Work begins on Minnesota health insurance exchange

Minnesota is taking the first step toward sweeping changes in the way more than a million of its residents and businesses buy health insurance.

A bipartisan coalition of lawmakers gathered at the Capitol on Wednesday to introduce long-delayed legislation that will set the groundwork for Minnesota's new health insurance exchanges. The system, a cornerstone of the federal Affordable Care Act, will allow consumers to shop online for their health coverage and choose the plans with the best coverage at the best price.

"A year from now, as a result of this legislation, I hope to be able to have Minnesotans buy their health insurance on a device like this or on their home computer," said the chief House sponsor, Rep. Joe Atkins, DFL-Inver Grove Heights, holding his iPad aloft. "The magnitude of this legislation is that 1.3 million Minnesotans are expected to be able to purchase their health insurance online."

The health exchanges were mired in partisan gridlock last session. Now, with a Democratic governor and a DFL-controlled Legislature, the bill is on a fast-track for passage and backed by moderate Republicans who would rather work on a state-based plan than wait for one to be imposed on Minnesota by Washington.

"When someone needs help, I would much rather be calling the area code of 651 rather than the [Washington, D.C.,] area code of 202," said Rep. Greg Davids, R-Preston, who is co-sponsoring the bill despite what he said are "major concerns" about parts of the legislation.

Lawmakers will have less than three months to sign off on the exchange before a March 31 federal deadline. The legislation introduced Wednesday lays the groundwork for how the online health insurance marketplace will operate. It will be governed by a seven-member board that will decide which plans will be offered to the public. Among the million-plus Minnesotans expected to use the exchange are 300,000 who are now uninsured.

The bipartisan show of support is an abrupt shift from the tensions that marked the health care debate last year. The Republican-controlled Legislature refused to even bring a health exchange bill up for debate.

Not everyone's on board

But the bipartisan spirit did not extend to Senate Minority Leader David Hann, R-Eden Prairie. Hann considers the exchanges expensive and unnecessary and would just as soon see Minnesota join the ranks of the 30 states that are refusing to come up with their own exchange plans in protest.

"Going forward, there will be Republicans who will work with Democrats to try to mitigate what they see as a damaging [policy] and try to make it as palatable as we can," Hann said. "But there are 30 states that elected not to do that and I frankly think that's a better idea."

It's not yet clear how much it will cost to set up the exchange, although the federal government is shouldering much of the expense. Once the system is running, it will be funded by an estimated 3.5 percent surcharge on the premiums of the plans purchased through the exchange.

Federal aid

Once the Legislature approves the exchange, consumers could begin enrolling this October and health care coverage would begin on New Year's Day 2014. It's estimated that one out of every five Minnesotans might use the exchange.