In July, Ramsey County officials learned that an impasse between the HealthPartners health system and UnitedHealthcare over the insurer’s senior Medicare Advantage plans could kick 2,400 county retirees and spouses out of network, effectively excluding them from Regions Hospital in St. Paul, Lakeview Hospital in Stillwater and other HealthPartners sites.

Former county workers who spent 20 years or more paying into their employee retirement benefits now face the prospect of losing access to HealthPartners cardiologists, cancer care specialists and other doctors they or their loved ones have seen for years. With a Jan. 1 deadline to break the impasse approaching, Ramsey County Board Chair Victoria Reinhardt has been urging the county’s human resources department to explore a fix.

“UnitedHealthcare keeps saying, ‘oh yeah, we’ll work this out.’ HealthPartners seems pretty strong in saying, ‘No, we won’t,’” said Reinhardt on Monday. “They are still talking, but I don’t know that they’ll come to an agreement.”

“When you’re of retirement age, generally you want to stay with the same doctors that you had before,” she added. “I’m in pretty good health, but I’m 71 years old. Things change when you get older. You don’t want to change your doctor. It’s not that simple.”

Tuesday debate

On Tuesday, the county board will debate whether to approve up to $1.2 million to cover the county’s portion of the cost of a senior supplemental plan that retirees could opt into at higher costs than their current UnitedHealthcare Medicare Advantage premiums. The exact amount of monthly payments will vary with their date of retirement, date of hire and years of service.

Victoria Reinhardt (Courtesy of the Ramsey County Board of Commissioners)

Employees hired after Jan. 1, 2006 would not receive a county contribution toward the senior supplemental and prescription drug plan.

“It’s different for every person, because everyone gets a different amount,” Reinhardt said. “Is it going to be a lot more? If you don’t get a county contribution, it’s going to be about double.”

The supplemental plan aims to maintain county retiree access to HealthPartners sites in 2025, though it could be extended for up to three years, according to a staff report to the county board. It’s unclear, however, if the spending proposal has the votes to pass. One seat on the seven-member board is currently vacant.

Funding and other details

About 2,400 county retirees and spouses are insured by one of two UnitedHealthcare Medicare Advantage plans, and 45% of them — or more than 1,000 — rely on HealthPartners hospitals and clinics, according to the county. To cover the cost of the supplemental plan, up to $1.2 million would come from an existing 6% payroll surcharge, currently charged to all county departments, which covers vacation pay-outs, severance pay and the costs of other post-employment benefits.

“It’s one-time money,” Reinhardt said. “And it’s coming out of the retiree benefits reserves, which are set aside for that. It cannot be used for anything else. I think it will cost significantly less than that, but you’ve got to budget for the worst that can happen.”

Open enrollment for county retirees begins in late October. If the impasse between HealthPartners and UnitedHealthcare is broken by Dec. 31, the county would host a special open enrollment period for county retirees again in January, allowing them to switch out of the supplemental plan and back to the cheaper UHC Medicare Advantage program, according to the proposal.

And if retirees opt to leave the county system entirely and subscribe to a different health insurer on their own, without a county contribution, they would still be welcome back anytime in 2025 or 2026 under a one-time exception to the policy of permanently dropping enrollees who choose to leave the county’s retirement benefits programs.

“Normally if you leave, you can’t come back,” Reinhardt said. “We wanted to make sure if people chose to leave in 2025, they’d be able to get back into the county system in 2026.”

HealthPartners opts out

In July, HealthPartners informed some 30,000 seniors by letter that UnitedHealthcare has been denying Medicare Advantage insurance claims at a much higher rate — sometimes 10 times higher — than other insurers and forces unnecessary waits for medical care. The health system has said it won’t be making appointments with the insurer’s patients at all next year, even if they’re willing to pay much higher, out-of-network rates.

Also impacted are retirees from the city of St. Paul and the St. Paul School District.

It’s possible the next county board could choose to explore other health insurance options, though Reinhardt won’t be around to weigh in as an elected official.

Reinhardt, who has served on the county board for 28 years, is not running for re-election this November, and neither is Commissioner Nicole Frethem. Former Commissioner Trista Martinson stepped down in August to accept a position in county employment. That means three of seven county board members will be new come January.

“It is anticipated we will do a request for proposals for retirement health insurance sometime after the first of the year,” Reinhardt said. “It’s a new county board. Until they see all the things that come in, you can’t promise it. But I believe that will happen. But that one will be up to the next county board.”

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Vanderbilt and Arkansas were fined Monday for fans storming the field after upset wins last weekend, but the Gophers will not be docked for supporters flooding Huntington Bank Stadium after the 24-17 win over No. 11 Southern California on Saturday.

