Archived Story

Who pays for health reform? [UPDATED]

Published 6:51am Friday, July 27, 2012 Updated 11:54am Friday, July 27, 2012

In the wake of this summer’s U.S. Supreme Court decision upholding the Affordable Care Act, Minnesota Gov. Mark Dayton has amped up efforts to get the state to fully implement the measure.

Not surprisingly, his political opponents see it differently.

Many want to wait until after Election Day, believing those results could give them enough political power to have the state opt out of the act — or even have it repealed at the federal level.

As both sides debate what’s the best next step, here’s a more fundamental question Minnesotans should encourage Dayton and his administration to answer as he moves forward:

Where is the money coming from to pay for specific parts of the act?

Please know this is not a new question. It’s been around since the run-up to passage of the act more than two years ago.

But now that Minnesota is among the states leading on implementation, it would serve residents well to let them know the details.

For example, the Minnesota Department of Commerce just last week announced a $41 million contract with a company to develop the state’s health insurance exchange.

This exchange is a key component in providing coverage for uninsured Minnesotans and for lowering insurance costs to people and businesses.

What is the source of the $41 million? Buried in the Department of Commerce’s news release was this: “… The total contract cost is $41 million. Over 93 percent of the costs of building the exchange will be borne by the Federal Government. The 7 percent of the costs that fall to the state will be paid by the Minnesota Department of Human Services from existing appropriations. …”

That helps, but it also raises more questions. Among them: What’s the source of the federal funds? (Last we checked, all tax dollars come out of some private entity’s pocket.) Given how tight state budgets are, where did the state health department get its $2.87 million?

And who pays to operate it after it’s built?

Remember, this is just one example. According to the U.S. Department of Health and Human Services, Minnesota already has received more than $100 million to implement various aspects of the act.

Much of that appears to be from the federal government.

Again, what was its source? Who pays ongoing costs? And what else is coming for which Minnesotans might have to pay?

Finally, please know these questions are not being asked out of opposition.

In fact, this board has supported the act simply because no other viable ideas for reform have been put forth.

Now, though, as it takes effect, Minnesotans deserve to know how and who will be funding these changes.

St. Cloud Times

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