It looks like clear sailing for the health care overhaul in Minnesota, at least politically. The state's political dogfight over the federal health care law appears over.
This week's election eliminated the possibility of a Mitt Romney repeal of the Affordable Care Act and staunch Republican opponents of the law, who refused to work on an insurance exchange, no longer control the Legislature.
Democrats now control the Capitol, led by Gov. Mark Dayton, who solidly supports the president's health care overhaul. DFL control of the Legislature will likely remove Republican roadblocks to completing a cornerstone of the law, a state insurance marketplace called an exchange. The exchange is intended to simplify the process of researching and buying health plans for consumers and small businesses.
Administration officials charged with implementing the federal health care law in Minnesota declined to comment in the election's wake. Spokesmen said it would be premature, and they were not ready to comment.
But Sen. Tony Lourey of Kerrick, now the highest-ranking Democrat on the key Health and Human Services Committee, is confident legislation enacting a Minnesota exchange will pass in the next session.
"I think it'll happen as a result of a thorough dialogue with all of the stakeholders in the broader health care community," Lourey said. "That's how we should approach all of these important public policy issues."
One of those stakeholders is the Minnesota Chamber of Commerce, which not only pushed Republicans to get involved in setting up an exchange but also pushed the Dayton administration to reveal more about its plans for an exchange. Chamber President David Olson said he thinks there is a chance now to make some progress but he still has questions.
“... Minnesota will end up being one of the leading and most innovative states with how it implements that exchange.”Joel Ario, health policy consultant
"We're still trying to figure out exactly what it's going to look like and move forward with the Dayton administration and their work on the exchange," Olson said. "We still have more questions than answers but we do think that there could be an opportunity here."
Even though state Republicans had firmly applied the legislative brake against the exchange moving forward during the past two sessions, the Dayton administration has moved ahead of most states. Dayton has secured a total of $70 million in federal funds to design and build an exchange. He created two task forces to collect information and make recommendations on how the exchange should work and whom it should serve. And, he awarded a $41 million contract to a Virginia company to build the technical part of the exchange.
Consultant Joel Ario, who formerly headed the U.S. Department of Health and Human Services' Office of Health Insurance Exchanges during the Obama administration, said Minnesota is well ahead of most other states.
"I expect Minnesota will be one of the first states to be approved for a state-based exchange," Ario said. "And Minnesota will end up being one of the leading and most innovative states with how it implements that exchange."
But if Minnesota is ahead of most other states, that's partly because so many are stuck in neutral.
Like it or not the law is here to stay, said Robert Laszewski, a health industry consultant and no fan of the federal health care law. He said a lot of other states, which opposed the law or were waiting until the election, are far behind in building their exchanges. It is doubtful that they will be able to begin enrolling consumers by October 2013 as the law requires.
"I don't see how the states, particularly the 35 states that haven't started work on insurance exchanges, are going to make these deadlines," Laszewski said. "It's hard to see how with no work being done in many of these conservative states, they're going to be ready."
The Affordable Care Act is often branded as a government takeover of health care in states not developing insurance exchanges. But a variation of that very outcome is likely to happen in those states. The law requires the federal government to run an exchange for states that lack their own.
At this point, it appears that will not be the case in Minnesota.