Minnesota moves to protect coverage.

• Author: Johnson, Sharon

As the nation braces for a repeal of the Affordable Care Act, the Minnesota Nurses Association has an idea that could serve as a model for advocacy groups in other states.

On January 26, Minnesota Governor Mark Dayton signed a bill backed by the union to help stabilize the individual market, which serves people who buy their insurance directly from carriers rather than state-run exchanges and who do not qualify for subsidies under the ACA. The move is important because many states are grappling with the problems of skyrocketing premiums and the exodus of carriers in the individual market.

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The Minnesota Nurses Association, an affiliate of National Nurses United, lobbied against a Republican proposal to allow insurers in the individual market to offer cheaper, bare-bones coverage, and would strip dozens of benefits that the ACA considers "essential services." Depending on the plan, maternity care and treatments for diabetes, cancer, chemical dependency, and other conditions would have been eliminated.

Instead, Minnesota's Republican-controlled legislature agreed to a one-time, $326 million bailout that will provide 25 percent rebates for residents faced with hefty premium increases this year in the individual market.

"2016 was a perfect storm in Minnesota's individual market," says Rose Roach, executive director of the Minnesota Nurses Association, which has 20,000 members in Minnesota and parts of Iowa and Wisconsin. "In addition to some of the country's largest increases in premiums, 50 to 67 percent on average, Blue Cross Blue Shield of Minnesota left the market, leaving people with the choice of only four carriers."

Nurses from around the state attended committee meetings and met with their local legislators.

"All of us stressed that repeal of the ACA would have a greater impact on Minnesota than other states because Minnesota has taken advantage of all the ACA offers," Roach says. "In addition to setting up our own exchange, Minnesota has expanded...