Last month, after much debate, Gov. Mark Dayton signed legislation establishing a competitive online marketplace where Minnesotans will be able to choose the quality health insurance they need at a price they can afford.

The Minnesota Health Insurance Exchange, now known as “MNsure,” is the most significant health insurance reform Minnesota has seen in 50 years. For the first time in state history, consumers will be on the same level playing field as the insurance companies. Health insurers will have to compete for consumers’ business.

Health insurance exchanges have long earned the support of both political parties. The concept originated with the Heritage Foundation, a conservative think tank. Before President Obama included exchanges in the Affordable Care Act, former Minnesota Gov. Tim Pawlenty and former Massachusetts Gov. Mitt Romney supported state-based health insurance exchanges.

Rather than accepting a one-size-fits-all, federally mandated exchange, Minnesota took the opportunity to build an exchange tailored to meet the needs of its residents and the state’s exceptional health care system.

As a result, an estimated 1.3 million Minnesotans will access high-quality, affordable health insurance by using MNsure, including 300,000 uninsured Minnesotans and 155,000 small-business employees. Minnesotans will save an estimated $1 billion by 2016 through the exchange, with the average premium dropping by 30 percent and the average family saving $500 annually.

Small businesses — which currently pay 18 percent more on health care than larger businesses — will save up to 7.5 percent on premiums by leveraging their buying power.

In Massachusetts, where there is already an exchange thanks to Romney, individuals have seen premiums drop by 21 percent, and families have seen a 40 percent decrease. In the rest of the nation over the same period, premiums have increased by 13 percent for individuals and 14 percent for families.

In Minnesota, uncompensated care costs will decrease by more than $150 million as people seek more preventive care and use emergency rooms less. Every taxpayer will benefit from those savings.

A recent commentary by Republican state Rep. Jim Abeler (“More cost. Lower quality. Less choice,” March 19) embraced the concept of an exchange but criticized how the Legislature financed it. The law funds MNsure through a small user fee on premiums of up to 3.5 percent of the premium cost for those who use the exchange. Estimates for actual costs are well below that, closer to 2 or 2.25 percent. This makes the exchange self-sustaining, so we won’t need to appropriate money from the general fund every year.

With a federal exchange, Minnesotans would have been forced to pay a locked-in 3.5 percent fee on premiums. I am glad the Legislature chose the more affordable option for Minnesotans.

Abeler also speculated that those who govern Minnesota’s exchange would be unaccountable to the public. That claim is false. The board chosen to manage MNsure will be appointed by the governor and confirmed by the Legislature — all elected officials accountable to the public. This board will be subject to oversight from the legislative auditor and the Legislature through mandated annual reports and independent third-party audits required by the Affordable Care Act.

The legislation also prohibits anyone who works for health insurance companies from serving on the board, avoiding a clear conflict of interest that would not serve the best interests of Minnesota consumers.

The exchange legislation received 73.5 hours of committee hearings in the Legislature, and 109 amendments were offered. Dozens of Republican amendments were accepted, especially in areas such as data privacy and oversight. While Republican opposition to the Affordable Care Act and Obama may have prevented Abeler and his colleagues from voting for the Minnesota exchange bill, it was crafted with their input and improved by their amendments.

Change is difficult. In the years ahead, we will be working on and improving this law, as we do with all laws. I expect that within a few years, Minnesotans will consider the health insurance exchange a part of the common good of our state, the same way we think of Medicare today.


Joe Atkins, DFL-Inver Grove Heights, is a member of the Minnesota House.