Proposed MinnesotaCare expansion would aid undocumented immigrants, small businesses

Jennifer Jacquot-DeVries, a self-employed fundraising consultant in Brainerd, says that without MinnesotaCare she would not have been able to afford the kidney transplant that saved her life last year.

Because her income was below a maximum limit, state subsidies helped pay the premiums for her MinnesotaCare coverage in 2021. But because her income varies, she and her husband, also self-employed, never know annually whether they can afford health care coverage.

“Every year we worry about earning just enough to lose MinnesotaCare, but not enough to truly afford the best private coverage we really need,” she said.

Jacquot-DeVries testified Monday in favor of HF11, that would establish the MinnesotaCare public option for persons with incomes greater than the MinnesotaCare income limit (200% of the federal poverty guidelines) but who meet all other MinnesotaCare eligibility criteria.

The bill would expand subsidized MinnesotaCare coverage to Minnesotans struggling to afford high deductibles and small businesses who want to contribute to their employees’ coverage, said Rep. Jennifer Schultz (DFL-Duluth), who sponsors the legislation.

“This is just the next step of allowing more people to buy in to this really successful program we’ve had since 1992,” she said.

On a 10-8 party-line vote, the House Health Finance and Policy Committee approved HF11, as amended, and referred it to the House Commerce Finance and Policy Committee. Sen. Melissa Wiklund (DFL-Bloomington) sponsors the companion, SF1029, which awaits action by the Senate Health and Human Services Finance and Policy Committee.

The bill would also:

• make ongoing the lower MinnesotaCare premiums required by the federal American Rescue Plan Act for 2021 and 2022 coverage;
• provide a transitional premium subsidy for 2023 and 2024 for qualified health plan coverage through MNsure;
• provide a transitional state cost-sharing reduction for 2023 and 2024 for coverage by subsidizing the purchase of gold plans; and
• provide a small employer transitional tax credit for the cost of employee health coverage in 2023 and 2024.

“Health care access and affordability has always been an issue with us as a small business,” said Lauren Gaffney, general manager of Mastel’s Health Foods in St. Paul.

Gaffney said the small employer transitional tax credit provisions in the bill would be extremely helpful for her business, which has three full-time employees and about 11 part-time employees.

“Some of us spend over $500 a month on our health care coverage, some of us go without because we just can’t afford it at all,” she said.

Opposition to the bill came from several business and health care insurers.

Joel Ulland, associate vice-president and public affairs officer of UCare, said the bill would have the unintended consequence of premium spikes due to the volatility it would create in risk pools.

Dan Dwight, health policy director of the Minnesota Business Partnership, said in a statement that the bill would “lead to greater cost-shifting for private-pay individuals in order to make up for the lower reimbursement rates from public programs.”

The bill would also make undocumented noncitizens eligible for MinnesotaCare.

That provision was the focus of an amendment unsuccessfully offered by Rep. Debra Kiel (R-Crookston), who said she wanted to ensure that “illegal immigrants” could not have access to MinnesotaCare. It was defeated along party lines.

“We should not use both state and federal money to subsidize the lives of those in America illegally, and we should especially not do so when it would put the entire program’s existence at risk,” she said.

“Humans cannot be illegal,” Schultz said, adding that undocumented noncitizens are easing workforce shortages across the state, especially in rural areas.

These individuals work and pay their taxes, Schultz said, and so they also deserve access to affordable health care.