Category Archives: MinnesotaCare-for-All

Dean Phillips isn’t Close to Being MN’s Strongest Presidential Candidate

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U.S. Rep. Dean Phillips (DFL-Edina) seems to be relishing the national attention that comes with his months of hemming and hawing about a long-shot potential challenge of Joe Biden for the Democratic presidential nomination. To be clear, Phillips is far from the best Democrat in the nation to serve as an alternative to Joe Biden. In fact, Phillips is not even close to being the best presidential candidate in little old Minnesota.

Phillips is fine. The former CEO of Phillips Distributing, his step-father’s inherited business, is thoughtful and decent, if also sometimes dull and self-righteous, as centrist politicicans tend to be. His bipartisan instincts have made him a good fit to represent the purple-ish 3rd congressional district, which is anchored by Minnesota’s most affluent western suburbs.

However, it’s time for Phillips to come out of the TV studios and return to representing his district. As Rep. Annie Kuster (D-NH) said in today’s Star Tribune:


There’s no path. There’s no outcry. Personally, I think it’s a vanity project by Mr. Phillips, and I think it could do serious damage by emboldening the Trump Republicans.”

To be clear, the most talented politician in Minnesota isn’t Phillips. It’s DFL Senator Amy Klobuchar, and it’s not even close.  Reports about Klobuchar’s erratic behind-the-scenes behavior are concerning when it comes to the world’s most pressure-packed job. Still, no Minnesota politician is better than Klobuchar at doing what presidential candidates must do well – sell progressive ideas and positions in both wholesale and retail settings to a wide variety of audiences. Whether on big or small stages, Klobuchar consistently comes across as warm, sincere, tough, bright, thoughtful, prepared, nimble, and persuasive. As such, Minnesota’s senior senator would be a much more compelling presidential candidate than Phillips.

While Klobuchar is Minnesota’s most skilled politician, DFL Governor Tim Walz ranks second. At the same time, Walz has more marketable policy accomplishments than Kloubachar or any other Minnesota pol. 

In a purple state with a slim one-vote DFL advantage in the state Senate, Walz can boast on national stages that he signed many state laws that national Democrats want to see on a national level, such as legislation creating a family and medical leave system, securing abortion rights, legalizing marijuana, expanding child care access, creating new gun violence protections, making voting more accessible, providing free school lunches for all, investing much more in public education, building a public option for health insurance, and requiring disclosure for dark money donors. 

All the while, the Minnesota economy has outpaced a relatively strong national economy, with a lower rate of inflation and unemployment than the nation as a whole.

Walz’s long list of significant policy accomplishments would be popular among the national Democrats he would need to win over in a primary challenge against Biden. Importantly, it also would be popular among the swing voters a Democratic nominee will need to win over in a 2024 presidential general election.  Politically speaking, Walz is well poised to make a “we will do for America what we did for Minnesota” pitch to Democrats clutching their pearls about Biden’s electoral viability.

State Capitol insiders are quick to point out that Walz’s myriad policy wins had more to do with House Speaker Melissa Hortman, Senate Majority Leader Kari Dziedzic, and a number of very capable DFLers chairing key committees. But that kind of inside baseball would largely be ignored by national pundits and reporters if Walz ran for President. Walz vocally supported those progressive changes and signed them into law. Therefore, it would be fair for him to tout them in early Democratic primary states.

But Klobuchar and Walz aren’t going to be in those states, not as candidates anyway. They have enough political sense to understand that they’re never going to defeat an accomplished, albeit ancient, incumbent, and that trying to do so at this late hour would irreparably ruin their reputation with the leaders and activists they need in order to be effective.

Phillips, for all his strengths, appears incapable of understanding that part.

Dueling Visions for Minnesota: Scandinavia or South Dakota?

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Elections in a purple state can give you whiplash. 

After red wave elections, we’re led by Republicans like Tim Pawlenty who push for low taxes, poor services, and culture wars.

After blue wave elections, we’re led by DFLers like Tim Walz who push for higher taxes, better services, and cultural tolerance. 

After elections with more mixed results, legislative stalemates cause us to keep the prevailing status quo frozen in place.

