A 15-member government task force on Wednesday debated a list of basic principles for a Minnesota health care exchange, highlighting strongly divergent views about the role health insurance plans and brokers should play.
The hot-button topic remains what type of body should govern the exchanges, a key component of the 2010 federal healthcare reform law that calls for the creation of a competitive marketplace in whcih individuals and businesses can comparison shop for health insurance.
Industry representatives argued that their expertise in health care will bring efficiencies to the process, while community-based panel members worried about conflicts of interest and leaving out consumers and marginalized communities.
The divisions showed up in discussions about the size of the board of directors. Advocates such as Sue Abderholden, executive director of the Minnesota Alliance on Mental Illness and Dorii Gbolo, CEO of Open Cities Health Center, swayed the group to vote in favor of a larger board of 15 to 20 members.
They were among those arguing that a larger group opened the way for more community involvement that might address health care disparities in the state.
As for the makeup of the board, Phillip Cryan, a health policy specialist with the Service Employees International Union in St. Paul, wanted to draw a "bright line" and prohibit anyone working for or affiliated with insurers or brokers.
Dannette Coleman, a vice president and general manager at Medica, argued against an "us versus them" mind-set. She argued that having a few board members who work in the insurance industry would be vital, given that they know how to run call centers and have expertise in handling millions of claims a year.
"We're not selling hammers on the exchange," she said.
In the end, the task force voted on a compromise that limited board members with conflicts of interest to a "small minority."
The task force is chaired by Commerce Commissioner Mike Rothman, whose office will regulate the exchanges. The group's action on Wednesday was the first major step in the process of designing the exchange.
The vote on what Rothman called “guiding principles” also addressed competition, risk pools, the role of navigators and assuring that hard-to-reach populations don’t fall through the cracks.
“We wanted to find a consensus so it would guide all of us - all Minnesotans - in developing an exchange,” he said.
Minnesota, like other states, has until the end of the year to prove it can get an exchange running by 2014, or else the federal government will impose its own version. As many as one million Minnesotans may be eligible, including those on public assistance, individuals without insurance from their jobs and those who work for small businesses.
The health care exchange is certain to be one of the biggest battles of the upcoming legislative session. Last year, a bill to set up a Minnesota-made exchange didn’t get out of committee. While there’s broad support among Democrats and some business groups, including the Chamber of Commerce, Republicans are divided. Some support a state-designed program, while a vocal contingent opposes all elements of federal health care reform law, including the exchanges.
Two DFLers have participated on the task force since it launched in November; two seats reserved for Republicans have been empty.
Jackie Crosby • 612-673-7335