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Minnesota, New York Offer Health Insurance for Lower-Income Residents for $20 Per Month

Of course, consumers would have a lot more money to spend on Christmas goodies if we behaved like every other civilized nation and implemented universal health care.

But Minnesota and New York are saving their people money and insuring nearly everybody by offering “Basic Health Plans” under the Affordable Care Act:

The basic structure of the ACA was this: Medicaid expansion for people living in or near poverty and marketplace plans for people with incomes above that. But the law included an option for states to more seamlessly integrate those two populations — and so far, the two states that have taken advantage of it, Minnesota and New York, are also among those states with the lowest uninsured rates. Just 4.3 percent of Minnesotans and 4.9 percent of New Yorkers lack coverage today.

They have both created Basic Health Plans, the product of one of the more obscure provisions of the health care law. This is a state-regulated health insurance plan meant to cover people up to 200 percent of the federal poverty level (about $29,000 for an individual or $50,000 for a family of three). Those are people who may not technically qualify for Medicaid under the ACA but who can still struggle to afford their monthly premiums and out-of-pocket obligations with a marketplace plan.

In both states, the Basic Health Plans offered insurance options with lower premiums and reduced cost-sharing responsibilities than the marketplace coverage that they would otherwise have been left with. In New York, for example, people between 100 percent and 150 percent of the federal poverty level pay no premiums at all, while people between 150 percent and 200 percent pay just $20 per month [Dylan Scott, “The US Doesn’t Have Universal Health Care—But These States (Almost) Do,” Vox, 2023.11.26].

$20 a month to make sure you can take your kids to the hospital without filing for bankruptcy—take a memo, South Dakota! That’s real, practical liberty.


  1. larry kurtz 2023-11-27 07:18

    There is a growing movement among Democrats and others to fund Medicare for all but I like the idea of rolling the funding for Obamacare, TriCare, Medicare, the Indian Health Service and the VHA together then offering Medicaid for all by increasing the estate tax, raising taxes on tobacco and adopting a carbon tax.

  2. Loren 2023-11-27 12:05

    According to an article in this morning’s WaPo, Trump is starting to campaign on… wait for it…… wait…. REPEALING OBAMA CARE! LOL! Do you suppose Thune and Rounds are gonna back it this time… AGAIN? Can’t wait for the plan on “infrastructure week.” :-)

  3. LCJ 2023-11-27 12:44

    Former Native American Indian, Elizabeth Warren, was a big supporter of Medicaid for all.
    Now she seems to not even like the ACA if you read Fridays Wall Street Journal.

  4. Mike Lee Zitterich 2023-11-27 14:38

    We have to continue to push to repeal the A.C.A it is a bad law, and it costs to much. And for $20 a month, your getting pretty crappy insurance, with a high deductible. Democrats do NOT think about the long term effects. Since 2010, the Federal Govt still has not forced me to buy health insurance. Get rid of Social Secuirity, Medicare, Medicaid, and ALL the Coporate Subsidiy programs – farm, corporate, housing, education, childcare, health and your tax liability will shrink by ore than 75%, and the size of the FED GOVT will shrink by 75%.

  5. larry kurtz 2023-11-27 14:39

    If Trump is the Earth haters’ nominee Liz Cheney will run as an unaffiliated candidate but she won’t if Nikki Haley is the GOP’s pick. Haley needs a Veep from a swing state. Who is it?

  6. larry kurtz 2023-11-27 14:43

    Zitterich is delusional.

    That “Pocahontas” thing Trump does to Senator Elizabeth Warren doesn’t just betray his hatred for women; it’s a tell that he detests American Indians no matter how much or how little Native blood a person has. That Republicans continue to prop up his assault on the courts and stoke his criminal race baiting are the most telling aspects of this march toward the abyss. Trump’s erasure of protections for Bears Ears and Grand Staircase-Escalante National Monuments was cruel retribution targeting Indigenous peoples.