That makes every election cycle extremely consequential.

The South Dakota Vision for Minnesota

In 2022, a decidedly purple Minnesota – at the time, it was the only state in the nation with one chamber of the state Legislature controlled by Democrats and the other controlled by Republicans – held a particularly high-stakes election. 

If Minnesota voters had elected ultra-conservative former physician gubernatorial candidate Scott Jensen and a Republican Legislature dominated by far-right Trumpers, Minnesota would have become a conservative promised land, much like its neighbor to the west, South Dakota. 

During the campaign, Jensen and other Republicans proposed a race-to-the-bottom on taxes, including eliminating the state income tax, which would have led to dramatically worse services.  Republican spinmeisters prefer to say “smaller government,” but the reality is that it would have meant much worse services. The anti-vaxxer Doc Jensen also pledged a South Dakota-like war on public health and culture war initiatives to force conservatives’ thinking on gays, guns, God, and gynecology on all Minnesotans. 

In other words, think Kristi Noem, with a stethoscope prop.

The Scandinavia Vision for Minnesota

Fortunately, 192,408 more Minnesotans voted for incumbent Governor Tim Walz than Jensen. More surprisingly, since it was predicted to be a historically horrible year for Democrats, Minnesotans also elected narrow DFL majorities in the state House and Senate.  The all-important Senate majority is especially razor-thin at 34-33.

Walz and the DFL-controlled Legislatures are armed with a $17.5 billion budget surplus and are offering a vision that is more like a social democratic-led Scandinavian country in the 1970s than South Dakota in the 2020s:

  • Paid family and medical leave;
  • An enormous funding increase for public schools;
  • A targeted child tax credit to dramatically reduce childhood poverty;
  • Free school lunches for all students;
  • An opportunity for people without employer-based health insurance to buy into public health insurance (MinnesotaCare/Medicaid), instead of only being able to choose private insurance;
  • Down payment assistance for first-time home buyers, homelessness prevention, affordable housing, and rent vouchers;
  • A huge package to save the beleaguered childcare sector and make child care free for poor families and more affordable for middle-class families;
  • Large subsidies for weatherization, electric vehicle infrastructure, and solar energy expansion to combat climate change;
  • A range of gun violence prevention reforms, such as universal background checks, red flag laws to prevent people who could be perceived as a threat to themselves or others from getting guns, raising the legal age for obtaining military-style rifles to 21, and banning high-capacity magazines;
  • Legalized marijuana and expunged records for past offenders;
  • Driver’s licenses for undocumented immigrants;
  • Automatic voter registration;
  • Enfranchising felons who have served their time; and
  • A capital gains tax hike for the wealthiest Minnesotans.

The list goes on. Overall, think Bernie Sanders, with a Fargo accent.

This is the most dramatic swing of state policy in my lifetime, and perhaps in the history of the state. And if somebody you may have never heard of, Judy Seeberger (DFL-Afton), had received just 322 fewer votes in her state Senate race, most of those changes would never have been possible. Without Seeberger’s handful of votes in the eastern suburbs of the Twin Cities metropolitan area, Minnesota would still be stuck in limbo between the South Dakota vision and the Scandinavia vision. 322 votes.

Does Walz Care About ONECare?

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So far, Minnesota Governor Tim Walz has largely been a responsive caretaker governor, responding to the crises du jour rather than than actively pushing a progressive agenda and building a legacy for himself.

Governor Walz’s legacy is essentially “pissed off all sides while consumed with thankless pandemic management.” I think he did a reasonably good job managing the pandemic, but he definitely had to make enemies doing it.

One partial break from caretaker mode was his poorly named “ONECare” proposal, which would give Minnesotans the option to buy into MinnesotaCare. MinnesotaCare is a longstanding program serving low-income individuals and families who can’t get employee-sponsored health insurance and don’t quality for Medicaid, which is called Medical Assistance (MA) in Minnesota.

Giving Minnesota health insurance consumers of all income levels this additional option would ensure that every Minnesotan in every county had at least one health insurance option available to them. That’s a big deal. It also would bring more competition to an individual market that sorely needs more competition. Over time, this could result in lower premiums for consumers.

