The goal is laudable: making sure everyone has quality, affordable health insurance. That's because the result could be hard to argue: healthier communities and fewer public dollars having to be spent because uninsured neighbors don't seek out cheaper, preventative care and typically don't see a doctor until it's in the priciest way possible, in emergency rooms.
But real fears persist that the federal effort to extend coverage to all will cripple our nation financially. And the effort's rollout so far has been rife with disasters: promises broken, coverages dropped and a website that won't work.
The Affordable Care Act also is the law of the land now, though. It's reality. And it's only six weeks into a major systemic and attitudinal national change.
While patience is easy to preach, it comes with early evidence to suggest the health-care overhaul can work. Look no further than Duluth, the state of Minnesota and the 13 other states that decided to go it alone, that decided to create their own websites and ways for the uninsured to get signed up for coverage, and that decided to forego the federal government's much-panned and oft-troubled HealthCare.gov.
Nationally, 106,000 people successfully have signed up for health coverage under the Affordable Care Act. While pundits and others argue whether that number should be bigger, lost in the political play is that most of those 106,000 previously uninsured Americans -- 79,000 of them or three-fourths of them -- are from those 14 states going it alone, including Minnesota.
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After only four weeks, about 11,000 Minnesotans no longer are uninsured. And that's a number that tripled in the last half of the opening month, suggesting momentum is building. In Duluth, it's not known yet how many of our 11,000 uninsured residents are now covered. That number is coming. The percentage of uninsured Duluthians is 11. Statewide, 9 percent have no coverage.
"All the HealthCare.gov stuff that's happening is happening independent of our operations here in Minnesota. We're not affiliated with that. Their (computer) issues are not our (computer) issues," John Reich, a spokesman for Minnesota's health-coverage effort, MNsure.org, said in an interview last week with the News Tribune editorial board. "It's really all about getting people more-affordable, quality health care."
In Minnesota that's as easy as going to MNSure.org and filling out a single form. Immediately you're told whether you qualify for tax credits, public health coverage through MinnesotaCare or federal medical assistance. With that information you can go shopping online for a health plan that best fits you and your family.
"It's efficient," Reich said. "It used to be if you wanted to apply for a public program in Minnesota it was by paper (and) it'd take weeks sometimes to get a response back. And then when the response did come back it was maybe that you needed to submit a whole bunch more information. This is one single streamlined application. This is faster" because so much information already is online now.
"It's definitely working here," said Angie Miller, executive director of Community Action Duluth, one of 17 community partners in Insure Duluth, a local collaboration working to help make sure MNSure works. "We had someone in our office this morning at 7:30 and about one hour and five minutes later he was out the door really happy to find out he qualified for MinnesotaCare, which was going to (result in) a huge savings. He was one of those people who was insured through a plan that (wasn't going to be) continuing because it doesn't meet the federal guidelines. But for him, he's now in a much better situation. He's going to pay $43 a month instead of $200, and his benefits are going to be a lot better.
"It was easy. It was quick. And he left very happy," Miller said.
Anyone who doesn't have health insurance and isn't entirely sure how to go about getting it under the Affordable Care Act can be assured: Help is available. The library has computers for public use. And there are people -- called "navigators" and "brokers" (see box below for details) -- just waiting to offer assistance.
"Somebody will actually sit down with you one-on-one and walk you through the whole process," said Jenny Peterson, executive director of Generations Health Care Initiatives, which also is a partner in Insure Duluth. "A lot of the news is about the federal issues. People who don't understand that Minnesota has a completely separate system, I think, can be confused by what they just hear on talk radio or wherever."
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Confusion abounds. So do real concerns about the potentially devastating long-term fiscal impacts of the Affordable Care Act. But a worthy goal remains. And in Duluth, in Minnesota and in other states there's early promise of optimism.
