By: Erilk Paulsen When the Affordable Care Act (ACA) passed in 2010, Americans were promised a health care system that would lower costs, expand patient choice and preserve access to the health plans and doctors they liked. Unfortunately, seven years later, too many families around the country are still feeling the negative impacts of a 2,000-page piece of legislation that dramatically altered one-sixth of the nation's economy. Contrary to the opinion of the Star Tribune Editorial Board ("A costly step back for U.S. health care," May 5), I believe there is a better way forward. This year in Minnesota, those purchasing insurance through the individual market saw another year of premium increases; this time, it was 59 percent, which was fourth-highest in the nation. They found that four of the five insurance providers offering plans had capped enrollment, making it more difficult for Minnesotans to pick the plan that fits their needs. This is on top of the more than 100,000 Minnesotans who had their plan canceled for 2017. Premiums for those with employer-based coverage have risen 27 percent, double the growth in wages and almost three times faster than inflation. This debate is about far more than just numbers, though. It's about people. It is about the very real impact on families and individuals like those I have heard from. It is about Nyla, a recently widowed mother of four who saw her premiums jump to $1,000 per month with a $13,000 deductible. That was before she received a letter in the mail notifying her that her plan would be canceled. It is about Susan and her husband, who are small-business owners and saw a 60 percent increase in their premiums and now pay more than $13,000 per year with a deductible equally high and lost access to their doctor. This debate is about Taryn, who, after being diagnosed with a brain tumor, suddenly had her plan canceled when her insurer pulled out of the market. Instead of developing a plan of action with her doctor, she had to spend precious time and resources looking for new coverage. The proposal passed by the House last week is aimed at addressing many of the shortcomings of the ACA by stabilizing insurance markets and beginning to bring down premiums. What's been missing from the opponents of the House bill, frankly, is an honest conversation about cost. The reality is that unless we address rising costs, the insurance market will continue to worsen for families, in terms of both access and affordability. Unfortunately, the ACA did not address the cost issue; instead it has led to steep increases in prices that have hit Minnesotans particularly hard. Rather than the one-size-fits-all Washington approach, we can empower states and consumers to take control of their own health care outcomes. This legislation will provide relief for the nearly 20 million Americans who have sought an exemption from the ACA's mandate or are paying the tax penalty. That's nearly double the number of Americans who have actually purchased insurance through the ACA marketplace. The bill empowers states to better design health care plans that meet the needs of their citizens. It provides a portable tax credit to assist Americans who do not receive coverage from an employer in purchasing health insurance. It enhances and expands the use of consumer-driven health care accounts, such as Health Savings Accounts, and it once and for all repeals the harmful medical device tax. It is also important to point out what is not in this bill. Nothing in this bill would allow an insurance company to deny someone coverage, including to those with a preexisting condition. Nothing would allow an insurance company to cancel someone's insurance policy should they become sick. Despite claims from opponents, the bill does not classify sexual assault as a preexisting condition. For those who maintain continuous coverage, the bill does not allow insurance companies to charge an individual more simply because they have a preexisting condition. It's also worth noting that this bill includes $138 billion to assist states in making sure everyone, including those with preexisting conditions, has access to high-quality, affordable health care. The legislation passed last week is certainly not the end of the road but instead a first step toward providing Minnesotans with a health care system that works for them. I will continue to champion other legislative ideas, including my initiatives on chronic care reform, treating and reducing obesity, and ensuring that seniors have access to rehabilitation services, all of which enjoy bipartisan support. At the same time, we must continue to have a thoughtful discussion on solutions that will provide high-quality, affordable health care coverage.