Walz has not pushed his proposal particularly hard. Meanwhile, other states’ Governors are leading their states forward.

Colorado and Nevada this year passed public option plans—government-run health insurance plans—that are set to launch in 2023 and 2026, respectively. They join Washington state, which enacted its law in 2019 and went live with its public option in January.

The early results from Washington state’s experiment are disappointing. In many parts of the state, premiums for the public option plans cost more than premiums for comparable commercial plans.

Many of the state’s hospitals have refused to take part in the public option, prompting lawmakers to introduce more legislation this year to force participation if there aren’t sufficient health insurance options in a geographic area. And consumer buy-in is also meager. In its first year of operation, the state health insurance exchange sold only 1,443 public option plans, representing fewer than 1% of all exchange policies.

Michael Marchand, chief marketing officer for the Washington Health Benefit Exchange, the state’s health insurance marketplace, said it’s premature to judge the program by its first year.

During the earlier years of Obamacare, the premiums for many commercial plans were high, he pointed out. Eventually, as insurers became more knowledgeable about the markets, prices dropped, he said.

If Governor Walz would get re-engaged in this issue and actively market his plan, they could learn from the experiences of Washington and avoid it’s mistakes. For instance, in areas where there is insufficient health insurance competition, Walz could require hospitals to participate.

A MinnesotaCare buy-in option is extremely popular — only 11% oppose it, according to a Minnesota Public Radio survey. This is probably in part because it is an option. Any Minnesotan who opposes buying into MinnesotaCare — because of conservative ideology or because MinnesotaCare turns out to be expensive or poor quality — they can vote with their feet, as consumers in the state of Washington are doing.

Fighting for a MinnesotaCare buy-in option makes sense for Walz. The polls consistently show that health care is a top issue for voters, and huge majorities consistently trust Democrats over Republicans on that issue.

Moreover, in the 2022 gubernatorial general election campaign Walz may very well be running against a physician, Scott Jensen. This will ensure that health care is high profile in the race. Therefore, candidate Walz needs to be seen fighting for better health care, and this proposal gives him that platform.

If a MinnesotaCare buy-in option passes, Walz finally has a legacy beyond pandemic management. If Senate Republicans kill it, which seems likely, Walz has a great political argument to make while running for reelection and trying to retake the Senate: “I worked my ass off to give you another health insurance option and bring you some price competition, but Republicans like Scott Jensen opposed it on orders from private insurance lobbyists. If you want to more options and more price competition, vote for me and change the Senate leadership.”

Pushing a public option is a great political option for Walz. So why is he so damn cautious about it?

Championing Both Medicare-for-All and Buy-in Option

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During last night’s Part I of the Democratic Presidential debate, moderators and candidates acted as if candidates must make a choice between advocating for Medicare-for-All and a Medicare buy-in option.  It was one of the few areas of division among the progressive candidates

Why?  Progressives should be simultaneously advocating for both policies. 

Stop Bashing Buy-In Option

Medicare-for-All advocates like Sanders and Warren need to stop taking cheap shots at a Medicare buy-in option. 

The reality is, without a filibuster-proof Senate majority, Medicare-for-All simply can’t pass for a while.  Therefore, progressives need a Plan B that helps as many Americans as possible, shows that Democrats can deliver on their health care rhetoric, and advances the cause of Medicare-for-All. 

That’s what a Medicare buy-in option does. 

It helps more Americans in the short-run by bringing much more price competition to the marketplace and ensuring every American has at least one comprehensive coverage option available to them, even in poorly served areas. 

Beyond helping Americans in the short-term, a buy-in option also advances the cause of Medicare-for-All. Americans have been brainwashed by decades of conservatives’ vilifying of “government run health care,” but a buy-in option will give younger generations of Americans first-hand evidence showing that Medicare is not to be feared. It will show millions of Americans that Medicare is cheaper and better than conservatives’ vaunted corporate health plans.

And that will help disarm conservatives’ red-faced criticisms of “government run health care” and Medicare-for-All.

Stop Bashing Medicare-for-All

At the same time, champions of a Medicare buy-in option like Biden and Buttigieg need to stop railing on a Medicare-for-All. 

