PUBLISHER'S NOTEBOOK:Health of Minnesota not served by partisan politics
Tuesday, April 02, 2013 4:32 AM
Perhaps the most important piece of legislation to come out of this session has - quietly for something of this magnitude - already been signed into law. Gov. Mark Dayton signed legislation Wednesday, March 20, creating a health insurance exchange in Minnesota, called MNsure.
There is little that is sure about this legislation, which creates a new marketplace for health insurance to comply with the federal Affordable Care Act, commonly known as Obamacare.
Starting in October, about 1.3 million Minnesotans, including 300,000 uninsured, are expected to shop and sign up for health plans using MNsure.
Little is known about this exchange, not only because of its complexity, but because the roles have changed - the DFL has replaced Republicans as the majority party - while the circumstances haven't - partisan politics rule. The legislation passed both the House and Senate without one Republican in favor.
As is usually the case with partisan issues, one side proclaims the legislation to be historic reform that is the best thing for the state in decades while the other party claims it's the end of the world. With such widely diverging opinions, it's difficult to know where the truth stands, so most Minnesota residents tune out the noise.
With such a new system it is difficult for even experts to predict what the ramifications will be and since it is also complex, it will take years before they are known.
While DFLers claim Republicans had input into the legislation, and to a certain extent they did even if not enough to support the final bill, DFLers ignored input from business interests, such as the Minnesota Chamber of Commerce, Minnesota Business Partnership and some insurance leaders, which claim now that their ideas could have made some big differences in making the exchange more efficient.
This isn't just a change in the way health insurance is delivered. By the time MNsure gets underway in October, about $300 million worth of federal and state tax money will have been spent to build it. And, it is projected to cost $68 million more every year to run it with most of that money coming from a tax levied on plans sold through MNsure.
The extra tax isn't the only thing to draw the ire of opponents. Rep. Jim Abeler (R-Anoka), said DFLers had a chance to win Republican support, but it didn't happen because they wouldn't agree to limit the power of the health exchange's board of directors or allow insurance industry representatives on the board.
That puts the focus on the next important issue to be addressed - Dayton's selection of six people to serve on MNsure's board of directors. Along with the state health commissioner, these people will ultimately make the decisions that will likely determine if the exchange is a success or failure.
The board needs to have a broad range of representatives, but this is hard to imagine if there are already restrictions in place. People with ties to big insurance providers are excluded by legislation, which makes some sense, but their perspective should not be ignored because, after all, the state wants broad participation in the exchange.
Already, there is concern about the level of participation. Insurers have until May 17 to submit their plans to the state for approval to be sold on the exchange. That's not much time for these firms to come up with broad plans.
Competition is what DFLers are counting on to aid consumers, but if they make the process difficult, it may not happen and the results won't meet the intentions.
MNsure is particularly important to rural Minnesotans, many who don't work for big employers with large group plans. The exchange initially won't be available to people covered under those large group plans.
The exchange will be an option for people in the state's individual and small-group markets - about 12 percent of the population - as well as the roughly 9 percent of residents in Minnesota public health insurance programs.
The hope is that the exchange will make it easier, and more affordable, for those people to get health insurance. It will also provide a mechanism for people to obtain federal tax credits that could significantly reduce out-of-pocket health insurance costs.
There is a lot to learn about MNsure. The state is scheduled to launch a public education and outreach campaign in May. A call center should be open by September, and enrollment begins Oct. 1 for coverage taking effect Jan. 1, 2014.
It could be a good thing for Minnesota, but it is off to a rocky start. We have seen the downfall of a narrow agenda based on partisan politics in the past several years when Republicans ruled the Legislature. That is one reason the Legislature flipped to DFL control.
DFLers appear to have forgotten the message voters gave: Minnesota works best when all voices come to the table to give input on the important issues facing this state.