Allow more Minnesotans the ‘public option’ of MinnesotaCare

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Minnesota is on the cusp of allowing more people the opportunity to buy in to MinnesotaCare, expanding affordable health care coverage for more people and providing a bridge to longer-term health care solutions.

For years, state leaders have heard from Minnesotans that the status quo of health care is not working. Lawmakers have done the work to design a policy expanding access to MinnesotaCare, the state’s high-quality health insurance program for working families. Now is the time to deliver it.

This month, the Legislature introduced the final bill needed to create a MinnesotaCare public option. The policy is a response to longtime statewide demands for a public option, and nearly a decade of legislative action. It is shaped by fresh data and analysis provided by the Commerce Department.

It is imperative that action on a MinnesotaCare public option happens this year, as our state finds itself at a pivotal crossroads. We have statewide demand to expand trusted, affordable public health insurance. On the other side, we have a critical opportunity to also avoid a health care crisis in the individual market in 2026 when the expiration of both reinsurance and enhanced federal premium tax credits threaten to cause a steep increase in premiums on top of already sky-high deductibles.

Under the public-option proposal, MinnesotaCare would be available on a sliding scale premium to households earning above the current income cutoff of 200% of the federal poverty level, or about $60,000 per year for a family of four.

As a health economist and former Human Services Committee chair, I know how groundbreaking the MinnesotaCare public option will be for Minnesota families, small-business owners, farmers and other self-employed individuals enrolled in the individual health insurance market. Foremost, it will allow more Minnesotans access to affordable, trusted health insurance with lower costs and lower stress.

For Minnesota farmers and child-care workers who have shared with lawmakers that they have been forced to reduce their incomes because they cannot afford to be kicked off MinnesotaCare and into high-deductible health plans, the MinnesotaCare public option will be life-changing for their economic and health security.

From an economic standpoint, we must lean into the benefits of competition the MinnesotaCare public option will provide. Health care costs continue to rise, far outpacing inflation the past 20 years. Every month, Minnesotans are paying the cost of corporate greed in monthly premiums and through our taxes, as pharmaceutical companies exploit their monopolies to inflate prices and our models of “managed care” do little to rein in health care costs. Market competition is crucial and the course we are on is unsustainable.

So, what would the MinnesotaCare public option do?

It would allow Minnesotans without access to affordable employer coverage to enroll in MinnesotaCare with sliding-scale premiums based on income and reduce out-of-pocket cost sharing for patients. The public option proposal would allow more Minnesotans to buy in to MinnesotaCare starting Jan. 1, 2027. Financing would maximize the use of state dollars, federal funding and individual premiums to cover costs.

Few states have a successful public health insurance program to expand. MinnesotaCare is a unique and strong foundation to build on, and we should be proud to expand access to more people this session and in the years to come.