Working late into the night, Governor Pawlenty and legislative leaders cut a deal that gave the  health care bill Pawlenty vetoed last week a second chance at life with some minor tweaks and a shiny new bill number: SF3780.

 

Not much has changed. A few provisions have been removed or modified, a couple others have been expanded. Some “fluff” language has been added that alludes to meaningful changes without actually enacting them.

 

The eligibility requirement for public subsidy to families with children has been reduced from 400% of federal poverty guidelines to 275% while the income cap has been raised to $57,000 per year for parents.

 

A health savings account provision has been tacked on for state employee health plans.

 

Notwithstanding a few cosmetic changes, the bill is essentially the same as HF3391, which the governor vetoed last week. The ultimate goal of the bill still appears to be to expand the number of people dependent on the state for their medical care.  The bill provides bounties paid to organizations and individuals that recruit new enrollees in the state’s medical welfare programs. Schools will be asked to single-out students who receive free or reduced-rate school lunch as targets for recruitment activities.  If a school is successful in enrolling a student’s family, they will earn a $25 bounty. To entice potential new enrollees, the bill suggests that organizations should "provide an applicant a gift certificate or other incentive upon enrollment." The latest version of this incentive program now includes licensed insurance producers as eligible for the bounty.

Employers will still be required to offer 125 plans, meaning that small businesses who don’t offer health insurance benefits will be required to deduct insurance premiums from an employees payroll and transfer those withholdings to an insurance company of the employees choosing. This provision forces employers to become bill collectors for insurance companies, but it now provides a one-time grant of $350 to employers who apply and qualify for it.

State-sponsored behavior modification also remains. The commissioner of health is directed to award grants to organizations that implement strategies to reduce the percentage of Minnesotans who are overweight or use tobacco. These organizations are to “address behavior change at the individual, community and systems levels; occur in community, school, worksite, and health care settings; and be focused on policy, systems, and environmental changes that support healthy behaviors.” Directly targeting alcohol use has been removed from the provision in this incarnation of the bill.

The governor spoke of tax credits for individuals and families who purchase their own private medical insurance. Such a plan would give people a tax break equivalent to that which employers receive. This plan didn’t materialize in the bill. The section dealing with tax credits merely directs the commissioner of health to develop a tax credits proposal, and submit a report and recommendations by 2009.

 

Lawmakers are selling this bill as meaningful health care reform. It isn’t. The bulk of the bill deals with expanding the number of enrollees to Minnesota Care, and state employee health plans.

 

What’s in it for the rest of us? Yet more nanny-state busybodies born of state-sponsored behavior modification.