABORTION

Editorial Board's inconsistency shines

"What's going on in Wisconsin, North Dakota, South Dakota and Iowa ought to be a wake-up call to Minnesotans who prefer that physicians, not politicians, guide an individual's medical care." Now, the key phrase there is "physicians, not politicians."

I would take it by that statement that the Editorial Board would be against Obamacare. Is not Obamacare going to be run by politicians? Or is this just one if those things that is conveniently overlooked by the Editorial Board? After all, sometimes we can have it both ways.

EDWARD McHUGH, East Bethel

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The editorial's headline was correct ("Women's health at stake in 2014") but the Editorial Board has no idea what it means. Abortion is not good for women. The adverse physical and emotional effects are well-documented – even if they are usually denied exposure by the politically correct media. Rather than taking away a problem, abortion makes you the mother of a dead baby, and when that fact hits home, the regret, depression and anger begin … and may never end.

And it is not just women who are affected: The men, including the ones who may have pushed for the abortion, also experience regret and a sense of loss of manhood, having failed to protect their offspring.

Dr. ROSS S. OLSON, Minneapolis

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When I moved to Minnesota in 2004, I was shocked to learn that there were only seven abortion clinics in the entire state. Today only five remain, four of them in the Twin Cities and one in Duluth. If you live anywhere else, you're in for a long drive in the dark hours of the morning, and only after your visit at least 24 hours earlier as your physician reads a mandatory state-written script that replaces the existing medical informed consent process.

If you're under 18, you will need to prove that you have notified both your parents of your decision: Minnesota has one of the nation's strictest parental notification laws. Furthermore, the state's largest public hospital, Hennepin County Medical Center, does not provide abortions. And while the national average cost for a first-trimester abortion is $450, the lowest price in Minnesota is over $600. For anyone struggling to make ends meet, cost itself is a significant barrier.

All this to say that, yes, things could be much worse for women in Minnesota. And would be, had Gov. Mark Dayton not vetoed abortion restrictions that the Legislature passed in 2012. But the state is far from a safe harbor for the one in three Minnesota women who will have an abortion in their lifetimes.

STACEY BURNS, Minneapolis