The House is set for its final vote on legislation that will change the way one out of every five Minnesotans shops for health insurance.

House and Senate negotiators have hammered out the final version of the new Minnesota Health Insurance Exchange; one that strips out abortion restrictions and settled nagging questions about how the exchange will be funded and how much power its board will have.

An estimated 1.3 million Minnesotans are expected to use the exchange, including 300,000 who are currently uninsured. The exchange is supposed to be up and running by January 2014.

With a federal deadline looming, the House debate began at 4 p.m. The Senate, which debated the exchange for 12 hours before passing its version of the bill last week, is expected to begin its final debate next Monday.

The insurance exchange is a cornerstone of the Obama administration's Affordable Care Act. If the Minnesota Legislature does not pass its exchange bill before the March 31 deadline, the state will have to use an exchange designed by, and run out of, Washington, D.C.

The exchange compromise that came out of the conference committee Wednesday night favored the House’s funding mechanism – a 1.5 percent to 3.5 percent user fee on insurance plans sold through the exchange. The Senate bill would have paid the exchange’s estimated $60 million annual budget with tobacco tax revenue out of the general fund.

The other major difference between the two exchange bills was the amount of authority its seven-member board will have to decide which plans will be offered on the exchange. The exchange will be an online marketplace where individuals and small businesses can shop around for the best rates for health insurance. Insurance companies don’t want the board to limit the number of plans the marketplace will offer.

In the end, conferees favored the Senate version, which gave the board greater authority to pick and choose the plans that will go on the exchange – the so-called “active purchaser model.” But that power won’t kick in until 2015, a year after the exchange is up and running.

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