Simpler, in that the MNsure collapse traces not to millions of lines of computer code but rather to a few lines of faulty reasoning that relate to the difference between its imagined purpose and its practical effect. More complicated in that health-care finance itself is complex, and distorted by government policy.
A report by the
As we move past the election season, we expect to see clear proposals for addressing what's wrong. Leadership from Gov.
"The core here is that the 2017 rate increases and enrollment caps are really just fingers in the dike helping to buy some time so policymakers can make critical changes,"
They'll need to focus on matters beyond the botched launch of MNsure -- the state's health care exchange under federal reform, where those who qualify can purchase subsidized coverage -- and its expensive website failures.
Sizing up the factors in play, Schowalter -- who brings expertise as former Minnesota Management and Budget commissioner -- told us that "the largest and most understandable is that we had a market that worked before."
He's referring to the
The federal Affordable Care Act resulted in more people with health coverage across the nation, but "an unintended consequence was visited on
We're now asking the quarter-million people in that individual market to help pay for those who require expensive care, Schowalter explains. "And that's not working. That's driving up the cost and creating at least some of the problems we're looking at right now."
He and others talk about efforts in
Montgomery's report also included this perspective on the market: Despite the big increases ahead, costs in
We were told it would "take several years to stabilize the market, and I think we're seeing that in
He told us he'd put "reinsurance" strategies in the short-term fix category, however. "It doesn't get at the underlying issues of the cost of care or getting consumers engaged in changing behaviors," said Beutner, who also is general counsel for
What's needed is "a really honest conversation about how we're going to do this in
Her assessment: "I have not seen a willingness from anyone to engage in that conversation, frankly."
It's time someone did.
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