Minnesota Legislature OKs Far-Reaching Health Plan : Medicine: Plan would subsidize costs for low-income people not otherwise protected. It calls for a tax on health care providers, cigarettes.

Overcoming fierce resistance from segments of the state’s medical community, the Minnesota Legislature has enacted the most far-reaching legislation in the country to expand access to health care insurance for hundreds of thousands of its citizens.

The measure, known as Health-Right, was the product of a bipartisan task force of state legislators. It cleared its final legislative hurdles Thursday night. Republican Gov. Arne Carlson, who vetoed a more costly plan last year, has said he will sign it.

The Minnesota plan, which will offer state-subsidized policies to an estimated 370,000 uninsured persons on a voluntary basis and will be funded by a tax on health care providers and a 5-cent increase per pack in the state cigarette tax, is the latest example of a growing national tendency for states to confront the health care crisis directly rather than waiting for federal action.

The plan would make available state subsidized health insurance coverage to low-income Minnesotans who are not eligible for the federal Medicaid program. These people, many of whom have jobs but are not provided health insurance for themselves and family members as part of their employment, account for most Minnesotans who were uninsured during at least part of last year.

However, because the program is voluntary and requires payment of a premium on a sliding scale based on income, it is not known how many will decide to sign up. Initial projections were that about 160,000 uninsured residents would enroll, at an estimated cost of $315 million.

The plan does not require federal approval to be implemented, and does not require employers to offer health insurance to employees. Instead, it targets Minnesotans who fall in the gap between those with access to employer-provided or other private health insurance they can afford and those who are eligible for various federal and state health care programs for the poor, such as Medicaid.

The availability of subsidized health insurance coverage will be phased in beginning with children and their parents this fall and will be fully implemented by July, 1994. The coverage emphasizes preventive health care services and includes a $10,000 a year limit for in-patient hospital care, one of several compromise provisions adopted at the last minute to hold down the projected cost.