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Excerpts from recent Minnesota editorials

March 18, 2019

The Free Press of Mankato, March 16

Tobacco: State must step in on cessation programs

Why it matters: A recent tobacco company merger may drain funds for Minnesota’s longtime tobacco cessation programs.

The Minnesota Legislature must act to stem the potential loss of funding for the state’s free tobacco cessation programs as a recent merger of tobacco companies has for now stopped their payments into the program.

A merger of R.J. Reynolds and Lorrilard tobacco companies has resulted in the elimination of KOOL, Maverick, Salem and Winston cigarette brands that were paying into Minnesota’s funds as part of the lawsuit settlement with tobacco companies in the 1990s.

While the state pursues a lawsuit to regain the funding, the Legislature is also considering proposals to restore this much needed program.

Without any funding, Minnesota would be the only state in the country without a tobacco cessation program.

Minnesota’s longtime QuitPlan service has helped more than 185,000 Minnesotans quit smoking, according to ClearWay Minnesota, the organization set up to implement the program.

Free cessation services have been effective in being part of a bigger effort to reduce the rate of smoking among all Minnesotans. Smoking rates have dropped significantly since QuitPlan was implemented in 2001. Some 22 percent of Minnesota adults smoked in 1999, a rate that has declined to about 14 percent last year.

QuitPlan spends about $15 million a year to fund the cessation program. That’s a small price to pay considering diseases related to tobacco cost the state $3.19 billion annually or $593 for every resident, according to Blue Cross Blue Shield.

A legislative proposal calls for funding a new youth tobacco and cessation program at a cost of about $12 million, using some of the money potentially recovered in the lawsuit.

Minnesota has made great strides in reducing the rate of smoking, but there are threats on the horizon. A recent state report shows a rise in youth tobacco use. Some 26 percent of high school students say they use tobacco, up from 24 percent in 2014. And national reports say vaping is also on the rise with youth.

We urge the Walz administration, Democrats and Republicans to revive and, indeed, expand tobacco cessation and prevention programs. It’s costly for taxpayers, but the alternative is more costly to the families whose loved ones are lost to this addiction.

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Post Bulletin, March 14

Dairy farms in need of help — now

Dairy farmers — the foundation for Minnesota’s family farm tradition and the backbone of the rural economy — are in serious trouble. Weak raw milk prices in recent months combined with a harsh winter have taken an immense toll.

The crisis hasn’t received the attention it deserves, which is why Saturday’s visit to Rob and Katie Kreidermacher’s Altura-area dairy farm by federal and state elected officials was important and appreciated. The Kreidermachers are among several farms across the state who suffered roof collapses caused by heavy snow.

Attention must lead to action, which Gov. Tim Walz and U.S. Tina Smith promised during the farm visit. The Legislature has responded to the crisis by quickly moving to provide loan money and working to encourage speedy payment of insurance money. The Rural Finance Authority is considering providing zero-interest loans to producers for natural disaster recovery.

The potential for federal assistance is uncertain. Dairy farmers have access to the Dairy Protection Program through which producers can purchase insurance policies that protect them from low milk prices. The program is woefully inadequate and insurance policies can be expensive.

Walz seems to understand what’s at stake for Minnesota’s entire economy.

“These dairy farms are the bedrock of the economy and their communities,” the governor said during Saturday’s event. “What we need to do is keep these dairy farms up and running.”

It is a tall task, given low prices caused by overproduction and falling milk demand. Minnesota’s dairy industry has been in a decades-long decline. There are approximately 3,000 dairy farms in the state, a mere fraction of operations that existed during the industry’s heyday.

Raw milk helped to build cooperatives like Land O’Lakes and private companies and created jobs. A study done in the 1980s found that each $1 of profit earned by producers generates $7 worth of economic activity the communities in which they are located.

Dairy isn’t the only farming enterprise that’s struggling. Grain producers are suffering from below-the-cost of production prices and high land and fertilizer costs.

A quote by turn of the 20th century politician and writer William Jennings Bryan seems appropriate.

“Burn down your cities and leave our farms, and your cities will spring up again as if by magic. But destroy our farms and the grass will grow in the streets of every city in the country.”

Minnesota’s farm economy is struggling and action is needed at the federal and state levels to prevent a repeat of the 1980s great depression in agriculture, which took an immense toll on farmers and rural communities.

