Counterpoint: Minnesotans benefit from competitive bidding on health insurance

Some parties may lose in the process, but not patients — nor taxpayers.

By Lucinda Jesson

September 6, 2015 at 12:52PM
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iStockphoto.com (The Minnesota Star Tribune)

Imagine if each of the nearly 2 million Minnesotans who attend the State Fair this year were given $225 as they passed through the gates — a total of $450 million. That is about the same amount we will save taxpayers next year through our statewide competitive bidding process — a nation-leading reform effort that requires health insurance companies to find new ways to deliver better quality health care for Minnesotans, at lower prices.

These reforms and cost savings were made possible by a pilot program approved by the Legislature in 2011 that empowered the Department of Human Services (DHS) to negotiate better health care benefits and get the best possible deal for taxpayers. Because of the program's success, the Legislature expanded competitive bidding statewide in 2014. Before these reforms, insurance companies did not have to compete by improving service quality and lowering prices. Instead, they lined up every year and received an average payment increase of around 6 percent from state government programs that serve 800,000 Minnesotans.

Because of competitive bidding and other reforms over the past five years, we will save taxpayers an estimated $1.65 billion by 2016. More than that, hundreds of thousands of Minnesotans will receive better quality health care. That is exactly the kind of smart reform Minnesotans expect, and deserve.

Still, a group of vocal critics — including one health insurer that was bested by its competitors in this year's cost-saving, quality-driven process — is now trying to overturn it. In previous years, when its bids were successful, that same company did not make any complaints. But now, it is using scare tactics to portray good policy as a bad deal. It could not be more wrong.

It is now claiming that competitive bidding will cause people to lose their doctors. That is not true. Take the case of the HealthEast Roselawn Clinic in St. Paul. The clinic has a reputation for serving people from immigrant communities particularly well, as noted in a recent Star Tribune story ("Life after UCare," Aug. 30). In 2016, patients on our public programs will still be able to see the same doctors and nurses at HealthEast Roselawn Clinic. The difference is that the cost of those visits will be paid by another health plan.

These same critics will also tell you that transitioning so many people from one health plan to another will be chaotic ("Let's hit the 'reset' button on UCare," Aug. 31). That is also not true. The DHS is one of the largest insurers in the state, and we successfully help people make changes in their health care all the time. In fact, we have open enrollment for all of our 800,000 enrollees every year.

During the first year of competitive bidding, we transitioned 80,000 enrollees to new plans in a situation similar to the one this year. That number is far greater this year, but we are ready to meet the demand. We are doubling our call-center staff to help enrollees who have questions. Someone who does not switch plans on time will be automatically assigned to a plan, which they can change later. No one will lose coverage, and every enrollee will have access to language interpreters and transportation, if they need those services.

Finally, critics say this will hurt the quality of care people receive. That could not be further from the truth. In fact, competition allows us to push health plans to improve quality and access to care, and to improve those areas where they fall short, like mental health care and dental care. For example, only 30 percent of the children enrolled in these programs currently get preventive trips to the dentist. We need to do better, and using competition to drive better care and better results for patients is the right way to ensure those improvements are realized.

Change is never easy. And in a fair, free and competitive market, there are always winners and losers. But at the end of the day, the goals of these cost-saving reforms are to improve the quality of health care for hundreds of thousands of Minnesotans, and to do so at a much lower cost to taxpayers. We gave all health plans equal footing in a fair and free market to compete for business, based on quality and cost. By all those measures, Minnesota's competitive bidding reforms have been an extraordinary success.

While a vocal minority may continue to express displeasure that their bids for state contracts failed to beat out their competitors, the vast majority of Minnesotans can be assured that they are getting the better value for their tax dollars that they deserve. More than $1.65 billion in savings to taxpayers is more than enough reason to laud the successes of real Minnesota health reforms — rather than undermining them with lawsuits and criticisms.

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

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Lucinda Jesson

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