Even though Medicare-for-All can’t pass right away, progressives need to keep explaining what the world’s other developed nations figured out a long time ago, that a single payer government-run is the only real solution for any nation that hopes to control costs, cover everyone, and improve health outcomes.

For far too long, progressives have been afraid to educate Americans about why a single-payer system is needed.  When fearful progressives sensor themselves from explaining why Medicare-for-All is needed, they leave the stage to conservative and corporate demagogues relentlessly spreading myths about the evils of “government-run health care.” 

And when progressives leave the stage to conservative demagogues — surprise, surprise – progressives lose the debate.

Start Pushing Both

What would it sound like to advocate these two positions simultaneously? It could sound something like this:

Ultimately, we must cover everyone, control skyrocketing costs, and improve health outcomes. And you know what? Ultimately, the only way to do that is Medicare-for-All. 

In America, Medicare has proven effective and is popular with those who use it. In developed nations around the world using government-run systems like Medicare, everyone is covered, costs are much lower and health outcomes are much better. 

So Medicare-for-All must to be our ultimate goal. We have to keep our eyes on that prize. We need it as soon as possible.

At the same time, the Republican-controlled Senate won’t pass Medicare-for-All.  That’s reality folks.

Given that reality, what can Democrats do right now to both help the American people and pave the way for Medicare-for-All in the long-run?  A Medicare buy-in option.  A buy-in option has lots of public support among Republican voters, so it has a much better chance of passing the Senate than Medicare-for-All.

Let Americans choose between corporate care and Medicare. If they want to keep their private health insurance, they can. But given them another option.

President Trump is afraid to give Americans make that choice. I’m not. He knows Americans will like Medicare better, and doesn’t want to give them that option. I’m not afraid, because I know that a Medicare plan that isn’t required to profit off of patients will be cheaper and better that corporate care. So let Americans choose.

Enacting a buy-in option now will show more Americans that they have nothing to fear from Medicare coverage. And that will help us move the American people towards embracing Medicare-for-All.

Pols and pundits keep framing this issue as if it must be a battle to the death for progressives. But Medicare-for-All versus a Medicare Buy-in Option is a false choice.  Progressives should be advocating for both, and stop savaging each other on the issue.

On MinnesotaCare Buy-In Option, Legislators Must Put Patients Over Lobbyists

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Why can’t the Minnesota Legislature give consumers a MinnesotaCare buy-in option so that they have a guaranteed health insurance coverage option, more doctor choices, and much better price competition?  An army of corporate lobbyists say it’s because reimbursements to the health care industry would be lower under that approach, an argument that froze legislators into inaction during the 2019 legislative session. 

To be clear, if that argument prevails, Minnesota lawmakers will never contain health care costs.

To contain costs, policymakers have to lower the amount of money going to the major cost drivers — insurance overhead, doctors, nurses, medical devices and pharmaceuticals.  If politicians reject a reform every time lobbyists for those cost-drivers object about getting lower reimbursements, they will never contain consumer costs.

Let’s look at one of those cost-drivers, physicians.  Politicians like to complain about insurance overhead and pharmaceuticals, for very good reasons, but that’s too easy.  Let’s look at the most sacred of health care’s sacred cows.  Doctors have an abundance of fans, campaign donating power, and lobbyists, so politicians are especially afraid to direct cost-control efforts at them. 

When you look at the long list of developed nations where physicians are paid less than in the U.S., paying less for doctors seems reasonable and doable.  For example, the average specialist in the U.S. earns $230,000 per year, while the average specialist in other industrialized nations receives less than half that amount, $107,000 per year. 

Remember that the next time you hear physicians and their lobbyists complaining about reimbursements being too low.

Oh and by the way, the health outcomes in those developed countries with modestly paid physicians are better than in the U.S. So don’t buy the claim or inference that better pay automatically leads to better care.  It doesn’t.

And about those pharmaceuticals.  American patients pay much more for pharmaceuticals than patients in many other developed nations around the world.  Remember that the next time you hear lobbyists complaining about Medicare and Medicaid reimbursements being too low.

