After two months, eight or nine committee hearings and almost 50 hours of debate, the House is set to vote on the creation of online marketplaces where more than a million Minnesotans could buy their health insurance next year.
Health insurance will be mandatory for all Americans, starting in 2014. The exchange is intended to help individuals and small businesses find the best and most affordable plans.
Supporters say the exchange will provide affordable health care to hundreds of thousands of people who are currently uninsured. Opponents fear it is too expensive, has access to too much personal information and could drive up the cost of health insurance for all Minnesotans.
But love it or hate it, Minnesota is getting a health insurance exchange. If the state doesn't produce a plan of its own by the end of the month, it will have to use an exchange set up by, and run out of, Washington.
Rep. Joe Atkins, DFL-Inver Grove Heights, author of the House exchange bill, said he would rather have Minnesotans calling area code 651 for help when shopping for a health plan, rather than Beltway area code 202. The exchange, he said, will drive down health insurance costs and even the cheapest policies in the exchange will offer better coverage than policies people could find on their own right now.
"Right now, as a small business person, it's really challenging for me to be in a competitive position with health insurers. They kind of have me by rear end, as far as being able to get a competitive bid," Atkins said.
An estimated 300,000 Minnesotans currently have no health insurance and supporters expect the exchange to eventually offer coverage to 1.3 million people and small businesses.
Creating the exchange will mean creating a massive network that will allow consumers to go online, enter information about their families, finances and needs and then comparison shop between plans and prices. It's a bit like the online sites that let people shop for the best rates on hotels or plane tickets – if those systems tapped into federal databases and countless health plans and cost over $60 million a year to operate.
Sen. Michelle Benson, R-Ham Lake, sees the exchange as a threat to Minnesota's standing as the state with "the best healthcare system in the country." She had many questions about the bills moving moving to the House floor Monday and the Senate on Thursday, including how they will be funded and how they will safeguard consumer's personal data.
"There are some significant problems," she said.
Minnesota is scrambling to meet federal deadlines. The health insurance exchange is supposed to start enrolling its first customers by October and the whole system is supposed to be up and providing health coverage by January.
"Is this going to be ready Oct. 1? This is one of the most significant IT projects in the state of Minnesota. It has to interact with health plans, it has to interact with state databases, has to interact with federal databases," Benson said. "How are we going to put 1.2 million people into the health exchange? … We haven't had the opportunity to test. We think this is really being rushed."
Even Gov. Mark Dayton, who lobbied unsuccessfully to get the previous Republican majority in the Legislature to work with him on an exchange plan, has concerns about assembling the exchange on the fly.
"This is a big gamble. I can't say it is going to succeed or not. It's a big attempt, it's a huge undertaking that's just gargantuan software to try to pull all this information on all these providers on a computer and have it be current and accessible and understandable. It's staggering. It's the law, it's federal law and we are going to make the best of it here in Minnesota," Dayton said during a Monday interview with Minnesota Public Radio.
The House debate begins at 3 p.m. and will likely continue well into the evening. More than 100 amendments have been filed on the bill.
