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WASHINGTON - With the Obama administration struggling to meet its own health law deadlines, a bipartisan coalition of Minnesotans is banding together to keep "Obamacare" from swallowing MinnesotaCare, the state's model health insurance program for the working poor.
Gov. Mark Dayton pressed the point Tuesday in a call to Health and Human Services Secretary Kathleen Sebelius, who has been sitting on the state's waiver request since last summer, frustrating state health and budget officials.
Dayton and Human Services Commissioner Lucinda Jesson originally had planned to meet with Sebelius in Washington. But that meeting was abruptly canceled Tuesday, as Dayton continues to recover from back surgery and prepare for Wednesday's State of the State address.
Still, Dayton's message to Washington was clear: The state does not want to transfer nearly 100,000 MinnesotaCare patients to the less-affordable federal health insurance exchanges that begin next year as part of President Obama's landmark health care overhaul to expand coverage to as many as 30 million Americans.
"These are pretty poor families that are struggling to make ends meet," said Jesson, who took part in the governor's call. For example, she said, a single adult getting by on $28,000-a-year could see monthly premium costs more than triple, from $28 under MinnesotaCare to $93 on a federal exchange.
With budget deadlines looming, state officials are still waiting for Washington to act on their request to count some of their federal health exchange subsidies toward the existing MinnesotaCare program instead.
State officials remained in the dark Tuesday. "They understand the difficult situation we're in," Jesson said of the federal officials on the call. "They're willing to work with us. But we don't have an answer yet."
A spokesman for Sebelius gave no indication Tuesday of when the department will rule on the state's petition, saying only that it's under review.
The request has special resonance coming from Dayton, a DFLer and one of the first governors to embrace the expansion of Medicaid for the indigent poor under the health care law. Now Minnesota is one of a handful of states -- along with Washington, Massachusetts and New York -- that want to maintain their own subsidized programs for people a few notches up the income ladder, people who otherwise would be thrown into the new online marketplaces that start in January 2014.
MinnesotaCare now covers people who earn up to twice the federal poverty level, or about $47,000 for a family of four. State officials say that without a waiver, more than 90,000 of MinnesotaCare's 130,000 enrollees could be forced into subsidized exchanges that many would still find unaffordable.
Civic and political leaders in both parties are rallying around the state's petition. Much of the state's legislative leadership and nearly the entire congressional delegation signed letters to Sebelius recently, saying "a wholesale switch from MinnesotaCare would be a step backward for many vulnerable people in our public programs."
The sole congressional holdout has been U.S. Rep. Michele Bachmann, an outspoken Republican critic of "Obamacare," a term adopted by both critics and backers of the 2010 Affordable Care Act.
"I support keeping decision-making in Minnesota as much as possible," Bachmann said in a statement Tuesday. "However, the very fact that waivers are being discussed is a case study in how Obamacare's one-size-fits-all approach to health care doesn't work."
Backers of the federal health care law say it allows states to set up their own basic health plans for low- and moderate-income people who make too much to qualify for Medicaid. Minnesota health officials believe the 20-year-old MinnesotaCare program largely fits the bill, with some minor tweaks to meet the new health care law standards. But the proposal still needs sign-off from Washington.
Meanwhile, Washington has its own deadlines, including an Oct. 1 target date to have the online exchanges in place for individuals and small groups to sign up for government-mandated coverage in every state next year.
Adding to the pressure, prominent Minnesota bishops and other clergy are calling on the Obama administration to approve the state's petition this week. The group says it will travel to Washington to press its case and seek "a partnership with federal and state officials."
Jesson said the prolonged delay in giving states guidance on new coverage options under the basic health program could jeopardize state lawmakers' ability to fund MinnesotaCare next year, with a new enrollment season coming up in the fall.
For planning purposes, Jesson said, the state needs an answer from Sebelius by the end of February. "She very clearly committed to work with us on a solution," Jesson said of Tuesday's phone conference. "We didn't define exactly what that would look like, but I think she was obviously very engaged."
Kevin Diaz is a correspondent in the Star Tribune Washington Bureau.