  7. larry kurtz 2023-11-27 14:48

    Zitterich was in grade school when this happened but recall former Montana Sen. Max Baucus threw President Barack Obama’s pick for Health and Human Services Secretary, former Senate Majority Leader and fellow Democrat Tom Daschle, under the bus during a pre-confirmation quarrel in 2009. Daschle was widely expected to push Congress toward a Medicaid-for-all health care plan in the weeks before Big Pharma-backed Baucus soundly rejected single-payer medical insurance and guided the passing of what would become the Patient Protection and Affordable Care Act.

  8. O 2023-11-27 14:48

    MLZ, heath care is a right — not a privilege. THAT is my pro-life position.

  9. Donald Pay 2023-11-27 15:17

    Mike Z., At least you are honest about your insane ideas. I want Republicans to run on cutting the ACA, cutting Social Security, cutting Medicare, cutting Medicaid and cutting child care, That’s what they would try to do if they ever got their hands on total power, so they should put that in their platform. I don’t think they will admit to any of those ideas. I think they understand they would find themselves ushered out in the next election, assuming they would ever allow another election in the first place. They, of course, would not cut corporate subsidies or tax loopholes to the corporate and wealthy elite. That is their donor class. They especially wouldn’t if Donald is heading the party.

  10. Arlo Blundt 2023-11-27 16:39

    The statistic that households are holding 8,000 dollars less personal indebtedness is highly significant. Probably the result of high interest rates and, most importantly, that during COVID households learned how to get along with less consumer spending. The sad fact is our economy is built on and dependent on consumer debt. I call it unrestrained consumer optimism.

  11. grudznick 2023-11-27 17:51

    Mr. Pay, we need several of those things you wish the National Party of Republicans (NPR) would put in their platform of ideas. We don’t need the ACA, however, as it has not forced Mr. Zitterich to get insurance. It is a big waste of money and useless. Now, do we need to tighten up on work requirements? You betcha, and the NPR should for sure put that in their platform of ideas. And no free lunches if your ma and pa can afford to pay for yours. Only free lunch for those who prove they need it, just like Medicaid. No work requirements on school lunch though maybe that’s debatable. Is your pa out there looking for a job, or just being a slackard. Show your proof like you do for unemployment payments. grudznick rambles, as these ideas are dandy and get me excited with more ideas…

  12. Mike Zitterich 2023-11-27 19:08

    I want the Donald Trump supported repealing of the A.C.A the Federal Government should NOT be involved in the private lives of Americans, let alone the State Republics themselves. I want Social Security, Medicare, Medicaid, the A.C.A all shutdown.

    In turn, I want South Dakota Citizens to form a Select Committee that includes the following persons:

    Lt. Governor, a Representative from the Attorney Office, the Director of Public Health and Human Services, and at least 1 Citizen from each of the 35 Legislative Districts making up a 38 Member Select Committee.

    I want this Committee to steer public discussion, research, and discuss a concept that allows S.D Citizens/workers the ability to contribute to the South Dakota Public Healthcare Fund – establishing a program that allows the State of South Dakota to contract with S.D Businesses/employers to qualify their employees, creating Payroll Contribution Tax or Fee that further provides Healthcare Plans to private employees working in South Dakota. Set up much like the FICA Tax – where the Employer pays 50%, and the Employee pays the other 50%. The State collects, and deposits the ‘revenues’ into the trust fund, using the monies to purchase Healthcare Coverage in that person’s name.

    Also, S.D Workers should be able to pay into the S.D Public Retirement Trust Fund allowing private citizens to voluntarily contribute to a “retirement account” that allows the S.D Citizen to avoid paying Social Security.

  13. Todd Epp 2023-11-27 19:18

    The Zit is back!

  14. Linda 2023-11-27 19:45

    Have any of the commenters on this thread even been on an ACA plan? I had it, for several years. It is fabulous coverage, for very low cost. I wish I had an ACA plan now. I currently have coverage through my employer, but they take $75 out of my paycheck, twice a month.