(On this front, the Minnesota Legislature needs to pass legislation to allow importation of Canadian pharmaceuticals, as I argued a while back.  Florida recently passed such a bill, but Minnesota politicians remain frozen by health care lobbyists.)

A Minnesota Care buy-in option — branded as “ONECare” in Minnesota by Governor Tim “One Minnesota™” Walz — would ensure that every Minnesotan always has at least one health insurance option available to them, which is particularly important in remote rural areas.  It would give them broader networks of caregivers, which again is important to Greater Minnesota residents.  It would provide comprehensive benefits and a service that gets good consumer reviews. It would bring better price competition to hold down the health insurance costs.  Those all would be huge benefits for hundreds of thousands of Minnesotans.

But not if Minnesota politicians get cowed into inaction every time corporate health care industry lobbyists complain about receiving lower reimbursement rates. If this group of legislators won’t do the right thing on a MinnesotaCare buy-in option, we should elect a new group who will.

If You Like TrumpCare, You’ll Love JohnsonCare

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Minnesota gubernatorial candidate Jeff Johnson (R-Plymouth) is crying foul over an Alliance for Better Minnesota television ad that says Johnson’s health care proposals would take health care away from Minnesotans who need it.

But the Alliance’s ad is accurate. Without question, the health care “reform” approach candidate Johnson is promoting during his campaign would take health care away from Minnesotans who need it.

Let’s break down the proposed JohnsonCare plan, piece-by-piece.

Johnson Eliminating ACA Protections

Johnson wants to make the Affordable Care Act (ACA) a thing of the past in Minnesota, via a federal waiver granted by the Trump Administration. More specifically, Johnson wants to eliminate the ACA approach that has:

  • Protected Record Numbers of Minnesotans. Under the ACA framework, Minnesota achieved the highest rate of health care coverage in state history.
  • Made Previously Unaffordable Protections Affordable. For lower and middle-income Minnesotans who don’t get coverage through their employer, the ACA has provided hundreds of millions in financial assistance to reduce or eliminate premium costs.
  • Strengthened Minnesotans’ Protections. The ACA also banned the hated preexisting condition denials, insurance payment limits, and dangerous junk coverage.  Because fewer Americans are no longer living one illness or injury away from being crushed by a mountain of bankrupting medical bills, personal bankruptcies have decreased by 50 percent during the time the ACA has existed.

If Johnson eliminates the increasingly popular ACA protections in Minnesota, that all goes away.  So yes, in several different and dramatic ways, Johnson absolutely would take health care away from Minnesotans who need it. The ad is correct about that.

Johnson’s False Claims

Johnson’s criticism of his opponent’s health care proposal is also utterly ridiculous.  Johnson says claims opponent Tim Walz “wants to eliminate private health insurance and force all Minnesotans onto one government program.”

The reality is, Walz supports a MinnesotaCare buy-in option. Under that approach, Minnesotans would have the option of either buying private plans or buying into the MinnesotaCare program, which is a government program operated by private health insurance programs.

In other words, Johnson’s claims that Walz wants to “eliminate private health insurance” and “force all Minnesotans onto one government program” are flat wrong.

If Walz is proposing a government-run single payer plan in the short-term, I’m not aware of it. Even if that were true, Johnson’s inference that eliminating private insurance in favor of government run health care would hurt Minnesotans is also wrong.  After all, Medicare, a government-run health plan, is popular and effective.  Medicare is helping Minnesotans, not hurting them.

Moreover, government run health plans are used in many other developed nations. Compared to the United States, consumers in those nations have 1) universal comprehensive coverage, 2) lower overall health costs and 3)  better overall health outcomes.

JohnsonCare and TrumpCare

Instead of the ACA, Johnson wants to back a high risk pool program that was very expensive for both consumers and taxpayers when it was used pre-ACA. Minnesota Public Radio reported:

Craig Britton of Plymouth, Minn., once had a plan through the state’s high-risk pool. It cost him $18,000 a year in premiums.

Britton was forced to buy the expensive MCHA coverage because of a pancreatitis diagnosis. He calls the idea that high-risk pools are good for consumers “a lot of baloney.”

