- Associated Press - Tuesday, October 25, 2016

Minneapolis Star Tribune, Oct. 24

Minnesotans beware: Heroin overdoses can end in death

Illegal street drugs carry no warning label about complications from use. But if there were, heroin’s would read something like this: “Caution: Even small amounts can cause your body to forget to breathe, a terminal condition that may necessitate the need for a body bag, the services of a medical examiner and grief counseling for your family.”

The past year has provided Minnesotans with sobering reminders of heroin’s dangers, with the most recent grim reports arriving over the weekend. Six people overdosed on heroin in a 12-hour period on Saturday, the Anoka County Sheriff’s Office reported. Two of them died. Authorities are also investigating heroin’s role in three medical emergencies that occurred at the Mall of America Friday night.

Law enforcement is sounding the alarm about a single source of heroin, one potentially contaminated or unexpectedly potent, that may have caused the overdose spike. Sadly, this kind of call has gone out before. In March, authorities in northern Minnesota pleaded for the public’s help in identifying users and dealers after seven heroin overdose deaths there.

That heroin and other drugs have a hold on too many Minnesotans is an undeniable reality. The state Department of Health (MDH) reports that drug overdose deaths rose 11 percent from 2014 to 2015. Prescription painkiller overdoses killed 216 people in 2015; heroin was the second-leading cause, claiming 114 Minnesotans.

A look at the data reveals a disconcerting reality. “Middle-aged adults have the highest numbers and rates of Minnesota’s drug overdose deaths,” the MDH report said. Drug abusers, in other words, often don’t fit the stereotype of hard-partying young adults.

The state has taken sensible measures as painkillers’ and heroin’s toll has risen. Increasing the availability of naloxone, a drug that can reverse heroin overdoses, is one such step. A relatively new policy that encourages medical providers to consult a prescription database before prescribing painkillers also should help discourage patient doctor-shopping.

But often it’s family members or friends who are in the best position to save a life. Vigilance to the signs of abuse is critical. Even more important is the step that must follow: getting a loved one into medical care. Minnesota is home to some of the world’s leading addiction experts. They can help, but an abuser must become their patient first.

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St. Cloud Times, Oct. 24

MNsure special session needs context

Late last week, Minnesota legislators and Gov. Mark Dayton began delivering the same basic message: Let’s have a special session to address some massive MNsure rate hikes coming in 2017.

That’s a start, but more context is needed. Specifically:

- No special session until after Election Day.

- Very targeted help for MNsure clients, making sure relief goes directly to only those Minnesotans who see massive increases but are not eligible for accompanying tax breaks.

- A special session must be the first step toward what this Editorial Board suggested Oct. 7: Shutter MNsure and replace it with Minnesota simply joining the federal exchange created under the Affordable Care Act.

Key legislative leaders from both parties last week quickly backed a special session, in part because MNsure enrollment opens Nov. 1. However, also looming is Election Day 2016, during which all legislative seats are on the ballot on Nov. 8. For that reason alone, it’s good to hear Dayton saying he will not call a special session until after ballots are cast.

Also worth noting is the MNsure enrollment period runs until Jan. 31, which allows for up to almost two months to craft specific solutions before affected Minnesotans start paying their 2017 insurance bills.

As much as MNsure is struggling, it must be stressed that the rate hikes drawing the most concern hit only about 5 percent of Minnesotans. These residents, numbering about 250,000, use MNsure to shop on the individual market. Those policies not only face increases up to 67 percent more than last year, but choices will be limited and enrollments could be capped.

As many experts have noted, the fundamental forces driving those conditions are too many consumers with high health-care costs and too few healthy people paying premiums but not needing care. In fact, Minnesota is not alone on this front. Dozens of other states are in similar situations, which is a huge sign that a long-term solution must come from the federal government, not the state.

The state’s solution must be short-term: Craft a solution that provides direct relief to only those Minnesotans who have to use MNsure for individual policies but who are not eligible for subsidies.

Obviously, MNsure needs to remain operational during the enrollment period for 2017. However, legislators and the governor should include as part of any special session serious discussions about how to begin closing it and transitioning Minnesotans to use the federal exchange.

As this board stated a few weeks ago, quite simply, the state exchange’s costs continue to outweigh its benefits.

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The Free Press of Mankato, Oct. 24

Special session: Provide relief to insurance premium increases

A Senate DFL plan to ask Gov. Mark Dayton to call a special session of the Legislature to mitigate huge health insurance premium increases on the state run exchange makes sense for what some are calling an “emergency situation.”

While it may appear that the Senate DFL is scrambling politically before the election to distance itself from the MNsure system it has supported in the past, all the political players should heed a good faith effort to save Minnesotans from horrendous premium increases and a loss of coverage.

When the MNsure health insurance premium rates were announced at increases of 50 percent to 60 percent, it was clear to many that the system wasn’t working as planned. Even when federal tax credits are applied, premium increases are too steep for the 5 percent of the people who buy on the individual market.

It’s not unexpected that the GOP would criticize the MNsure exchange as they have from the start. But they can play a key role in fixing it and take at least half of the credit.

When the rates were announced, the Senate DFL was the first to suggest and ask Dayton to call a special session to address the issue. There are apparently already some plans in place that nearly won approval last year that would create temporary relief from high prices.

Senate Majority Leader Tom Bakk has proposed a bill introduced by his caucus last year that would provide tax rebates to people facing the high insurance costs. The bill would limit premiums to about 10 percent of a person’s income. Bakk says the tax rebates could be paid for with the state’s budget surplus or rainy day funds. The rebates would only be in place for one year until the Legislature could find a more permanent solution.

It’s hard to find a good reason for not calling the special session and approving a rebate bill or some other form of relief. Whether it’s before or after the election shouldn’t matter too much, though people can begin choosing a plan Nov. 1 and have until Jan. 31 to finalize their choice.

There are many complex reasons prices are increasing so drastically on the MNsure exchange. Translating them into election-year sound bites won’t serve anyone.

We urge the DFL and GOP to get together on a solution and put together immediate relief in a special session.

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