By Erik Paulsen When Minnesota Supreme Court Justice David Stras was nominated for the U.S. Circuit Court of Appeals for the Eighth Circuit, the news was met with enthusiastic support by Minnesotans from across the political spectrum. A diverse group of judges, attorneys and law professors urged the Senate to act on Stras' nomination and confirm him for the Eighth Circuit. Among those who signed letters of support for Stras are former colleagues on the Minnesota Supreme Court, including retired Justice Alan Page and others appointed by a bipartisan list of governors, as well as former Gov. Tim Pawlenty and Gov. Mark Dayton. Stras is also supported by 12 former members of Congress from Minnesota (Republicans and Democrats), by members of the faculty at the University of Minnesota Law School and by more than 100 prominent Minnesota attorneys. Despite this widespread, bipartisan support, the U.S. Senate has stalled on considering the Stras nomination. Stras has no confirmation hearing in sight, even though other judges nominated around the same time have either had a hearing or will have one soon. When the Senate held a confirmation hearing in July, it was for another Eighth Circuit nominee -- Judge Ralph Erickson from North Dakota -- whose nomination was submitted to the Senate after the White House submitted Stras' name. The reason for the delay is that Stras' nomination is being held up by Minnesota's Democrat U.S. senators -- Amy Klobuchar and Al Franken. Neither senator has returned the "blue slip" necessary for the nomination to move forward. Under Senate tradition, any senator can delay or halt a nominee from the senator's home state by refusing to return the blue slip to the Senate Judiciary Committee. Thus, as long as the Senate follows the blue-slip tradition, Klobuchar and Franken can block Stras from receiving a confirmation hearing simply by refusing to return their blue slips. To be clear, Klobuchar's and Franken's refusal to return their blue slips has nothing to do with Stras' merit. There is no dispute that Stras has all the qualifications and attributes to be an outstanding judge. He received a well-qualified rating from the American Bar Association, which is the highest recommendation possible. He is a renowned expert on federal courts -- before joining the Minnesota Supreme Court, Stras was a scholar on federal courts at the University of Minnesota Law School. And in the seven years he has served on Minnesota's high court, Stras has demonstrated a commitment to the impartial rule of law, basing his decisions on reasoned analysis of the Constitution, statutes and precedent without personal or political bias. As he explained in one case, "my role as a judge is not to implement my own policy preferences, but to interpret the law as written." Stalling Stras' nomination is the latest example of partisan game-playing in Washington. By blocking his confirmation, the senators are keeping an outstanding legal mind off the Eighth Circuit court, and preventing another Minnesotan from joining a court where the majority of judges are from other states. This is unacceptable. Along with many other Minnesotans from across the political spectrum, I urge Sens. Klobuchar and Franken to end their obstructionism and allow Stras' nomination to proceed for a confirmation hearing and vote.

By Erik Paulsen When the Affordable Care Act (ACA) passed in 2010, Americans were promised a health care system that would lower costs, expand patient choice and preserve access to the health plans and doctors they liked. Unfortunately, seven years later, too many families around the country are still feeling the negative impacts of a 2,000-page piece of legislation that dramatically altered one-sixth of the nation's economy. Contrary to the opinion of the Star Tribune Editorial Board ("A costly step back for U.S. health care," May 5), I believe there is a better way forward. This year in Minnesota, those purchasing insurance through the individual market saw another year of premium increases; this time, it was 59 percent, which was fourth-highest in the nation. They found that four of the five insurance providers offering plans had capped enrollment, making it more difficult for Minnesotans to pick the plan that fits their needs. This is on top of the more than 100,000 Minnesotans who had their plan canceled for 2017. Premiums for those with employer-based coverage have risen 27 percent, double the growth in wages and almost three times faster than inflation. This debate is about far more than just numbers, though. It's about people. It is about the very real impact on families and individuals like those I have heard from. It is about Nyla, a recently widowed mother of four who saw her premiums jump to $1,000 per month with a $13,000 deductible. That was before she received a letter in the mail notifying her that her plan would be canceled. It is about Susan and her husband, who are small-business owners and saw a 60 percent increase in their premiums and now pay more than $13,000 per year with a deductible equally high and lost access to their doctor. This debate is about Taryn, who, after being diagnosed with a brain tumor, suddenly had her plan canceled when her insurer pulled out of the market. Instead of developing a plan of action with her doctor, she had to spend precious time and resources looking for new coverage. The proposal passed by the House last week is aimed at addressing many of the shortcomings of the ACA by stabilizing insurance markets and beginning to bring down premiums. What's been missing from the opponents of the House bill, frankly, is an honest conversation about cost. The reality is that unless we address rising costs, the insurance market will continue to worsen for families, in terms of both access and affordability. Unfortunately, the ACA did not address the cost issue; instead it has led to steep increases in prices that have hit Minnesotans particularly hard. Rather than the one-size-fits-all Washington approach, we can empower states and consumers to take control of their own health care outcomes. This legislation will provide relief for the nearly 20 million Americans who have sought an exemption from the ACA's mandate or are paying the tax penalty. That's nearly double the number of Americans who have actually purchased insurance through the ACA marketplace. The bill empowers states to better design health care plans that meet the needs of their citizens. It provides a portable tax credit to assist Americans who do not receive coverage from an employer in purchasing health insurance. It enhances and expands the use of consumer-driven health care accounts, such as Health Savings Accounts, and it once and for all repeals the harmful medical device tax. It is also important to point out what is not in this bill. Nothing in this bill would allow an insurance company to deny someone coverage, including to those with a preexisting condition. Nothing would allow an insurance company to cancel someone's insurance policy should they become sick. Despite claims from opponents, the bill does not classify sexual assault as a preexisting condition. For those who maintain continuous coverage, the bill does not allow insurance companies to charge an individual more simply because they have a preexisting condition. It's also worth noting that this bill includes $138 billion to assist states in making sure everyone, including those with preexisting conditions, has access to high-quality, affordable health care. The legislation passed last week is certainly not the end of the road but instead a first step toward providing Minnesotans with a health care system that works for them. I will continue to champion other legislative ideas, including my initiatives on chronic care reform, treating and reducing obesity, and ensuring that seniors have access to rehabilitation services, all of which enjoy bipartisan support. At the same time, we must continue to have a thoughtful discussion on solutions that will provide high-quality, affordable health care coverage.