“That is catastrophic cost,” Britton says. “You have to have a good living just to pay for insurance.”

And that’s the problem with high-risk pools, says Stefan Gildemeister, an economist with Minnesota’s health department.

“It’s not cheap coverage to the individual, and it’s not cheap coverage to the system,” Gildemeister says.

MCHA’s monthly premiums cost policy holders 25 percent more than conventional coverage, Gildemeister points out, and that left many people uninsured in Minnesota.

Johnson also wants to promote “junk,” “short-term,” or “skinny” plans, which are cheap because they don’t cover basic protections.  Promoting junk plans to reduce health care costs is like promoting cheaper cars lacking seat belts, airbags, crumple zones, safety glass, and anti-lock brakes. They look good if you’re only considering the price tag, but they’re a disaster when you and your family are in dangerous situations and desperately need those life-saving protections.

On health care, as with so most other issues, Jeff Johnson is aping Trump. President Trump is obsessed with eliminating Americans’ ACA protections in favor of a skimpy TrumpCare replacement. Trump insists that TrumpCare will cover everyone and cut costs, while the nonpartisan Congressional Budget Office finds that 23 million Americans would lose their protections, and millions more would pay higher premiums.

So Minnesotans, if you like TrumpCare – and only 17% of Americans do – you’re going to love JohnsonCare.

MN DFL Should Champion Importation of Canadian Medications

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Here’s a political idea for the DFL: Find a massively expensive thing that enrages voters.  Then make it dramatically cheaper. Oh, and do it without increasing government spending or taxes.

I understand the skepticism.  It does sound akin to the classic Student Council President campaign promise to reduce the cost of cafeteria soda — a crowd-pleaser but infeasible.

But there actually is such an issue available to Minnesota state leaders –empowering Minnesotans to purchase cheaper prescription medications from Canada.

According to drugwatch.com, prescription drugs are on average 65 percent cheaper in the Canada than they are in the United States. This is because Canada has huge government controlled health care plans using their purchasing power to negotiate lower prices from the pharmaceutical industry, and the U.S. doesn’t. Minnesota state lawmakers can’t change the underlying problem driving high drug prices in the U.S., but they could at least allow U.S. citizens to benefit from the more sane Canadian system.

After all, the Vermont Legislature just did it. Why not Minnesota?

In the upcoming 2018 elections, this should be the top issue Minnesota DFL state legislative candidates stress. Making more affordable Canadian medications available to Minnesotans would improve the lives of ordinary Minnesotans, and it’s a huge selling point with voters. Just ask Mark Dayton, who in 2004 made a lot of political hay by financing busloads of senior citizens going to Canada on medication shopping trips.  This proposal is similar, but it eliminates the long bus rides.

Nearly two-thirds of Americans like this idea. By an overwhelming two-to-one margin, a Kaiser Family Foundation survey found Americans support “allowing Americans to buy prescription drugs from online pharmacies based in Canada.”

This is an easy-to-understand issue to explain the difference between Republicans and DFLers to swing voters, and it especially appeals to seniors, who are the most likely to show up to vote.

This issue communicates important messages:  DFLers hear voters who are struggling to pay their medical bills; Republicans don’t. DFLers are proposing something real and tangible to control health care costs; Republicans won’t. DFLers will put the interests of ordinary Minnesotans over special interest lobbyists; Republicans won’t.

Coupled with the DFL’s MinnesotaCare for All buy-in option, offering cheaper Canadian medications would give Democrats the upper hand on perhaps the number one issue in the 2018 elections.

I can already hear overthinking DFL wonks explaining why they shouldn’t do this. President Trump won’t allow it to happen, they’ll say. I say force Trump’s hand. Though Trump’s HHS Secretary, a former pharmaceutical company executive, calls it a “gimmick,” Trump enthusiastically proposed this very idea during the campaign.

“…the last provision of his new seven-point plan is: “Remove barriers to entry into free markets for drug providers that offer safe, reliable, and cheaper products.”

“Congress will need the courage to step away from the special interests and do what is right for America,” the plan says. “Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe, and dependable drugs from overseas will bring more options to consumers.”

