This blog post is the second in our legislative session series; to catch up on our housing policy conversation from last week, click here. Today’s focus is on health care, with energy to soon.
As we entered the 2021 Minnesota Legislative Session, Tunheim started getting questions from our clients about what policymakers’ priorities would be, and what can be expected to happen, within specific policy areas. With legislative leaders focused on the budget and COVID leading up to Session, we wanted to dig deeper and engage with Committee Chairs and Commissioners in three key policy areas for us and our clients: housing, energy, and health care.
For our health care discussion, we reached out to Minnesota Department of Human Services Commissioner Jodi Harpstead, Minnesota Senate Health and Human Services Finance and Policy Chair Michelle Benson, and Minnesota House of Representatives Health Finance and Policy Chair Tina Liebling and asked them to share their thoughts on the state’s most urgent health care needs and the possible solutions that may be explored this Legislative Session. Their input is reflected in the conversation below.
What do you see as the biggest needs for Minnesota to tackle as it pertains to health care?
COVID-19 has highlighted the life-and-death consequences of understanding that my health is directly dependent on the health of my neighbor. It has also brought out in sharp relief our long-standing disparities in social drivers of health and health outcomes. As a state, we have seen and experienced these disparities, we have measured and tracked them, we have noted their profound impacts on individuals and families in our communities, but we have not moved the needle on them in the right direction. Addressing these disparities, especially with respect to social drivers of health, is our most pressing need.
We have also learned about the importance of exploring alternative ways to access care, including through the use of telemedicine. Federal and state waivers gave us a rare opportunity to quickly expand telemedicine services for Medicaid enrollees during the pandemic. Our statewide study of these services indicates support for continued use of telehealth as an option for some services.
The most pressing need for our state right now is the rollout of COVID-19 vaccines so we can move to return our state to pre-pandemic normalcy. Once vaccines become readily available and we begin recovering from the effects of COVID-19 then we must work quickly to ensure stability in our health care system. Our health care system has been forced to undergo dramatic changes during the pandemic, and we need to restore some stability in our health care infrastructure. Additionally, we must also work to close health disparities. The inequalities in our health care system have become very clear during the pandemic. We need to implement proven practices to reduce disparate outcomes.
The pandemic has exposed the deep dysfunction, waste, and inequity in our health care system. The biggest need right now is to ensure that health care is accessible and affordable everywhere in the state, regardless of people’s employment status.
What are your health care priorities this Session?
The state, of course, faces a budget shortfall. Balancing the state’s budget in a manner that mitigates the impacts of spending cuts on our residents who most need our support — many of whom also bore a disproportionate share of the health and economic hardships from COVID-19 — will be both a high priority and a tremendous challenge.
While we have a few proposals in to the Governor’s Office for consideration in the budget he and the Lieutenant Governor will release at the end of January, we can point to the report of the Health and Human Services Blue Ribbon Commission, co-chaired by the commissioners of health and human services, which included more than $100 million in savings strategies and additional strategies for improving administration of services and fostering health equity.
Minnesota’s Blue Ribbon Commission was, of course, disappointed in having its work interrupted by COVID and not being able to fully vet “health transformation strategies.” Additionally, some healthcare strategies may need to wait for the health care market to settle out after COVID. In the meantime, many of the commission’s strategies are worthy of consideration during the 2021 Legislative session.
The other area that is a priority for us is the list of COVID waivers that was extended during a summer special session through June of 2021. The most interesting, of course, are those we call “tele-everything” that allow for a raft of remote healthcare services. Our Community Supports Administration has released a study of the efficacy of remote behavioral health, for example, for consideration by the Legislature as it considers extending tele-health waivers from 2020 into long-term policy.
Our first goal is working to end this pandemic and reopen our state. We want to evaluate the lessons we have learned from COVID-19 and how we can move forward. During the pandemic, we have seen incredible innovation in our health care system. We are really working on capturing and incentivizing innovation in health care. Next, we need to evaluate the gaps in our health care system and work to address those disparities. These goals will take longer than one legislative session but are a key priority of our caucus agenda.
Another goal we are focused on is reducing the price of prescription drug pricing. COVID-19 has distracted us from many ongoing health care challenges, but we cannot lose sight of the high costs of prescription drugs.
We also are working hard to hold the Department of Health and the Department of Human Services accountable. Strong legislative oversight is critical to ensure executive agencies function in an open and transparent way. Commissioner Malcolm, Commissioner Harpstead, and I have good working relationships, and I hope we can work together to reform and improve our executive agencies.
We will be working to make prescription drugs more affordable and to improve affordable access to healthcare for all, including behavioral health (mental health and substance abuse treatment). Our new Preventive Health Division will take a closer look at ways to improve the health of Minnesotans outside the health care system. We will continue our work with the governor and MDH/DHS to protect and improve the health and well-being of all Minnesotans.
Looking at this Session, with it being a budget year and dealing with COVID, what do you think can realistically be done this year in this policy area? How do you predict things will play out?
The Walz/Flanagan Administration and the Legislature have voiced their eagerness to pursue policy changes, many informed directly by our experience addressing COVID-19. However, especially for Health and Human Services, the federal government serves as a critically important partner in our work. Consequently, it is difficult to predict how things will play out at the Legislature until we have more information about how Congress and President Biden’s Administration will address the remaining financial and policy needs faced by residents and states. Those federal decisions will have a significant impact on the tools and resources available to Minnesota.
And, as mentioned above, some healthcare strategies may need to wait for the healthcare market to settle out after COVID.
This session is a complete roller-coaster and it is difficult to predict what will happen. I am hopeful we can work together to get a solid budget for the people of Minnesota. I believe setting realistic goals will be critical to accomplishing shared objectives this year.
A lot will depend on the February forecast—which is very uncertain at this point. There is a lot of interest in using telehealth to expand access to services and possibly even reduce costs, but much work must be done to decide how this tool can best be used and paid for. Without question there will be a need to find savings, and we hope to do that without reducing health care services to people who need them.
Tunheim would like to give our sincerest thanks to Commissioner Harpstead, Senator Benson, Representative Liebling, and their respective staff for participating in this health care conversation, and for their service to the State of Minnesota and its citizens. Stay tuned later this week for a policy spotlight on energy.
If you have questions on how what was shared here means for your organization or how you can help achieve policy goals in the health care space email me, Tunheim Senior Consultant Sarah Hinde, at email@example.com.