Why we don't need a failed MNsure

For some people, Obamacare and MNsure are the answer they've sought. But for many Minnesotans, it has resulted in headaches and, worse, heartache.

Last month, the U.S. Supreme Court gave our state a new way to look at MNsure: It's just unnecessary. Given that MNsure is funded through a tax on your health insurance — and exceptionally low enrollment means that the insurance tax is 50 percent higher than original projections — unnecessary is the smart way to look at it.

The sloppy construction of Obamacare convinced some that federal tax credits intended to offset the massive insurance price increases brought on by the law's mandates were available only through state-created insurance exchanges.

In 2013, DFLers used this idea as a major selling point to build the $200 million new state agency and failed website known as MNsure. At the proposal's first hearing in the Minnesota House, Rep. Joe Atkins — MNsure's architect — announced that a state exchange would "provide access to federal health care tax credits that are otherwise not available."

This sounded appealing — federal money pouring into states to build exchanges. They'd be tailored to meet the needs of each state. Boosters promised that it would be as simple as using Travelocity or Amazon. There would be unprecedented comparison shopping and competition.

Unfortunately, the reality is far from what DFLers promised. MNsure came with endless red tape, with the federal government essentially dictating how Minnesota runs its exchange. Prices doubled and tripled for many families. Those who couldn't afford the new Obamacare plans without a tax credit were forced to endure the frustrations of MNsure over the past two years — vanishing applications, hours on hold, unreliable customer service.

And now that tax credits — thanks to the court's recent decision — are definitively available through the federal exchange, the last remaining justification for keeping the commercial side of MNsure has vanished.

That's just on the commercial side. On the public program side, MNsure is riddled with flaws that leave hardworking families prone to sign-up and billing errors. As of July 10, over 21,000 low-income and working families were waiting to add coverage for spouses, newborns and other life changes. State officials are on the cusp of canceling insurance for 60,000 working families because of unreturned paperwork, but aren't sure they even received the correct paperwork. Last week, we learned that another 120,000 people on Medical Assistance and MinnesotaCare have had policy renewals delayed because of system failures. If that sounds familiar, it's because essentially the same thing happened last year.

As early as last summer, a nonpartisan health expert at the University of Minnesota said the MNsure website was unnecessary and had little to do with reducing the number of uninsured. Even traditionally liberal states have shut down their exchanges (Oregon, Hawaii) or demanded major improvements. In Vermont, where lawmakers originally hoped to use Obamacare as a vehicle to single-payer insurance, the Democratic governor has threatened to abandon that state's exchange unless major milestones are met soon.

Yet there remains little accountability from DFLers who created MNsure. Starting this year, Minnesota taxpayers are solely responsible for funding MNsure, but there's been nary a peep from our governor about improving performance. During this year's legislative session, Republicans prevented any new state tax dollars from going to MNsure and required the state to seek a waiver that would allow Minnesotans to get the tax credits wherever they choose to shop.

Thirty-six states already have opted for the federally built website. Of those, 17 used a partnership model, retaining control over important functions like running their own consumer assistance center and maintaining review and approval of insurance plans sold. Beyond that, they figured there was no sense in increasing insurance costs just to risk building a replica of the federal IT system that might not work. And, by all accounts, the federal site is a much smoother experience for consumers than is MNsure.

Before MNsure, Minnesota was a leader in health care delivery and innovation. Now, it's one of about a dozen remaining embarrassments from the state exchange experiment. With the recent Supreme Court ruling reversing DFLers' initial selling point for MNsure, it's time for us to consider going the same route as two-thirds of the states, while retaining control of some key functions.