So, either make an honest man of Trump or expose him and his congressional Republican enablers for flip-flopping and being the cause of outrageously high drug prices.

This is the right thing to do, and it’s an extremely popular thing to do.  Empowering Minnesotans to benefit from more affordable Canadian medications should be one of the centerpieces of Minnesota DFLers’ 2018 campaigns.

A Policy Agenda For Minnesota’s Next Progressive Governor

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In 2018, progressive Governor Mark Dayton will be retiring, and Minnesota voters will be selecting a new chief executive.  To retain control of the Governor’s office in 2018, Minnesota Democrats need a compelling policy agenda. It goes without saying that they also need a compelling candidate, but this discussion is about policy.

What constitutes a compelling policy agenda? First, it’s bite-sized. It can be quickly consumed and remembered by casually engaged voters. It’s more like five proposals, not fifty proposals. That doesn’t mean leaders should only do five things as a governor, but it does mean that they should only stress and repeat five-ish policies as a candidate, so that the agenda can be remembered.

Second, a compelling policy agenda delivers relatively bold change. It’s not merely about protection of the status quo from the bad guys, or small incremental improvements (see HRC campaign). It’s aspirational, and not limited to ideas that currently have the necessary votes to pass. If a candidate has to scale it back after elected, so be it. But they should run with a bold vision.

Third, a compelling policy agenda needs to have popular support beyond the political base. After all, a campaign agenda is about winning votes.

Fourth, it’s is easy to understand. Few have the time or inclination to study the intricacies of a 15-point tax reform plan, so candidates should stick to things that most can easily grasp and embrace.

Finally, a compelling policy agenda must be directed at Minnesota’s most pressing problems. It shouldn’t merely be about kowtowing to the most powerful interest groups, as is so often the case. It must actually be about the problems that most need fixing.

What fits those criteria? In no particular order, here’s my recommendation for a progressive gubernatorial candidate’s agenda.

  • MinnesotaCare for All Option. Allow all Minnesotans to buy into the MinnesotaCare public health insurance program. This will put competitive pressure on private insurance companies to keep premiums down, and ensure Minnesotans will always have a coverage option, even if health plans pull out of the market.
  • Transportation Jobs Fund. Increase the gas tax by a nickel per gallon — one penny per gallon per year over five years — and put the proceeds into an untouchable fund that will put Minnesotans to work improving the state’s roads, bridges and transit system. This will lift up the portion of the workforce that is struggling the most, and ensure Minnesota has a competitive economy and quality-of-life into the future.
  • Achievement Gap Prevention Plan. Ensure every child under age five has access to a high quality early learning program, starting with the children who can’t afford those programs on their own. This will prevent low-income children from falling into Minnesota’s worst-in-the-nation achievement gaps, gaps that opens before age two, lead to lifelong inequity and pose a grave threat to our economic competitiveness.
  • Fair Share Tax. Create a new, higher tax bracket for the wealthiest 10% of Minnesotans.  During a time when income inequality is the worst it has been since  just prior to the Great Depression (1928), the wealthiest Minnesotans are paying a lower share of their income in state and local taxes.   Adjusting the state income tax is the best way to remedy that disparity.
  • Super-sized Rainy Day Fund. Increase the size of the state’s rainy day fund by 25%. This will control taxpayers’ borrowing costs and help keep Minnesota stable in the face of 1) an economy that, after the longest period of economic expansion in history, may be due for a downturn and 2) a federal government that is threatening to shift many fiscal burdens to states. Bolstering the rainy day fund will also communicate to moderate voters that a progressive will be a level-headed manager of their tax dollars.

Yes, worthy issues are left off this agenda.  But we’ve seen time and again that when Democrats try to communicate about everything, they effectively communicate about nothing.  Long, complex “laundry list” policy agendas may please the interest groups who are constantly lobbying the candidates and their staffs, but they are simply too much for busy voters to absorb.  As legendary ad man David Ogilvy preached, “the essence of strategy is sacrifice.”  To be heard, many things must be left unsaid.

This kind of progressive gubernatorial policy agenda would be simple enough to be understood and remembered, but not simplistic.  It would be relatively bold and visionary, but not pie-in-the-sky.  It would be progressive, but swing voter-friendly.

