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GOP legislators hope to change health-exchange bill in conference

Republican lawmakers continued pressuring Democrats on Friday to compromise with the GOP on the implementation of Minnesota’s health insurance exchange.

The chambers of the DFL-controlled Legislature this week passed different versions of legislation to establish a state-based exchange along near party lines. Republicans have raised alarms about the Democrat-backed exchange since session began, and they say their concerns have largely been ignored.

Now lawmakers have to come together on a single plan and secure Gov. Mark Dayton’s signature on the bill before the end of the month — or face a federally imposed exchange. More than a year of executive branch labor and weeks of brutal committee stops and lengthy legislative debate have gone into avoiding that outcome.

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MinnPost photo by James Nord
House Majority Leader Erin Murphy said there are significant differences between the House and Senate versions of the health insurance exchange bill.

“As the bill came off the Senate floor last night, we have significant differences between the House and the Senate,” House Majority Leader Erin Murphy told reporters on Friday. “Next week a conference committee will be appointed and those differences will be ironed out.”

Supporters say the huge health insurance overhaul could affect 1.3 million Minnesotans and provide a one-stop shop for consumers and small businesses to compare and purchase coverage while also significantly reducing health-care costs.

Republican legislators largely ignored implementing an exchange, a key mechanism of the federal health-care reform law, during their stint in the majority over the last two years. Now that Obamacare is the law of the land, though, Republicans have come forward this session to attempt to shape Minnesota’s exchange legislation.

So far, they’ve been disappointed.

“This exchange results in more cost, less choice and no privacy,” Assistant House Minority Leader Kelby Woodard said on Friday, summing up GOP opposition to the exchange.

Republicans offered roughly 100 amendments to the exchange legislation ahead of the House vote on Monday and had even more on hand during Thursday’s 12-hour debate and eventual vote in the Senate.

Democrats argued that they did listen to Republican ideas by adopting 14 GOP-backed amendments in the Senate on Thursday.

'All voices were heard'

“We’re all a little tired,” Deputy Senate Majority Leader Jeff Hayden said Friday morning. “It was a robust debate, a spirited debate and one that we wanted to have. We think it was important that all voices were heard, and they were. Sometimes, over and over and over, but we know that’s the way it works around here and we think it’s important.”

But Republican lawmakers are looking for substantive, ideological changes to the exchange’s governing board and conflict-of-interest rules, regulatory model and data privacy practices.

Sen. Michelle Benson
Sen. Michelle Benson

“As we move forward, I hope the conference committee will listen very closely to the debate that was in the committees, the debate that was on the floor and come out with something that can be good for Minnesota,” said GOP Sen. Michelle Benson, an outspoken critic of the exchange. “Some Republicans could support it if there are significant changes, but if it comes out looking like it went in, it will remain a DFL exchange.”

It’s unclear if Republicans will have the opportunity to shape the bill through the conference committee process, which is where the final legislation will come together.

GOP Rep. Jim Abeler voted for the exchange — despite opposing the bill in its current form — in order to have a shot at becoming a conferee. Sen. Julie Rosen, who voted against the bill in her chamber, also said she’d like to be on the conference committee.

One DFLer opposed House bill

Rep. Laurie Halverson, a DFLer from Eagan, was the only Democrat in the House to oppose the exchange bill.

DFL Sen. Terri Bonoff of Minnetonka was the only member of her party in the Senate to vote against the legislation there.

“While I strongly support this exchange in concept, I see areas of improvement that I think should be addressed before it becomes law,” Bonoff said in an email.

Despite the sudden rash of input and small pockets of bipartisanship, Republicans didn’t seem particularly optimistic about their ability to meaningfully reform the exchange.

“I’m not holding out any great illusions of it coming out of conference committee any better than it is right now,” Rosen said. “I just hope and pray that it will work, and I’m sure we’ll be seeing it back here at the Capitol.”

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Comments (9)

Headline edit

Let me suggest a minor revision to the headline of this article that would more accurately reflect the situation as it stands. More accurately, the headline should read:

"GOP legislators hope to gut health-exchange bill in conference"

The GOP is receiving an election consequence - as it should be

The GOP should have thought about the Insurance exchange while they were in control in St Paul. Instead they chose social engineering and sexual escapades as their main contributions to the state of Minnesota. If the party were not run by a fringe element, if they were not conducting their war on women, minorities, and common sense their election outcome may have been different. The GOP's own stupidity will continue to take them down until they make meaningful changes in the direction of the party. So far there is not any indication they are moving in that direction. There is lip service, but no real changes. How many elections will they be willing to lose because they are on the wrong heading?

The republicans

Too little and too late

Health Exchange

The fallacy of the Health Insurance Exchange is that without individual underwriting, it isn't insurance. Beyond that, if you review the prerequisites of an insurable risk, most chronic health care is not insurable. Let's call it what it is - access to an entitlement program.

To bring up underwriting

To bring up underwriting standards in traditional insurance, in the context of implementing Obamacare, is absurd. We are not talking the old system where the big insurance companies could decide who has health insurance AT ALL, because of some pre-existing condition or a change in jobs.

This is a law requiring that everyone have, and pay for, health insurance. That's good.

What needs fixing?

What are the specific complaints these legislators (incl. Halverson and Bonoff) have about the way the exchange is taking shape?

Oh that's easy

They're not upset about the WAY the exchange is taking shape.

They're just upset about the FACT that the exchange is taking shape.

Obstructionists are never happy when progress occurs.

I'm in the health insurance

I'm in the health insurance industry and I agree that people need to get over it. The Affordable Care Act (ACA) is not going anywhere so you just need to deal with it.

Unfortunately, the word affordable should not be used in describing the ACA. This does not do one thing to lower costs. An MRI is still going to cost the same in 2014. An office visit is going to cost the same. These are examples of the things that drive health care costs. In Minnesota, on average 92 cents of every premium dollar goes towards paying claims. There is not a lot of waste here.

Quite franklly, In my opinion, we had a good thing going here in MN and the ACA is going to ruin it. We had guaranteed issue coverage for small businesses. A high risk pool (MCHA) for those who are declined for individual coverage. And one of the lowest uninsured rates in the US. It's actually quite hard to not have insurance in MN because of the many programs we offer. Unfortunately it is often portrayed that cost is the only reason people are uninsured. Yes, that is some of the people but not all of them. You'd be amazed just how many people don't know about the public programming available.\

I bring this up because the majority of your federal tax dollars will not be going to MN. They will be going to states that are way behind the insurance curve.

ACA

Unfortunately, ACA is the best Obama could get through the legislature. What was really needed was a universal single payer government run system along with compensation reform. But given how much the Republicans fought the bill as it was, this was the best that could be done. Not only fought, but continue to fight. Paul Ryan just submitted his 35th attempt to repeal ACA and our state Republicans have submitted over 100 modifications to the health care exchange in an attempt to derail it.

Business as usual is not going to fix the issue. ACA isn't the final step needed to get us to where we need to go, but it is a step in the right direction.