Legislators will offer dueling bills on how insurance marketplace should be organized -- or restricted.
Two DFL legislators on Monday fired the first salvo in the partisan war to shape how upwards of 1 million Minnesotans buy health insurance by 2014.
Within a week, said Sen. Tony Lourey, DFL-Kerrick, and Rep. Joe Atkins, DFL-Inver Grove Heights, they will offer bills to establish a federally mandated "health care exchange," essentially an online marketplace where individuals, families and small businesses can shop for appropriate insurance coverage.
A few hours later, a chief critic of the concept, Sen. David Hann, R-Eden Prairie, said he and others soon will offer bills to limit what an exchange might do.
Not only are there dueling legislators. Their work is fueled by competing task forces, at work since last fall.
About 100 people representing insurance, health care, state agencies, advocacy groups, businesses and the Legislature are at work on the governor's task force. Republican legislators declined to participate, concerned that the presence of their four members among 22 on the task force would allow Gov. Mark Dayton to claim bipartisan support.
The Republican Party has had its own task force at work since fall, with 20 to 30 legislators and people from business involved, said Hann, chairman of the Senate Health and Human Services Committee. Last year he threatened to sue Dayton to stop implementation of an insurance exchange.
"I've glanced at the [Dayton task force] report, and so far I don't see a description of a problem or a solution to a problem," Hann said. Republican bills will limit what an exchange can do and protect insurance agents, consumers and businesses, he said.
"We'll have to see the [DFL] bills, but it looks like this is just saying we want to implement Obamacare -- a law I think is unconstitutional and is now before the Supreme Court."
The Accountable Care Act and its state health insurance exchanges also has been derided by Republican presidential candidates and is sure to be a core election issue.
Task force proposals
The first glimpse at what might go into the DFL bills came Monday when Dayton and Commerce Commissioner Michael Rothman unveiled preliminary recommendations from the task force, including Atkins and Lowery, that Dayton appointed in November.
The exchange would serve people without employer-sponsored coverage, small businesses with 50 to 100 employees, and people on Medicaid, MinnesotaCare and other state programs. Many would qualify for subsidies.
Among the Dayton task force recommendations:
•The exchange should be led by a board of 15 to 20 people, some appointed and some elected by the board itself, in a public-private partnership. Most should represent consumers and small businesses, and a "small minority" could have conflicts of interests, including working for health insurance companies.
•A wide range of "navigators" -- including insurance agents, advocates and people from health clinics, ethnic organizations and faith-based groups -- would help those who need assistance shopping for insurance.
•To avoid some insurers getting hit with the most-expensive patients, the rules should be the same for policies sold inside and outside the exchange, and should promote competition, innovation, health improvement and affordability.
•It should be financed by those who benefit, including Medicaid, but not unfairly burden businesses or other groups, starting by July 2013 to help fund the navigators.
Battle lines forming
"There's still a lot of work to do, but this is a logical, practical way to improve health coverage and health care itself," Lourey said.
"I've been talking with some of my colleagues on the other side of the aisle," Atkins said. "The positive feedback that I've gotten makes me very optimistic that we can get this done in a bipartisan fashion this year."
Hann said he's ready for the battle: "This is an attempt to get federal takeover of health care and health insurance, and most people, when they know that, will oppose it."
Warren Wolfe • 612-673-7253