This agenda would put Republican opponents in a political bind, because these progressive proposals are popular with moderate swing voters.  The partial exception is the Transportation Jobs Fund, where swing voters are conflicted.   Surveys tell us that gas taxes are somewhat unpopular, particularly in exurban and rural areas, but the transportation improvements that would be funded by the higher gas tax are very popular with voters of all political stripes, as are jobs programs.  On that front, one key is to guarantee that tax proceeds could only be spent on improvements, something many skeptical voters seem to doubt.

If such an agenda were sufficiently repeated and stressed by a disciplined candidate, fewer Minnesotans would be lamenting that they “have no idea what Democrats stand for.” Most importantly, this agenda also would go a long ways toward fixing some of Minnesota’s most pressing problems.

Is Minnesota GOP Sabotaging The Individual Health Insurance Market By Rejecting MinnesotaCare-for-All Option?

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Minnesota Republican legislators spent their 2016 election campaigns expressing grave concerns about whether private health insurance companies in the individual market* have sufficient competitive pressure to keep prices down, and whether Minnesotans who live outside of the Twin Cities metropolitan region will have at least one solid coverage option available to them in coming years.

Those are legitimate concerns shared by both parties. But after Republicans won control of the Minnesota House and Senate, they have been unwilling to do one very important thing that that could achieve those two goals. They have been unwilling to give those Minnesotans the option of buying into MinnesotaCare health coverage.

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Governor Dayton’s proposed “MinnesotaCare-for-All option” would allow any individual market consumer to buy into the state government-run health plan that has served over 120,000 Minnesotans since 2006. An unsubsidized version of MinnesotaCare would be an available option for all Minnesotans.

In other words, MinnesotaCare for all would be a Minnesota-specific “public option” that would always be there for Minnesotans. MinnesotaCare wouldn’t be able to abandon individual market consumers the way corporate insurance companies can and do. Moreover, MinnesotaCare’s presence in the marketplace will pressure private insurers to offer more competitive prices, because MinnesotaCare’s prices don’t have to account for corporate salaries and profits.   Representing the buying power of about a million public plan consumers, the large MinnesotaCare plan should also have leverage to negotiate consumer-friendly reimbursement rates with health care providers, which helps keep premium costs more affordable.

In fact, Governor Dayton’s office estimates that Minnesota families who purchase MinnesotaCare coverage would pay on average about $838 per person less in 2018 than they pay for private coverage in 2017.  To secure those long-term annual savings for Minnesota families, a one-time taxpayer investment of $12 million – a relatively tiny drop in the State’s $39 billion annual budget — would be required to establish the option. In subsequent years, no additional taxpayer funds would be needed to keep the lower costs flowing to Minnesotans. The MinnesotaCare-for-All option would be self-sustainable.

If you believe that government-run operations are always less efficient and customer-friendly than corporations, here’s your chance to prove it. If that’s true, comparison shopping Minnesotans will “vote with their feet” by rejecting it en masse. But if it’s not true, Minnesotans in the individual market will finally have the peace of mind that comes with knowing that at least one coverage option will always be there for them and their loved ones.

Given that 71% of Americans support having a similar Medicare-for-All option, a MinnesotaCare-for-All option is likely popular with Minnesotans.  Still, Republican state legislators killed the proposal this year.

Minnesota Republicans can’t have it both ways. They can’t reject the MinnesotaCare-for-All option and then turn around blame others if competition is insufficient in some parts of Minnesota, or if corporate insurers’ prices prove to be unaffordable to many Minnesotans. No one can know for sure if this idea will work, but if Republicans are unwilling to give things like this a try to help vulnerable consumers, then Minnesota voters should hold them accountable for their obstructionism.

*(Note: The “individual market” is made up of the 10 percent of Minnesotans who a) can’t get insurance through their employer and b) whose incomes are not low enough to quality for either of Minnesota’s two publicly subsidized health insurance plans — Medical Assistance (Minnesota’s version of Medicare) for very low-income citizens or MinnesotaCare a subsidized option for the working poor. Last year, about 250,000 consumers bought coverage in Minnesota’s individual market.)