Insurance exchange bill clears final hurdle

The Minnesota health insurance exchange cleared its final hurdle Monday and is on the way to the governor's desk to become law.

State senators held a short, sharp debate on the legislation, which will create the online marketplace where more than a million Minnesotans could be shopping for health insurance by this time next year.

Sen. Tony Lourey, DFL-Kerrick, who was the lead bill sponsor, called it "a health insurance exchange that will work for industry and at the end of the day has the backs of the people of Minnesota as well."

It passed the Senate on a vote of 39-28, without a single Republican vote of support. It passed the House early Friday morning.

The exchange is a cornerstone of the federal health reforms and is supposed to make it easy to comparison-shop — online or over the phone — for health insurance policies that offer the best coverage at the best price range. The exchange is designed to serve the uninsured, the self-insured and small businesses that struggle to find affordable coverage for their employees.

Critics say the exchange bill was rushed through without sufficient checks on its $64 million budget or the power its seven-member board will wield over which insurance companies and plans will be offered on the exchange. Although the exchange bill started the session with some bipartisan interest and support, Republican support withered as the vote neared.

Senate Minority Leader David Hann said the bill could have gotten bipartisan support if the majority had accepted more Republican amendments.

Now that the exchange bill has cleared the Legislature, the real work begins. In coming months, insurance companies will begin submitting plans to the exchange. This has been one of the main sticking points of the exchange bill. Some wanted the board to have the power to pick and choose which plans will be offered to the public. Critics thought that was unfair to the insurance companies that went to the effort of crafting plans just for the exchange.

In the end, the Legislature offered a compromise, of sorts. For the first year, any qualified plan will be allowed into the exchange. After 2015, the exchange board will have the ability to select the plans it wants. The lawmakers who fought for this so-called "active selector" model feared that consumers would be overwhelmed by an avalanche of plans without some sort of quality-control filter from the exchange.

"I don't think this is the final step," said Rep. Terri Bonoff, DFL-Minnetonka, who pushed to give insurance companies more of a voice in the exchange. "I believe we have tackled a sweeping piece of legislation and that it's all right to come back at it if we think certain provisions we passed don't work."

Minnesota has just months to get the exchange up and running before it begins enrolling its first customers on Oct. 1. There is a massive database to build, call centers to staff and a population to educate about a marketplace that doesn't exist yet.

The bill now moves to the desk of Gov. Mark Dayton, who is expected to sign it into law later this week.