Star Tribune Ed Board Puts Focus On Costs & Consequences Of ‘Dauntingly Complex’ Public Option

As Minnesota legislators kick off the 2024 session, the editorial board of the Star Tribune is cautioning legislators that “implementing a public option is a dauntingly complex undertaking,” calling attention to many important questions that remain unanswered about the public option’s costs and consequences and urging that a “risk-benefit calculation should be at the forefront of policymakers’ minds” in debating whether to push ahead with the creation of this new health insurance system.

The editorial board’s comments come after the Minnesota Department of Commerce delivered a report and recommendations to the legislature regarding the proposed creation of a public option health insurance system in the state.

As the editors point out, the “estimated annual price tag for the first model, the buy-in, ranges from $943 million to $1.3 billion. The cost range for the second: $1.2 billion to $1.3 billion … The Milliman report also doesn’t reflect administrative and information technology costs to launch a public option in Minnesota. Detail is needed on that, because it would likely be a considerable sum.”

The Star Tribune’s editors also raise several key questions, including:

• “Minnesota’s uninsured rate is 4.7%. Milliman concludes that two-thirds of those uninsured would not be eligible to enroll. Of those eligible, many may not want to pay a monthly premium for coverage. If a major goal is to reduce the uninsured rate, is there a better way to achieve this?”
• “What would happen to the state’s individual market and MNsure, which serves it, if the bulk of consumers migrate over to the Model 1 public option?”
• “Given providers’ financial health, would even the increased reimbursement scenario outlined in the report suffice? If it must go higher, that would add substantially to the program’s cost.”
• “Would the projected monthly premiums be affordable for consumers? Again, are there other ways to drive down out-of-pocket costs, such as targeted aid for those with lower incomes?”

“None of these questions have easy answers, which is why benefits and trade-offs must be in focus. The report advances the debate over a public option, but it does not offer a slam-dunk case for implementing one,” they conclude.

The facts show that the public option has failed in the states where it has been tried, and research warns that creating the same unaffordable new health insurance system in Minnesota could threaten patients’ access to affordable, high-quality care, especially in rural and underserved communities where it could put vulnerable hospitals at even greater risk.

• To read the full piece from the Star Tribune editorial board, click here.
• To learn more about how creating the public option could threaten Minnesotans’ access to high-quality care, click here.