Three local lawmakers have signed onto a letter urging members of Congress to include changes in the way Medicare dollars are paid to states as part of any health care reform bill approved this year. Sen. Kathy Sheran, DFL-Mankato, Rep. Kathy Brynart, DFL-Mankato, and Rep. Terry Morrow, DFL-St. Peter, joined more than 50 other state legislators in signing the letter, which asks Minnesota’s congressional delegation to pass reform legislation that “achieve[s] the President’s goal of reducing health care costs while giving states an incentive to maintain their existing high-quality, low-cost care delivery systems.”
The text of the letter can be found below. A copy of the letter will be delivered to President Obama, Sen. Al Franken, Sen. Amy Klobuchar, and the state’s eight US House members.
Letter Text
Dear President Obama and Honorable Members of Congress:
We, the undersigned, strongly support enacting health care reform legislation this year that includes significant reform of Medicare’s geographic payment inequities in order to achieve the President’s goal of reducing health care costs while giving states an incentive to maintain their existing high-quality, low-cost care delivery systems.
Minnesota’s health care system is ranked #1 in the country for quality (AHRQ) and is ranked #43 in Medicare per patient spending (Dartmouth Atlas Project). We spend 20 percent less per patient than the national average and 31 percent less than in the highest cost state. In 2006, Medicare saved $1 billion in Minnesota relative to national average spending and $1.52 billion relative to the highest cost state. Across-the-board cuts in Medicare provider rates without any mechanism to reward this high-quality, low-cost care will lead to greater cost-shifting, will stifle health care innovation, and could harm Minnesota’s patients if providers use higher volume to compensate for under-payments. Moreover, any extension of Medicare’s existing payment disparities to a public option would be detrimental to Minnesota’s health care system.
To achieve a payment system that rewards innovation, higher quality, and lower costs, we recommend eliminating Medicare’s geographic variation and instead, paying Medicare providers on the basis of high quality and low cost (both measured relative to national averages). At a minimum, states should be offered optional Medicare waivers and the flexibility necessary to implement payment reform that includes a critical mass of patients across multiple payers (Medicaid, Medicare, and private insurers).
Reforming the Medicare payment system to move away from existing geographic inequalities toward a system that emphasizes health care value would deliver significant financial savings to the federal government and the Medicare program. We support the efforts of the Minnesota congressional delegation to prioritize Medicare payment reform in the current federal debate and we hope you will work with them on this important issue as you negotiate the final legislation.
The State Rail Plan process continues as the committees prepare draft reports for the body to consider. Yesterday, I reviewed a draft technical memorandum on Minnesota’s Passenger Rail System. You can read the draft memorandum here
The memorandum includes information on possible Mankato-Twin Cities passenger rail service. Surprisingly high potential ridership along this route was the most striking information I came across in reading the memorandum yesterday. Of course, the State Rail Plan process is intensive and exhaustive—this memorandum is a draft and will likley change as investigation and discussion continues. Nonetheless, it is a boost to local efforts to institute rail service from Mankato.
The Mankato Free Press wrote about passenger rail service and the Mankato-Twin Cities route in today’s edition. The Free Press included a chart summarizing some of the memorandum’s information:
Representative Terry Morrow has confirmed that the Minnesota Department of Transportation has allocated $2.5 million to rehabilitate the Minnesota Prairie Line. These funds are part of Minnesota’s share of the American Recovery and Reinvestment Act (ARRA) funds that the state received for transportation projects. Minnesota’s initial allotment under ARRA of $503 million for transportation was devoted primarily to road and bridge work. The Minnesota Prairie Line is the first Minnesota freight rail project to receive ARRA funding.
MnDOT’s investment of recovery money into fixing the Minnesota Prairie Line is a tremendous development.
On December 17, 2008, I contacted MnDOT to urge it to use some of the expected federal recovery transportation money to rehabilitate the state’s freight rail lines. I reminded MnDOT that the Minnesota Prairie Line is a publicly owned rail line and that it is a shovel-ready project. We continued to talk throughout the spring. The news that the Minnesota Prairie Line will be upgraded with federal recovery money is a great conclusion to our efforts.
Investment of federal recovery money to fix the Minnesota Prairie Line culminates combined efforts of the Minnesota Valley Regional Rail Coalition, the Minnesota Valley Regional Rail Authority, the Twin Cities & Western Railroad, Congressman Tim Walz, and local officials. Together, this group prepared and submitted materials to MnDOT demonstrating that the project was shovel-ready and would support economic development in the region. In addition, the Coalition hosted MnDOT Commissioner Thomas Sorel and Minnesota Department of Employment and Economic Development Commissioner Dan McElroy this spring to talk about the Minnesota Prairie Line and its current and future economic impact.
The past two years have demonstrated that a coalition of public officials, businesses, and citizens can come together to create economic opportunities.
In the past two years, we have secured $7 million in state bond funds, $2.5 million in federal recovery funds, and almost $1M in federal fund through Congressman Walz’s office. I am confident that our team will continue its work and folks will see more and more jobs and businesses spring up along the line. (more…)
Representative Terry Morrow received a letter on Monday from Minnesota Department of Transportation (MnDOT) Commissioner Thomas K. Sorel committing the department to completing the final environmental impact studies for Highway 14. A final EIS is necessary before purchasing right-of-way and taking other steps toward expansion of Highway 14 from a two-lane to a four-lane highway. MnDOT’s commitment came after Representative Morrow brought a bill in the 2009 legislative session to require that MnDOT complete the studies.
MnDOT’s commitment to completing the Highway 14 studies is a tremendous step forward. We worked on this Highway 14 issue throughout the winter and spring this year, trying to figure out a solution that would finally complete the EIS while still respecting MnDOT’s ability to set transportation plans. On behalf of everyone in my district and those who use Highway 14, I thank Commissioner Sorel for his understanding of this project’s importance to the safety and economy of Southern Minnesota.
MnDOT will hold a public open house on the environmental impact study (EIS) for the North Mankato-New Ulm segment of Highway 14 in August or September. The goal is to have the final EIS approval occur by December 2010. (more…)
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