State starts shaping health exchange

  • Article by: JACKIE CROSBY , Star Tribune
  • Updated: November 8, 2011 - 9:26 PM

Minnesota must make its case for a plan by 2013, or use a federal exchange.

Blocks away from the Capitol, where a fresh round of partisan bickering erupted over health care on Tuesday, a newly minted task force began chipping away at the daunting task of helping the state create a health care exchange.

States have until Jan. 1, 2013, to prove to the federal government that by 2014 they'll have exchanges up and running at which people can buy affordable coverage. States that can't make the case will have an exchange imposed on them by the feds.

"Slapping a one-size-fits-all exchange on Minnesota is not the best approach," said Commerce Commissioner Mike Rothman, who convened the inaugural meeting of the 15-member task force at the St. Paul RiverCentre.

The exchanges, a key part of federal health reform law, aim to create a simple way for people to buy affordable health insurance by allowing them to easily compare costs and benefits among a range of plans. Minnesota's advisory committee includes representation from consumer groups, businesses, Indian tribes, the health care industry, mental health advocates and unions.

The group will help design a plan, tackling such issues as who will be eligible, what kind of body will oversee it, and what kind of technology can be used to safeguard privacy.

"We're at the point where we have little time to waste in harnessing our expertise to set up an exchange for Minnesota," Rothman said.

Other states are farther along in the process. Twelve have voted to set up exchanges, with Illinois and North Dakota scheduled to take up legislation this week. Eight other states are moving forward on executive orders.

The types of exchanges vary. Indiana's and Hawaii's are operated by nonprofits. Those in Rhode Island, Utah, Vermont and West Virginia are run by state agencies.

A public-private partnership governs exchanges in California, Colorado, Connecticut, Maryland, Massachusetts, Nevada, Oregon and Washington.

The notion of creating an exchange by Minnesotans and for Minnesotans has broad support, though it's not unanimous by any stretch. It is backed by the Chamber of Commerce, Minnesota Business Partnership, the Council of Health Plans, and consumer advocacy groups.

Legislators from both sides of the aisle have voiced support for the idea, which was first proposed by Republican Gov. Tim Pawlenty in 2007. But many GOP lawmakers now oppose the exchanges, including a cohort of newly elected Republicans who campaigned on their opposition to federal health law.

An exchange bill introduced by Rep. Steve Gottwalt, R-St. Cloud, never got out of committee last session.

On Tuesday, Gov. Mark Dayton and state Sen. David Hann, R-Eden Prairie, got into a spat over a $25 million federal grant aimed at sick, disabled and elderly Minnesotans. Dayton accused Hann of blocking it; Hann said he merely asked for "further review."

Noticeably absent at the task force were two seats reserved for Republicans from the House and Senate, though two Democrats attended. A spokesman for Senate Republicans said they don't plan on participating, at least for now, given lingering concerns about the governor's actions.

Task force members expressed concern about making sure the exchange addressed disparities among groups that currently don't have access to affordable care.

Some legislators fear that Dayton will try to go around them and move forward on an exchange with an executive order.

Dorii Gbolo, CEO of Open Cities Health Center, wanted to know how the final outcome will be shaped.

"Who'll make the decision?" she said. "Oftentimes, the final product doesn't look like you thought it would."

Staff writer Warren Wolfe contributed to this report. Jackie Crosby • 612-673-7335

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