Minnesota has a proud tradition of providing health care coverage, not just for those who can afford it but for people in need. Under the Affordable Care Act, our state will be able to provide coverage to another 120,000 Minnesotans by 2016 through an expansion of Medicaid. All of the cost will be picked up by the federal government for the first three years and 90 percent after that.
Many of those newly eligible for Medicaid are already eligible for or are receiving MinnesotaCare, a program that costs state taxpayers more money and offers fewer benefits than Medicaid.
The bottom line: Expanding Medicaid is a greater value for Minnesotans at a lower cost to the state, a deal few could pass up.
That's what makes state Rep. Sean Nienow's recent commentary so puzzling ("Without an audit, Medicaid expansion shouldn't proceed," July 3).
While it is true that our Medicaid spending is higher than that of other states, this is for a sound reason. Minnesota has chosen to cover more elderly and people with disabilities, beyond what the federal government requires. It's part of our culture to take care of the elderly, children and others who are vulnerable. Our Legislature has decided that paying for optional Medicaid benefits such as prescription drugs, eyeglasses and inpatient psychiatric care for children is worthwhile. Choosing to spend more on people in need is a policy decision we can debate, but to suggest that it is fraud is faulty.
Nienow makes two points we can agree on: the need to become smarter purchasers of health care, and the constant need for greater transparency and accountability. Minnesota has already started to address both. Gov. Mark Dayton has offered to open the books to anyone who wants to audit the past 10 years of Medicaid spending. Since taking office, the Dayton administration has taken a number of steps to strengthen Minnesota's Medicaid program:
Accountability: Republicans and Democrats came together last session to support third-party audits of the state's health plans, as well as a study of whether the existing managed-care program is bringing value to taxpayers. We expect to work together to address any weaknesses the audits identify. The Department of Human Services also established an Office of Inspector General to detect and go after fraud where it exists.
Transparency: Dayton, through executive order, also established a public website with a wealth of information about health plans and their finances, contracts and performance outcomes. DHS is developing a comprehensive managed-care report that will be issued annually, beginning later this summer. The report will be in a format easily understandable to the public.
Competition: For years, Minnesota paid health plans based on their previous costs. This year, DHS required health plans to compete for the state's business -- reaping hundreds of millions of dollars in savings. Competitive bidding began in the Twin Cities and soon will begin in other parts of the state.
Should we expand Medicaid? Consider the perspective of the 84,000 Minnesotans who have gained health care coverage under early expansion, which allowed states to extend coverage to people with incomes up to 75 percent of the poverty line. Dayton made that one of his first acts as governor. Or, consider the perspectives of individual Minnesotans: the construction worker who lost his job and got sick, for example, or the woman who struggles with mental illness but can't afford to pay for the medication necessary to treat it.
From each perspective, the answer is clear: The Medicaid expansion allowed by the ACA is the right path for Minnesota.
Tony Lourey, DFL-Kerrick, is a member of the Minnesota Senate.