Duluth News Tribune, Nov. 17
Duluth, states making Obamacare work
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.
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."
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.
Minneapolis Star Tribune, Nov. 16
Reform of state's sex offender program takes political hit
On Wednesday, it became increasingly clear that the state of Minnesota is unable to uphold the U.S. Constitution on its own. Instead, state government appears ready to hand off that fundamental duty to a federal judge — a dispiriting and likely costly outcome after nearly two decades of debate over the controversial program that locks up many sex offenders for treatment long after they've served their sentences.
Gov. Mark Dayton's decision to suspend his administration's support for provisional release for a limited number of sex offenders sent an unmistakable message to watchful federal courts: State policymakers still aren't capable of setting aside politics and hammering out the reforms needed to balance public safety with escalating constitutional concerns and the program's soaring cost.
The civil-commitment program, which has released one person in 18 years, is already in judicial cross hairs. In August 2012, the two judges overseeing a class-action lawsuit filed by offenders forcefully signaled their alarm and willingness to exercise their authority over the program if policymakers failed to act.
In the wake of Dayton's announcement, it's unclear when officials will be able to summon the collective fortitude to call a political cease-fire and make necessary fixes.
Following weeks of criticism of his administration's tacit support for the provisional release of some sex offenders, a clearly angry governor directed Department of Human Services (DHS) Commissioner Lucinda Jesson to oppose future petitions for release until legislators act to reform the program and fund any changes. He also directed Jesson to suspend plans to move any offender in the program to secure community-based facilities. A state-owned facility in Cambridge had been under consideration for about a dozen offenders, sparking outcry from local residents.
Dayton's move came as Republicans and a high-ranking official in his own political party, DFL Attorney General Lori Swanson, ripped the governor for the administration's decision not to oppose the provisional release of one of the 698 offenders in the program. The offender, 58-year-old Thomas Duvall, has been convicted three times for sexually assaulting teenage girls.
An internal panel at the DHS evaluated Duvall and said he met the statutory criteria for a provisional release. Duvall would not simply be set free but would be placed in a halfway house with tight security, and would be subject to GPS monitoring, surveillance and other restrictions.
Dayton repeatedly blasted the criticism of the provisional release measures as political "gamesmanship." At the same time, his decision to suspend support for a crucial reform — one that potentially could have helped allay growing constitutional concerns — allows gamesmanship to triumph yet again in Minnesota, a state where sincere attempts to address the program's failings have been met for years with "soft on crime" attacks by political opponents in both parties. Swanson's criticism is especially curious. She's defending the DHS in the class-action lawsuit while giving opposing counsel plenty of ammunition for its argument that the state's "treatment program" is a flimsy disguise for retroactive life imprisonment.
Instead of standing firm on the need to make difficult reforms to the program, Dayton essentially threw up his hands and walked away.
Duvall was an easy target for those trying to score political points, including GOP gubernatorial candidate and state Rep. Kurt Zellers. But that neither Dayton nor his critics indicated they might respond differently to a future release sought by an offender with a less troubling record than Duvall's is a reason for pessimism about their political motives and commitment to make thoughtful changes.
Especially lamentable is that this year likely was Minnesota's best chance to tackle the difficult challenges the program presents. Jesson has worked the hardest of any DHS commissioner on this issue and has done everything she possibly could. A bipartisan task force led by former State Supreme Court Chief Justice Eric Magnuson that includes legislators has offered up a general road map of reforms, with a more detailed plan coming early next month. That good work built upon a 2011 report by the Office of the Legislative Auditor that came to similar conclusions.
The timing also seemed promising because lawmakers didn't face an election this fall. Last spring, a bipartisan majority of state senators passed legislation to begin the long process of reform even though leadership in both parties in the House failed to get it to a floor vote.
Minnesota lawmakers may not have come together to find solutions. But they and their constituents will have to face the consequences of inaction together. Choosing to let the federal court exercise its authority means ceding key decisions about which offenders get out, where they go and how much alternative facilities will cost. Those decisions will be made by two federal judges whose expertise lies in constitutional law — not in state budgets, corrections or public safety.
"It might look attractive to have a federal judge take over this, but it won't be so attractive when the Legislature finds itself on the short end of a federal court injunction, when it's a federal court or master who is making judgments about where to send state dollars," said Eric Janus, dean and president of William Mitchell College of Law. "I don't think that will feel welcome at that point."
The Minnesota Daily, Nov. 19
Exorbitant student debt is keeping graduates out of grad school.
Graduate school enrollment is on the decline at the University of Minnesota, Minnesota Public Radio reported last week. Over the past five years, the university's graduate enrollment has dropped by 9 percent, while the state has seen a more than 13 percent decline system-wide.
Some colleges on the Twin Cities campus have been hurting more than others. Graduate school enrollment has dipped 16 percent at the Humphrey School of Public Affairs, 22 percent at the College of Biological Sciences and as much as 23 percent at the Carlson School of Management.
The drop in graduate enrollment is part of a nationwide trend. The U.S. has seen an 11 percent drop in the number of students pursuing graduate and professional programs, according to MPR's report.
The drop is the result of a long trend of rising tuition costs as well as shrinking government funding for student positions. According to a recent survey, roughly one in five postgraduate applicants at the University of Minnesota declined an offer of admission for financial reasons.
Large debt accrued as an undergraduate can become a serious deterrent regarding the decision to go to grad school. Interest remains high — applications are up nationally — but graduates either can't or aren't willing to take on more student debt. This has serious consequences for universities and the U.S. as a whole. Administrators at the University of Minnesota may have to restructure graduate programs, and the nation's talent pool will inevitably shrink if this trend continues.
The solution may be uncertain, but the cause is clear: Rising tuition prices are keeping graduates from reaching their full potential. Lawmakers at both the state and federal levels should understand that the urgency to decrease tuition costs at public universities has never been higher.