Democratic-NPL gubernatorial candidate Tim Mathern unveiled his health care plan on Tuesday, which he said would help expand health insurance coverage to about 65,000 uninsured North Dakotans.

"Health care is breaking the banks of too many middle-class families," Mathern said during a Tuesday press conferenceat St. Alexius Medical Center. "The health care system as we know it is headed for a meltdown."

His plan, which also includes a state-sponsored loan program for rural hospitals and preventative medicine incentives, would cost about $134 million every two years if approved by the Legislature.

Mathern, a state senator from Fargo, said he would increase the maximum income level to enroll children into the state Children's Health Insurance Program from 150 percent of the poverty line to 200 percent or $42,400 for a family of four.

Mathern said about 15,000 North Dakota children go without health insurance, but his Republican opponent Gov. John Hoeven said many of those children are eligible for SCHIP and have not applied for coverage.

"We have to do more outreach," Hoeven said on Tuesday. "We are working very hard to get these people enrolled."

Mathern also offered a plan to extend health care to an estimated 50,000 North Dakotans without health insurance. Under his plan, those people would be able to buy into a state employee health insurance plan that would be more affordable because its price is determined by a state bidding process, Mathern said.

Rural hospitals also would be able to apply for low-interest loans from the Bank of North Dakota to help pay off debts as a result of sluggish Medicaid reimbursements, Mathern said. He said 22 of the state's 27 rural hospitals are in the red.

"There is a fundamental flaw in the health care reimbursement," said Kimber Wraalstad, the chief executive officer of Presentation Medical Center in Rolla who joined Mathern at his Tuesday press conference.

Wraalstad said equipment in hospitals is out of date and is more than 2 years older on average when compared to other hospitals nationally.

Hoeven, in response to Mathern's call for quicker state-funded Medicaid reimbursements, said federal Medicare reimbursements are a larger problem.

Chip Thomas, president of the North Dakota Healthcare Association, said both candidates bring up valid points: Medicare and Medicaid reimbursements need to be fixed.

"(Rural hospitals) are facing some financial challenges and if we don't get some financial solutions for them they're going to facing some difficulties," Thomas said.

Mathern also addressed preventative medicine in his plan, which he said would save the state $2.1 billion over time if less people are sick and not missing work.

He said he would give employers things such as tax credits if they could promote a healthier workforce, adding all schools in the state should have physical education programs.

(Reach reporter Brian Duggan at 223-8482 or www.bismarcktribune. com.)