We appreciate the high-level attention February’s record snow and the resulting disaster on farms has brought. We expect Walz, Smith, ag department Commissioner Thom Petersen, Reps. Jeanne Poppe and Steve Drazkowski and Sen. Michael P. Goggin to bring the Legislature to action this week. There is no time to waste.

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Minneapolis Star Tribune, March 15

Help those with mental health issues by passing parity bill

Insurers in state should treat it the same as cancer and other conditions.

Jeff Christensen said his son took his own life in 2016 after his family fought unsuccessfully with insurers to get the 25-year-old into a specialized mental health program. Another Minnesota parent, Kelly Jay, told Minnesota lawmakers in a sometimes shaky voice how a health plan cut off coverage for her teenage son’s residential treatment program just days after his care providers took him off 15-minute, round-the-clock suicide checks.

In a somber session at the State Capitol on Tuesday, two families shared their pain with a House committee weighing a long overdue bill that would ensure that mental illness is covered by insurers the same as cancer, heart disease, diabetes and other conditions. The bill, which merits swift passage in the House and Senate, has a small but commendable cadre of DFL and Republican supporters. Their commitment reflects an admirable understanding of how common mental health diagnoses are, with 4 percent of U.S. adults struggling with a serious mental illness.

Regrettably, Rep. Greg Davids, R-Preston, callously made it clear on Tuesday that his sympathies lie not with the families, but with the insurers. Dramatically waving a sheaf of paper, Davids lamented the regulatory burden the bill would put on industry. He called it a “sledgehammer,” and said (with curious confidence, given that his party is not the House majority) that it’s going nowhere.

The tone-deaf theatrics were a low point of the 2019 session. No, Rep. Davids, the bill does not victimize insurers. In fact, not even the state’s insurance trade group is arguing that it would create unreasonable red tape. Nor does Davids have inside knowledge on how the Senate, which his party controls, will handle the bill. His bizarre bravado suggested the legislation would be dead on arrival in the upper chamber. A statement from the Senate GOP communications office on Friday said leaders have just started reviewing the bill. A spokeswoman added: “Rep. Davids does not speak for us.”

The bill will indeed be a tougher sell in the Senate, which is often viewed as friendlier to insurers than the House is. Still, there are influential Republican champions in the Senate, and their colleagues should realize it wouldn’t create a huge new set of regulations. The reality is that the bill would improve enforcement of a national law already on the books. That law, passed in 2008, mandates mental health “parity,” meaning equal coverage for mental and physical health conditions. But compliance has shamefully lagged. The evidence isn’t just in anecdotal stories like those shared Tuesday. Earlier this month, a federal judge slammed United Behavioral Health for discriminating against patients with mental illnesses in order to boost its bottom line.

The Minnesota bill would more rapidly shift enforcement from a system that is complaint-driven to one in which regulators proactively determine that insurers are in compliance, helping to avoid situations where treatment access is cut off or denied. As part of that, state officials would have clear authority from the Legislature to require data from health plans to assure parity is implemented. That would enable the deeper analysis required to ensure equitable care. Examples where the data may be helpful: reviewing whether patients have access to new drug treatments or whether their care options are disproportionately out of network. The bill would also require a yearly public report on compliance and enforcement actions.

Insurers should already be analyzing internal data to ensure that they’re in compliance with the 2008 law, so asking them to provide that information to the state when asked isn’t onerous. The amended bill also would streamline the reporting requirements, so it’s doubtful that the thick pile of paper waved by Davids is accurate. In an interview, Davids disputed an editorial writer’s characterization of his behavior and said he remains a health care advocate.

The Minnesota Council of Health Plans does have concerns about the bill. The main one, the trade group said in statement this week, is that it’s not a panacea for parity. Many employers’ plans are regulated at the federal level, so the safeguards put in place by the state may not yield improvements for these health care consumers. The council, and Davids, prefer a work group approach to improve parity.

The Star Tribune Editorial Board disagrees. Struggling families, not the industry’s preference for legal compliance, should be the priority. The trade group is right that the bill would help some but not all health plan enrollees. Nevertheless, it is a step forward and would send a strong signal that compliance is critical. Said Kelly Jay, who testified this week with Jeff Christensen: “Jeff lost his son. And I’m working very hard to get my son the treatment he needs. We don’t have time for work groups. We need this enforced.”