September 2019, Volume XXXIII, No 6
Governor, State of Minnesota
During your first term as Governor, you worked with a divided Legislature. What can you tell us about drawing both sides to the table?
From the beginning, I said that I wanted to do things differently than what’s happening at the federal level. I worked with the Speaker and the Majority Leader to set benchmarks for when we wanted work to be done, and we committed to building our relationships over the course of the legislative session. When it came to negotiations, we were able to come to the table in good faith and have honest conversations because of the work we had done up to that point.
No one got everything that they wanted, but we got a budget done without shutting down the government or resorting to name-calling. Minnesota is showing the rest of the nation that Republicans and Democrats can still find compromise and work together.
In the face of GOP opposition to new taxes, the Legislature renewed the provider tax at a reduced rate of 1.8%. How will this benefit all Minnesotans?
The provider tax directly impacts the one in five Minnesotans who rely on the health care access fund. Without the provider tax, many low-income and vulnerable Minnesotans would have to go without reliable, comprehensive health care through Medical Assistance and MinnesotaCare.
It is unacceptable that Minnesotans are being denied life-saving drugs like insulin.
The benefits of the provider tax go beyond just those Minnesotans receiving health care through Medical Assistance and MinnesotaCare. When patients are uninsured or underinsured, they don’t stop experiencing health concerns—they just go without regular or preventative health services, resulting in costly emergency room services or long-term care for what might have been a treatable condition. This leads to poorer health outcomes and higher costs for all patients and providers, which is why we saw hospital leaders and health care providers from across the state calling for an end to the sunset on the provider tax.
Despite partisan disagreements over elder care regulations in the 2018 session, lawmakers this year reached agreement. Please highlight the gains for older Minnesotans.
In recent years, we’ve seen some truly heartbreaking reports of the abuse and neglect experienced by Minnesota seniors in our assisted living facilities. No Minnesotan or their family should have to worry about their safety when putting their trust in an assisted living facility, and the Legislature came together to create increased protections. Now, assisted living facilities must be licensed to ensure they are safe and high-quality care centers, and residents have increased protections, including the right for them or their family to install a camera in the resident’s room, should they suspect that abuse or neglect is taking place. In creating these requirements, Minnesota joins the other 49 states in ensuring this important protection for those receiving assisted living services.
New legislation will also address mental health on several fronts. Please describe these.
Mental health care is health care, and I’m committed to making sure that mental health care services are affordable and accessible across our state. One achievement I’m proud of is increasing the mental health services available to our farmers, who are facing incredibly challenging environmental and economic conditions.
Significant investments in the 2019 session will make the behavioral health system more sustainable and fill gaps, while new resources will help Minnesota respond more effectively to behavioral health needs statewide. The state will continue to build on the success of Certified Community Behavioral Health Clinics, expanding the number of one-stop shops that combine mental health care and substance use disorder services. Changes to the behavioral health care funding structure will bring in more federal money, while reducing the financial burden on counties and making services more readily available when people leave residential treatment. Other investments will expand the state’s capacity to serve children who need intensive mental health care and give more children access to school-linked mental health services. A new opioid fee will raise money to improve and expand opioid treatment and prevention services, reducing the burden of the crisis and expanding access to culturally specific care for disproportionately affected tribal communities. The budget also invested in a comprehensive, community-based suicide prevention program that builds upon a public/private partnership to expand, strengthen, sustain, and support community-based suicide prevention across Minnesota.
How will increased fees on prescription drug manufacturers and distributors benefit the state’s efforts to address the opioid epidemic?
The opioid crisis has devastated every corner of our state, and there isn’t a one-size-fits-all solution for every community. The fee on prescription drug manufacturers and distributors creates an opioid stewardship fund, which can then be used to fund innovative and effective services from local providers who are on the frontlines of this crisis. The fund will also alleviate the costs that counties and municipalities face when dealing with the consequences of this crisis.
Please describe legislative initiatives regarding pharmacy benefit managers (PBMs).
I signed bipartisan legislation this year that will require pharmacy benefit managers to be licensed in order to do business in Minnesota. This effort aims to lower the cost of prescription drugs for Minnesotans, provide better transparency to consumers and pharmacists regarding PBM business practices, and improve Minnesotans’ ability to shop for lower-priced pharmaceuticals.
Among the bills that failed to pass in 2019 was one that would have provided insulin to uninsured people with diabetes. Will you continue to push for initiatives to reduce the cost burdens of this and other prescription drugs?
Yes. It is unacceptable that Minnesotans are being denied life-saving drugs like insulin, drugs that have not substantively changed for decades yet have risen in price. People are dying from rationing or going without insulin. I know the Legislature has come up with a few solutions. As soon as they decide on a path forward, I am ready to pass this bill, sign it into law, and save lives.
What can you tell us about the future of reinsurance and a consumer buy-in option to MinnesotaCare?
My proposed budget included several alternatives to reinsurance that would have provided more relief directly to consumers. However, as part of the compromise with Senate Republicans, reinsurance was extended for two more years. I will continue to advocate for health care initiatives that provide relief directly to Minnesotans, and that includes providing additional, comprehensive health care coverage options through the ability for Minnesotans to “buy-in” to public health care options.
What else would you like to share with Minnesota health care professionals regarding the 2019 session?
I’d like to thank the health care providers who traveled to the Capitol, sometimes from great distances, to share their expertise and experience. Good bills get passed when lawmakers hear from the people who are directly impacted and do this work every single day. Your voices made a difference, and I look forward to your continued advocacy.
Former Gov. Mark Dayton was a strong advocate for health care. What initiatives of his will you continue to advance during future sessions?
Every Minnesotan deserves access to quality health care at a price they can afford, and providing access to affordable health care was a key part of the first budget we proposed. My proposal included funding to extend low-cost coverage to thousands of farmers, small business owners, and entrepreneurs. The budget proposals also would have provided every Minnesotan with an additional health care option, encouraged stability in the individual market, and made health care more affordable in Minnesota. I will continue to advocate for these priorities in future legislative sessions.
© Minnesota Physician Publishing · All Rights Reserved. 2019
Tim Walz is Minnesota’s 41st Governor. His career has been defined by public service, from serving our country in the military, to serving students as a high school teacher and football coach, to serving in Congress on behalf of Minnesota’s First Congressional District. In 2018, he was elected as Governor.