A Big Ten Conference spokesman told the Pioneer Press that Minnesota will not be subject to a fine, but shared a statement about the need for safety for people at games:

“The safety and security of student-athletes, coaches and staff is of upmost importance. The Big Ten requires host institutions to provide adequate security for visiting teams from their arrival for a game through their departure. If adequate security is not provided, there is a process in place that begins with a private reprimand for the first offense, public reprimand for second offense, and the discretion to implement a fine plus additional penalties for a third offense. We routinely review our policy as needed to ensure a safe environment for everyone.”

It appears the Gophers’ field storming is being treated as a first offense under a newer policy. Fans previously gathered on the field after its last Top 20 win over No. 18 Wisconsin in the Battle for Paul Bunyan’s Axe in 2021.

The Southeastern Conference has fined Arkansas $250,000 after its 19-14 win over then-No. 4 Tennessee because it is a second offense. Future offenses will cost the school $500,000. It was Arkansas’ first home win over a top-five opponent since beating No. 3 Tennessee in 1999.

Vanderbilt, a first-time offender, was fined $100,000 after its 40-35 win over then-No. 1 Alabama .It was the school’s first-ever win over a No. 1 team. Fans tore down a goalpost and dumped it in the Cumberland River, 2 1/2 miles from the stadium.

The Associated Press contributed to this story.

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Matthew Wilkinson never qualified for the state track meet. Now the former Gophers distance runner is an Olympian.

Now that a federal grand jury has handed up an indictment charging an alleged gunman with the attempted assassination of former President Donald Trump, a question remains about whether the state of Florida is being sidelined in its own investigation by a dispute with U.S. authorities over access to evidence.

In a Sept. 23 letter to FBI Director Christopher Wray and U.S. Attorney Markenzy Lapointe of the Southern District of Florida, state Attorney General Ashley Moody requested that both clarify whether the Justice Department intends to invoke a federal statute that reserves jurisdiction for federal law enforcement to investigate the case.

“If Federal investigative or prosecutive jurisdiction is asserted for a violation of this section, such assertion shall suspend the exercise of jurisdiction by a State or local authority, under any applicable State or local law, until Federal action is terminated,” the statute reads.

Moody, who authored the letter and posted it on her department’s website on Sept. 23, says both Lapointe and Jeffrey Veltri, special agent in charge of the FBI in Miami, raised the statute with two state officials shortly after the arrest of Ryan Wesley Routh, 58, who now stands accused of attempting to assassinate a presidential candidate, along with the commission of four gun-related violations. He has pleaded not guilty and is awaiting a jury trial without bail.

“To avoid any misunderstanding, I write to advise you that the State of Florida does not believe this provision has been properly invoked,” Moody told Wray and Lapointe of the jurisdictional limit.

She said Lapointe had raised the statute in a conversation about the case with Statewide Prosecutor Nick Cox, while Veltri discussed it with a state law enforcement official she did not identify.

“To be clear, I believe it would a grave mistake for the federal government to invoke this provision, and I urge you to cooperate with the state’s investigation rather than frustrate it,” Moody wrote. “In the meantime, however, we must advise our agents in the field and consider any legal course of action we may wish to take going forward.”

Moody asked Wray and Lapointe to respond to her letter by Sept. 27, which was 10 days ago.

It was not known if either official responded, or if they did, what they said.

Moody’s press secretary, Chase Sizemore in Tallahassee, did not respond to an emailed request for comment last week. Lapointe’s spokesperson at the U.S. Attorney Office in Miami, Sarah Schall, acknowledged receipt of a list of questions from the Sun Sentinel but had yet to provide responses.

Moody sent the letter shortly after Florida Gov. Ron DeSantis announced the state would conduct its own probe of the case against Routh, saying federal authorities had failed to appropriately charge the defendant.

After his Sept. 15 capture by local law enforcement on Interstate 95 in Martin County, Routh initially faced only a pair of federal weapons violations, charges that were seized upon by DeSantis and Trump as a dramatic understatement by the Justice Department of the gravity of events.

Two days later, on Sept. 17, DeSantis issued an executive order assigning the Office of the Statewide Prosecutor Florida to pursue a case against Routh in conjunction with the Florida Department of Law Enforcement and the Florida Highway Patrol.

“I have directed state agencies to move expeditiously and to provide full transparency to the public,” the governor said during a news conference, adding that he lacked trust in the ability of federal agencies to be transparent with the public about their investigation.

“‘Don’t you want to have investigative agencies that are just going to pursue this without any other agenda creeping in?” he asked. “I don’t think anyone can honestly claim that the federal government has been forthright and transparent about its past investigations.”

Critics called the DeSantis initiative a political exercise.

And on Sept. 24, a federal grand jury handed up an indictment charging Routh with the attempted assassination of a presidential candidate, in addition to four weapons-related charges. During a three-hour detention hearing the day before, Assistant U.S. Attorney Dispoto informed U.S. Magistrate Ryon McCabe that the government intended to  “ask a grand jury to consider a charge that the defendant attempted to assassinate Trump,” which carries a “maximum sentence punishable by life in prison.”

