Updated: 10/13/2009 5:33 PM KSTP.com | Print |  Email

Pawlenty Offers Ideas for Changing Health Care

ST. PAUL, Minn. (AP) - Republican Gov. Tim Pawlenty, a prospective presidential candidate who has criticized Democratic efforts to overhaul the nation's health system, offered proposals for Minnesota on Tuesday that include letting people buy coverage from out-of-state insurers.

As Congress weighs sweeping health care changes, Pawlenty said he wants Minnesota to be the first to permit health insurance sales across state borders. He said he isn't deterred by previous failed efforts to open the market in that fashion, including defeats as recently as 2008 in the solidly Democratic Legislature.

"People are hopefully more open-minded about health care reform and marketplace choice and competition as a way to drive quality and to save money," Pawlenty said. "My hope is the Legislature would look at this anew rather than just rejecting it out of hand."

State Rep. Paul Thissen, a Minneapolis Democrat active in the health debate, said he doesn't sense a changed environment.

"We've seen this before. It didn't make sense then and it doesn't make sense now," said Thissen, a candidate for governor. He and other opponents are concerned about maintaining consumer protection.

Another top Democrat on health matters, Duluth Rep. Tom Huntley, said he'd consider the proposal as long as the distant companies were adequately vetted by Minnesota insurance regulators. But he questioned whether the extra competition would result in any meaningful cost savings to policyholders.

Pawlenty also wants a requirement that two state-subsidized health programs for poor residents use a rating system for providers based on quality and efficiency. He said the state would reward people in the MinnesotaCare and Medical Assistance programs who choose higher-quality, lower-cost clinics.

And Pawlenty would make certain MinnesotaCare participants pay a higher deductible, while giving them an electronic benefits card that could be used for out-of-pocket health expenses. Those who go with better-rated clinics would get more value from their state contributions, he said.

Although the state would be involved in rating providers, Pawlenty said the changes shouldn't be seen as government intrusion in medical decisions.

"This is a program that already exists that we're paying for entirely," he said. "And we want to bring pay-for-performance measurements and considerations into that system instead of just paying blindly for random acts of medical care."

Minnesota lawmakers can't act on the proposals before February. Pawlenty said he wanted to give then plenty of time to digest his ideas and it was a coincidence that his announcement came within hours of a Senate committee's vote in Washington on a Democratic health proposal he's called too costly and heavy handed.

Cal Ludeman, Minnesota's Human Services commissioner, said the state could save between $40 million and $100 million a year by attaching new requirements to MinnesotaCare and Medical Assistance. Some of that could be sent back to people to buy eyeglasses and over-the-counter medicine, officials said.

Savings for the other changes were tougher to quantify.

In arguing for allowing out-of-state companies into the state market, Pawlenty cited Kaiser Family Foundation statistics showing Minnesota residents pay 6 to 7 percent more in insurance premiums than the national average.

Minnesota currently requires health maintenance organizations that sell coverage in the state to be not-for-profit. Pawlenty's proposal would open the door to for-profit plans.

The leader of a trade group that represents the dominant Minnesota HMOs said more than 190 companies already sell policies in the state and reducing regulations on them might do more to curb premiums than what the governor is proposing.

"I don't see where Minnesotans buying insurance from a Mississippi company is going to help Minnesotans improve their health care," said Julie Brunner, Executive Director of the Minnesota Council of Health Plans. "That's what we should be about."

(Copyright 2009 by The Associated Press. All Rights Reserved.)