    I had part-time employment for several years, with no benefits. While working part-time, I had an ACA plan through Sanford Health. I had a Silver plan. They have Gold, Silver and Bronze plans. I paid about $15 per month, although I had them run my credit card for a whole year’s worth of premiums, so it was about $180. If I lost coverage through my employer, I would not hesitate to sign up for another ACA plan. There were modest co-pays for some doctor visits, while on the ACA plan.

    SD ACA plans for dental coverage SUCK. The only participating dentists are those at the Community Health Dental offices. So I joined AARP and was able to get Delta Dental through the AARP. Those premiums are similar to what you pay for an employer-sponsored dental plan, but the co-pays are bit more. SD ACA plans may have added more dentists to their program, but as of a couple years ago, options were quite limited. Premiums for dental plans are separate from the medical plans. You are not required to buy both medical and dental plans.

    I have little patience for people who claim they cannot get health insurance. For single individuals, they can get Medicaid Title 19 if their income is upto ~$8k. SD Medicaid Managed Care has an income level upto~$13k. As of July 1st, Medicaid Expansion covers those with income up to ~$19k. Before Medicaid Expansion started, those incomes above ~$13k could get an ACA plan. ACA will cover those with incomes up to ~$29k. If you earn over the $29k, the premium gradually increases. Family plans change the amounts.

    Private insurance plans are very expensive for those who are older, but not old enough for Medicare. The ACA provides an excellent option for those who may need to reduce their working hours, due to age or health reasons. And for working families with kids, it is such important coverage. And it IS available in SD, you don’t have to be in Minnesota or NY.

  15. Dennis litfin 2023-11-27 19:47

    Zitterich, isn’t it miraculous that Trump ia able to get illiterate people to follow and worship him like Jim Jones did.

  16. Arlo Blundt 2023-11-27 23:28

    The Trump sponsored repeal of the ACA was defeated by the vote of Senator John McCain of Arizona and that’s good enough for me. McCain was dying of cancer after nearly 30 years of the best medical treatment in the world provided at little cost to McCain by the government of the United States, through the best health insurance policies on Earth. McCain, a political conservative, voted as his conscience dictated.Trump has no conscience.

  17. larry kurtz 2023-11-28 07:26

    SCOTUS agreed to hear the case brought by the San Carlos Apache and the Northern Arapaho who argue that the Indian Health Service is screwing tribes. On the Navajo Nation a third of the people don’t have access to clean drinking water so sugared drinks purchased from dollar stores and obesity are an epidemic comorbidity.

    Both parties agree that IHS is woefully underfunded, leading to “‘persistent health disparities’ in American Indian communities.” According to documents in the case, IHS spends $4,078 per capita, compared to $8,109 for Medicaid and $13,185 for Medicare.

  18. larry kurtz 2023-11-28 10:53

    Exactly, epo. I’d be shocked if Zitterich has any medical insurance let alone a living income so he’s probably a Medicaid enrollee right now and spouting BS just to gaslight us.

  19. Mike Zitterich 2023-11-28 13:35

    As a self employed worker, and business owner, I do have sufficicent income, not that is none of your business. I am NOT a medicaid enrolloyee, and I have a Group Insurance Package through my business, that serves me just fine. I provided a plan above on how the S.D Ctizens should establish their own Group Plan as a State, and to support the repeal of ACA

  20. jerry 2023-11-28 13:50

    Sounds like a trust fund baby to me

  21. larry kurtz 2023-11-28 14:15

    Same with Bayer and other chemical giants who have degraded human health for decades: make them pay.

  22. O 2023-11-28 14:55

    My Dear Mr. Zitterich, welcome to the Socialist agenda: your membership card should be arriving soon. Why have individual accounts for your medical care option? Let’s just outright socialize medicine? In fact, bigger pools are better pools; so do it nationally (that way no nasty trifles happen when I’m visiting my Great Aunt Petunia across the border, and I get sick.

  23. e platypus onion 2023-11-28 17:08

    I provided a plan above on how the S.D Ctizens should establish their own Group Plan as a State, and to support the repeal of ACA

    And no one with a single live brain cell believes you.

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