MNsure backers make their case

March 18--ST. PAUL -- A move to connect Minnesota to the federal health exchange would cost the state millions of dollars and jeopardize health coverage for Minnesotans, state Rep. Jennifer Schultz said on Friday.

"We had consultants come in and estimate the cost of going to the federal exchange," Schultz said of a bipartisan panel on the idea of abandoning the state's version of the exchange, which is known as MNsure. "It was going to cost the state more than $5 million a year."

A bill to make the move was introduced by state Rep. Matt Dean, R-Dellwood, who is a longtime critic of Minnesota's exchange. In a telephone interview on Friday, March 17, Dean argued that MNsure has required increasing subsidies from the state, from $8 million in 2015 to $22.5 million this year.

Moreover, Dean argued that MNsure is dysfunctional. "The consumer experience under MNsure has never been good," he said. "It's hurt people."

But during a roundtable meeting with reporters on Friday, Schultz and MNsure CEO Allison O'Toole defended MNsure and argued that Minnesotans are much better off now than they would be in the federal marketplace.

"We wouldn't have any control," Schultz said. "Those rates would be determined by the federal government, and so those rates could continue to go up with absolutely no state control over the product, over customer service."

O'Toole argued that in spite of challenges such as the decision by Blue Cross Blue Shield to pull out of MNsure last year, other companies imposing enrollment caps and insurance premiums that rose steeply, Minnesota's version of the exchange was more successful than ever in the enrollment period that ended on Jan. 31.

Among current MNsure enrollees, two out of three receive tax credits at an average of $7,500, and in Duluth that average is almost $8,000, O'Toole said. MNsure enrolled about 120,000 Minnesotans into private plans in the just-completed period, a growth of about 40 percent over the previous period, she said.

The 96 percent of Minnesotans with some form of coverage is a record for the state and one of the highest marks in the country, O'Toole said.

O'Toole said she's confident that whatever happens in Washington won't affect the next enrollment period beginning Nov. 1. But with the Republicans' American Health Care Act moving through the U.S. House, she doesn't know what to expect beyond that.

Stephen Collins of Benes Insurance Services in West Duluth said at the roundtable that he was relieved the Republican plan would continue to have coverage for people with pre-existing conditions and provide for women's health care, "but there's a lot of things that scare me."

"As a broker we look at the coverage and the benefits, and the benefits in many cases are gutted in the new plan," Collins said.

A Kaiser Family Foundation analysis concluded that, at least when it comes to tax credits, the GOP plan "would hurt everyone" in St. Louis, Lake and Cook counties, O'Toole said. "A 40-year-old, in this region, making $30,000, is going to pay about 20 percent more, a 20-year-old is going to pay about 25 percent more, and a 60-year-old is going to pay about 63 percent more under this new plan."

Collins also spoke against a proposed rule from the federal Centers for Medicare and Medicaid Services to limit open enrollment in the health exchanges to 45 days, compared with 90 currently.

"You'd have to have 10 people on staff for those 45 days just to try to touch everybody," he said. "You can't do it."

O'Toole agreed. "We took a quarter-million calls in three months," she said. "They're talking about doing that same level of service in six weeks. ... People need help with this decision, and we need to give them time."

Schultz said she thought the 45-day limit was proposed in an attempt to limit enrollment and to limit federal subsidies.

In the state Legislature, Schultz said, Democrats are concerned that -- as things stand now -- there are no guarantees that insurance plans will sell policies on the exchange in Minnesota. An alternative plan from Democrats would allow people whose incomes exceed limits for the state's MinnesotaCare to pay premiums and buy into that plan, Schultz said.

Dean charged that the Democrats would destroy the individual health insurance market, sending almost everyone to MinnesotaCare. The problem, he said, is that MinnesotaCare pays hospitals and clinics only 50 percent of the private rate.

"It would not take long for the small clinics in greater Minnesota to shut their doors, and it would cascade from there," Dean said.

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