MNsure debut is a civic milestone

At the heart of the long, bitter debate over the 2010 Affordable Care Act has been this question: Will it work?

Today, with the historic expected opening of MNsure and other states' new health insurance marketplaces for enrollment, consumers and small employers no longer have to listen to experts or politicians with vested interests tell them how they'll be affected by the health reform law.

Now they can decide for themselves by going online to comparison-shop for coverage and to get individualized information about monthly premiums, provider networks and financial assistance available to many in the new marketplaces' target audience: those who are uninsured or buy coverage on their own, as well as employers with two to 50 staffers.

(Those who get coverage through larger employers or through Medicare won't need to use the new marketplaces.)

The marketplaces' launch, and the knowledge consumers will now have, should mark a turning point in the debate over the landmark law. Facts should replace the speculation that has yielded the toxic battle in Congress to tie the law's existence or rollout to federal budget talks.

While not everyone will find that the ACA yields a good deal, the individualized data that users of MNsure and other marketplace users will soon have should make the debate more informed. That's a step forward.

Congressional rancor unfortunately threatens to eclipse the new marketplaces' launch, which is slated to take place throughout today as the new exchanges officially go online with federal data systems. Many experts don't expect a federal government shutdown to affect the new marketplaces, but the congressional standoff added uncertainty to the daunting information technology challenges posed by today's nationwide launch.

MNsure and other states' marketplaces are the key tool by which the Affordable Care Act will reduce the shamefully populous ranks of Americans without health insurance. Those who use these sites will find out if they qualify for assistance to substantially cut coverage costs. Others may learn that they qualify for even-more-affordable public medical assistance programs.

Today also begins to "usher in a new era of insurance market rules, rules that are considerably more in the consumer's favor,'' said Len Nichols, a George Mason University professor in a recent Health Affairs posting. Those with preexisting conditions can't be denied coverage or charged more, though where you live, tobacco use and age can affect coverage cost.

A system that was affordable mainly for the healthy or those working for large employers will now be accessible to millions more people in Minnesota and elsewhere. That's why the marketplaces' launch and the rollout of the Affordable Care Act in 2014 is a civic milestone on par with the implementation of Social Security or Medicare.

While MNsure's debut was marred by a data breach of insurance brokers' information, the new marketplace should uphold Minnesota's reputation as a health care leader. Rates offered on it will be the lowest on average in the nation, according to initial analyses. The part of MNsure serving small businesses and their employees should be fully operational, one of the few states where this will be the case.

The state owes a debt of gratitude to everyone who has worked to make MNsure reality. Its hardworking 82 staffers and its vendors have logged long hours, with executive director April Todd-Malmlov providing steely leadership throughout.

The work on MNsure isn't finished, however. Further dedication will be required to work through the technical challenges inherent in any website launch. Those who will rely on the site, and critics who will rush to judge it, should exercise patience. Flawlessness initially isn't realistic, though the high-profile Paul Bunyan campaign heightened expectations for Oct. 1.

Fortunately, there's no need to rush to use MNsure. Enrollment continues through March 31. Those who want coverage to begin Jan. 1 have until Dec. 15 to complete enrollment; enrollment after that will take a matter of weeks to process, resulting in a short delay of 2014 coverage.