MNsure: Legislators likely to keep hands off health exchange this session

Key DFL lawmakers don’t want to act on legislative changes to MNsure this session, making it very unlikely that the health exchange will be substantially transformed through political action.

Republicans have introduced a bunch of bills – many of them amendments they proposed to the initial MNsure legislation last year – to reshape its governing board authority, legislative oversight and budgeting process.

With the passing of the first legislative policy deadline last week, those bills appear to be going nowhere.

And a proposal from DFL Rep. Tina Liebling to address the wide variance in insurance rates across the state also appears dead. That measure had received one hearing.

“We want to make sure that they’re able to do the job that they’re doing without making tremendous changes to it right now as they’re just getting on their feet,” House Majority Leader Erin Murphy said in an interview. “Right now I don’t think it’s likely.”

House Commerce Committee Chairman Joe Atkins, who sponsored the MNsure legislation last year, said he didn’t want to spend too much time on the exchange this session.

And Gov. Mark Dayton criticized Republicans last week when asked about a letter GOP lawmakers sent to him asking for the federal health law’s enrollment penalty to be postponed in some way. That penalty takes effect next week.

Republicans say the potential MNsure issues they predicted last year have come to pass.

“Many of the questions we raised last year at exactly this time — questions that we asked and should have been answered then — a lot of those issues have come into fruition now one year later,” said Rep. Tara Mack, who co-wrote the letter to Dayton.

“And that’s not an ‘I told you so,’ ”she said in an interview. “That’s just how it happened.”

Democrats argue that their political opponents across the aisle are simply using MNsure’s rocky launch to bolster their election-year efforts.

“They’re rooting and doing everything they possibly can to make MNsure look bad,” Dayton said at a press conference last week. “They’re very blatant about it.”

To be sure, MNsure’s initial technical and enrollment failings provided political fodder to the Republicans and a massive headache for Democrats. But since the lowest of the lows, the exchange has changed leadership, resolved technical glitches and reduced long call-center wait times.

At least 130,000 people have signed up for coverage using MNsure, which is close to the exchange’s initial enrollment goal — one that looked out of reach late last year.

Still, such Republicans as Sen. Michelle Benson, who sits on the exchange’s legislative oversight body, have a list of changes they’d like to see in the fledgling organization.

Although they don’t support MNsure, Benson and other Republicans have said that they’re willing to work with Democrats to improve the exchange.

“I don’t think MNsure is the solution for health care in Minnesota, but if we’re going to have it, it has to work well — and it’s not,” Benson said, rattling off a list of changes she’s introduced this session.

Those include:

• Removing the “active purchaser” provisions (PDF)  from the exchange,

• Instituting more legislative oversight of the governing board’s decision-making and MNsure’s budget,

• Removing administrative exemptions for rulemaking,

• And limiting the sort of fees the exchange could levy on health insurance carriers.

Rep. Matt Dean has similar proposals in the House, but Dean said he hasn’t been able to get a hearing on his legislation.

“I’m not quite sure why they wouldn’t want to fix it,” he said. “It’s really broken.”

Liebling, who chairs the House Health and Human Services Policy Committee, also faced difficulty with her proposal to examine why insurance costs vary so much across the state. Those disparities are particularly evident in Rochester, which she represents.

Since her committee approved the bill in mid-March, there hasn’t been much movement.

“The bill, I don’t think, is going to progress this session,” Liebling said in a recent interview, citing Atkins’ reluctance to hear MNsure bills during this year’s short legislative session.

But, Liebling said, it’s important to keep in mind where Democrats are coming from.

“The whole goal of everything we’re trying to do here … is to be able to have Minnesotans have access to health care at an affordable cost when they need it,” Liebling said. “It’s a very complicated issue and it just – as we see – is not accomplished in a day.”