The state’s respected Office of the Legislative Auditor provided a valuable service to Minnesota with its recent in-depth look at MNsure’s miserable launch. What’s needed now is a thoughtful, expert look forward at the health insurance marketplace’s future.
That’s why Gov. Mark Dayton’s push for a new task force on health care financing makes sense. In effect, Dayton is calling for a timeout as legislators of both parties offer up a flurry of fixes for the state-run online shopping tool, one of the cornerstone reforms of the Affordable Care Act (ACA).
A timeout is needed. It’s easy to see how changes now under serious consideration at the State Capitol would serve political needs. Scrapping MNsure and relying on the federally run healthcare.gov marketplace, as Republicans have proposed, would allow the party to declare victory over Obamacare in Minnesota. Making MNsure a state agency, DFLers’ main proposal, would give the Dayton administration more control of MNsure operations and make it less transparent, resulting in less negative publicity.
But MNsure reforms need to serve consumers, not politicians. A task force representing consumers and experts from the state’s world-class health care community would ensure that wider changes are evaluated, that priorities are in the right place and that further changes are not made too quickly after several years of health care upheaval.
The task force also would have a more in-depth understanding of reforms’ impact. Relying on healthcare.gov, for example, sounds like a simple solution. It isn’t. Healthcare.gov hasn’t solved a key MNsure problem — relaying consumer data to insurers. It also would send enrollees in public programs right back to the state. Minnesota still would have to replace its antiquated human services computer system — the expensive challenge dogging MNsure — but it would be starting from scratch.
Having a task force also would allow careful evaluation of up-to-date information. With MNsure into its second year, there’s now data showing how the market has responded and the effect policy decisions have had. MNsure’s financing — a premium withheld on private plans sold through it — needs serious reconsideration. The state’s decision to continue MinnesotaCare for the working poor, to keep coverage affordable, nevertheless put thousands of potential private health plan customers into this public program. Also worth scrutinizing: whether the premium tax provides a financial incentive for insurers to keep customers away from MNsure or move them to plans not offered on it.
There are no easy solutions. Relying on a task force that gives due care to MNsure fixes and evaluates new opportunities available through the ACA in 2017 to tailor reform for Minnesota is a smart step.