file, Star Tribune
"The 2013 deadline poses a potential challenge for many states, particularly those that have not yet taken significant steps to establish an exchange.''
Source: Kaiser Family Foundation Focus Report on health exchanges, July 2011
Editorial: An ill-timed health reform blame game
- August 18, 2011 - 10:04 PM
The Minnesota Legislature failed this session to accomplish one of its most important tasks: laying the groundwork for the state's health insurance exchange, a task that the state's business community has repeatedly urged legislators to prioritize.
Now, as other states move forward on this critical issue, the state Republican legislative leadership is trying to deflect blame for its own dithering.
In a Tuesday news release and news conference, lawmakers including Sen. David Hann and Rep. Steve Gottwalt blasted Gov. Mark Dayton's administration for seeking federal planning grants for the new online health insurance marketplace, charging that the administration was acting "behind closed doors.''
GOP officials conveniently did not mention that exchange bills went nowhere in a do-nothing Legislature this year while 13 other states enacted legislation. Two states -- Utah and Massachusetts -- already have exchanges, which allow consumers to comparison-shop for health plans while insurers compete for their business.
The landmark 2010 federal health reform law requires each state to have a health exchange up by 2014 and to have made significant progress by Jan. 1, 2013.
The secrecy charges are a stretch. Forty other states have gotten exchange planning money -- there's nothing nefarious about doing so. And it's hard to argue that administration officials hid what they were doing when they issued news releases and when there was a placeholder in the budget for federal planning funds.
While the Dayton administration could have done more to communicate with GOP leadership, it was clear that legislation to implement an exchange was going nowhere this session. The administration needed to keep things moving so that the state didn't fall further behind.
Republican lawmakers also could have checked in more often with state officials. Concerns about the GOP's input -- or lack thereof -- should have been handled with phones calls long before now instead of a news conference after the session's end.
Some states, such as Indiana, may set up exchanges through an executive order. But lawmakers and state officials should be partners on this issue and should seek extensive input from consumers and the health care industry.
Lawmakers' inaction means that Minnesota is a laggard -- an embarrassing development for a state that's long been a health care leader. But the Legislature's inaction this session does not mean that the Dayton administration should move too far forward on its own.
As Gottwalt said on Thursday, there are other ways for lawmakers to be involved short of passing legislation. And he's right in arguing that the exchange is too important to let its design default to the administration.
At the same time, the GOP needs to act, not bow to the anti-Obamacare absolutists in the party.
Ignoring the issue won't prevent an exchange in Minnesota. Federal officials would step in with a one-size-fits-all model without progress by 2013.
Key exchange decisions should be made here -- which insurance plans will be sold on the exchange, for example. A smartly designed exchange could help hold down costs by prioritizing plans that deliver affordable, quality care.
Health providers and plans, and the Minnesota Chamber of Commerce have long urged policymakers to act.
On Thursday, the chamber said again: "We continue to support an exchange customized to Minnesotans rather than having one imposed by the federal government. We encourage the Legislature and governor to work together for an exchange that works for Minnesota."
The GOP's news conference indicated the process isn't working yet in Minnesota. Cooperation -- not angry sound bites -- is needed to move forward.
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