The Ramsey County Board voted 5-1 on Tuesday to put $1.2 million toward a supplemental health insurance plan for county retirees, with the goal of maintaining access to HealthPartners hospitals and clinics next year for former county employees subscribed to the UnitedHealthcare Medicare Advantage program.

The board noted the one-time spending will come from the county’s post-employment benefits fund, which is fueled by a 6% payroll surcharge charged to every county department, but the effort falls far short of a cure-all, given premiums that could in some cases double under the supplemental plan.

With the same goal of ensuring retiree access to Regions Hospital and other HealthPartners sites, the St. Paul Board of Education, or school board, is scheduled to vote Tuesday evening on a $3.5 million contribution toward its own supplemental health insurance plan for UHC Medicare Advantage subscribers.

HealthPartners and UHC continue to be locked in a dispute over claim denials, and HealthPartners informed some 30,000 UHC Medicare Advantage subscribers this summer they will be considered out-of-network in 2025 and not be able to access Regions Hospital and other HealthPartners sites next year unless the dispute is soon resolved. Thousands of city of St. Paul, St. Paul School District and Ramsey County retirees are among those impacted.

Ramsey County Board Chair Victoria Reinhardt and Commissioner Nicole Joy Frethem (Courtesy of Reinhardt and Frethem)

“I don’t feel like we can put our retirees out, hanging out on a limb, because they’re having a fight that we, again, had nothing to do with,” said Ramsey County Board Chair Victoria Reinhardt, a lead proponent of the supplemental plan. “No one should be put in this position.”

She noted that county retirees who opt for the pricier supplemental plan would be able to switch back to the cheaper UHC Medicare Advantage program next year if the two sides come to an agreement by the end of the year.

County Commissioner Nicole Frethem, who cast the sole “No” vote against the $1.2 million county proposal, said the county should instead be dedicating those dollars toward employee benefits for existing workers, rather than rewarding UnitedHealthcare with extra spending. The county is currently in labor negotiations, and benefits are part of that discussion, she noted.

“I have concerns. I could see an action going two ways. It could reassure our employees we will keep with the spirit of our commitments … or it could make a challenging (labor) negotiation even harder,” Frethem said.

Cheapest option isn’t always the best

Frethem said her own uncle had complained to her that the county had not stepped up to protect retiree health insurance benefits.

She said that perception was wrong — the county was unfairly roped into an ongoing dispute between a health system and a for-profit insurer.

“I am really frustrated that we could be spending up to $1.2 million, that we could be spending on our current employees, to bail out UHC and HealthPartners,” she said. “Why is it not UHC’s responsibility to provide that breach in coverage? … You need to work it out. Put on your big kid pants and work it out. … This is not an easy decision.”

Frethem and other members of the county board urged state lawmakers to get involved and promote a public healthcare option.

County Commissioner Rafael Ortega said the supplemental option is “not perfect, but given the stories that some of the retirees are facing serious health issues, it’s not just a matter of changing doctors. They’re in the middle of treatment.”

He said the county should look for a new health insurance vendor in early 2025, and the cheapest option might not be the best one.

“Quite frankly, we went with the lowest bidder as part of our criteria, and we really need to look at that in the future,” Ortega said. “I think the first thing we do next year is put out a (request for proposals).”

On Monday, a spokesperson for HealthPartners said negotiations with UnitedHealthcare were still underway. A spokesperson for UnitedHealthcare released a written statement on Tuesday making similar claims, but no further information.

“We are currently engaged in good-faith negotiation with HealthPartners,” reads the unsigned statement from UnitedHealthcare. “Our goal is to renew our relationship and ensure continued, uninterrupted network access to the health system. We hope HealthPartners continues to engage with us and work toward a new agreement.”

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