To date, no state charges have been filed.

Routh was arrested after a U.S. Secret Service agent spotted a firearm tucked amid shrubbery near the Trump International Golf Club on Summit Boulevard. The agent, assigned to Trump’s security detail, opened fire, prompting the suspect to flee in an SUV. He was arrested by law enforcement authorities about 45 miles north in Martin County.

The Secret Service has said Routh did not fire any shots and never had Trump in his line of sight, although court testimony from an FBI agent indicated the suspect’s AR-15 style weapon had been set up about 100 feet from the sixth hole, and Trump and his entourage had reached the fifth fairway during their afternon outing on Sept. 15.

The incident occurred only two months after Trump was grazed by a bullet and a bystander was killed at a rally in Butler, Pennsylvania. The gunman, who had stationed himself on the roof of a nearby building, was killed by law enforcement.

FBI investigators are shown at Trump International Golf Club in West Palm Beach on Sept. 16, one day after the arrest of suspect Ryan Wesley Routh, who has been charged with the attempted assassination of former President Donald Trump. (Amy Beth Bennett / South Florida Sun Sentinel)

Hands off?

Since the governor’s directive, it is unclear how much of an investigation state authorities have been able to conduct.

In her letter to Wray and Lapointe, Moody noted that state and federal agencies have frequently collaborated on criminal investigations, and that the alleged attempt on the former president’s life at the Trump International Golf Club in West Palm Beach was of high importance to Florida because it took place within the state.

“Because the second assassination attempt against President Trump occurred in Florida and was perpetrated against a Florida citizen, the State understandably desires to investigate violations of its own laws, including attempted murder,” Moody wrote.

“In light of the above, I was surprised to learn that FBI and DOJ officials have indicated they may not cooperate with the state of Florida or allow the state access to evidence already collected by federal agencies,” she wrote.

To cooperate, or not cooperate

In separate interviews, three people not involved in the Routh investigation agreed that state and federal officials have a history of collaborating in a variety of criminal investigations, including cases ranging from narcotics trafficking and money laundering to organized health care and securities frauds.

Palm Beach County State Attorney Dave Aronberg, whose office is not involved in the investigation, told the South Florida Sun Sentinel last week that while it is not unusual for federal and state agencies to collaborate, “what is unusual is a competing investigation based on mistrust, and that’s what the state has launched.”

“Fortunately, the state investigation is being led by Nick Cox who is a professional and doesn’t do politics,” Aronberg said. “He’s going to follow the evidence and the law. He’s a very likable person so he is going to have a good relationship with Markenzy Lapointe, who is another good guy.”

Aronberg said he doesn’t see the emergence of a “turf war.”

“Because the trial is going to happen sooner than later, the state can wait until the federal prosecution is completed before going full force into its own investigation,” Aronberg said. “I think the state will move forward to a limited extent. They will avoid any direct conflicts. For example, the state is not going to give immunity to witnesses because that could affect the federal case. Also, the state is going to depend on the federal government to access key evidence, including an interview with the Secret Service agent who could be a victim in all of this.”

Robert Jarvis, law professor at Nova Southeastern University in Davie, said it’s customary that the state “stands down if the federal government asserts jurisdiction. But the state does not have to do so — as a separate sovereign, it can prosecute the individual but normally does so only after the federal government has finished prosecuting the individual.”

“The U.S. Supreme Court has made it clear that a person can be prosecuted for the same crime by both the federal and state governments without violating the Constitution’s Double Jeopardy clause because of something known as the ‘dual sovereign doctrine,’” he added.

But Miami criminal defense lawyer David Weinstein, a former federal prosecutor, called a parallel investigation by the state a “bad idea.”

“They should be working in concert with the federal authorities,” he said. “The state case is going to take much longer. To have a state law enforcement agency re-interviewing the same witnesses is now going to create different statements by the witnesses and it’s a way for defense counsel to create reasonable doubt.”

Indefinite delay sought

In the end, the state might end up with all the time it needs to gather and evaluate evidence for whatever case it seeks to mount as federal prosecutors, apparently overwhelmed by the volume of evidence it has collected, need more time to evaluate all of it.

The trial, initially scheduled for Nov. 18 by U.S. District Judge Aileen Cannon in Fort Pierce, is now the subject of a request for a delay by the government.

Cannon, who dismissed the U.S. Government’s classified documents case against Trump last summer, is entertaining a prosecution motion to delay the Routh trial until an unspecified date.

On Thursday, Cannon responded to the request by giving Routh’s public defenders until Oct. 9 to file a waiver of the Speedy Trial Act, “along with a clear statement of Defendant’s position with regard to the ends of justice being served by the United States’ request.”