Bill to make MNsure a state agency sparks criticism

Health exchange
Sen. Tony Lourey, DFL-Kerrick, pictured here in a 2013 file photo, has introduced legislation to make MNsure a state agency.
Jennifer Simonson | MPR News 2013

A MNsure board member took state lawmakers to task on Thursday for a proposal that would turn the state's online insurance exchange into a state agency.

"Minnesota needs another state agency like it needs a hole in the head," said Tom Forsythe, a General Mills executive who has served on the MNsure board since its inception.

State Sen. Tony Lourey, DFL-Kerrick, has introduced legislation to create a stage agency, placing it in the governor's administration, a plan Gov. Mark Dayton supports.

In a report earlier this month, Minnesota Legislative Auditor Jim Nobles was highly critical of MNsure and its leadership for bungling the launch of the health care website.

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Nobles cited widespread problems with the online enrollment system and customer service that caused big problems for consumers, insurers, counties and the state Department of Human Services. His office last week recommended that the troubled agency's CEO be directly accountable to the governor.

Forsythe concedes that the MNsure board deserves a share of the blame. But he said creating a state agency would do nothing to address its problems.

Instead, Forsythe said, making MNsure a state agency would make the exchange less accountable than a board that makes decisions in meetings open to the public.

Forsythe contends the problems that have plagued MNsure trace back to choices made by lawmakers and Dayton administration officials well before the board was named or took control.

"Many of these strategies were set when MNsure was operating like a state agency," he said.

Forsythe said MNsure's architects gave the exchange responsibility for too many functions. MNsure's architects, he said, pursued a strategy that relied on Affordable Care Act money to update antiquated Department of Human Services technology that would be used to administer the state's public health plans, Medical Assistance and MinnesotaCare. The DHS part of the system is where the bulk of the exchange's problems lie, he said.

MNsure could do a better job, Forsythe said, if it could concentrate solely on helping Minnesotans easily shop for and enroll in private health insurance plans called "qualified health plans."

"I think we should separate MNsure from DHS," Forysthe said. "I think DHS should layout its own IT blueprint. It should have its own consumer and customer interactions. MNsure should focus on a much narrower vision."

Lourey, however, disagreed on several fronts. He said his bill would accomplish the important task of correctly establishing MNsure's governance structure.

Forsythe is correct that the MNsure board had nothing to do with the exchange's mission or design, Lourey said. The problem with the board, he said, is that it has been too removed from public scrutiny.

"When the board did take over we've had a really hard time getting answers," Lourey said. "I mean, we've had several outstanding questions about how are they going to use the public funds that are available to improve the IT system and we have very sketchy information that's coming back. I think our agencies do a better job of being open, accountable and transparent."

Lourey also said Forsythe's proposal to make DHS — not MNsure — responsible for enrolling people in public health plans contradicts the one-stop-shopping premise of the Affordable Care Act.

Lucinda Jesson, commissioner of the Minnesota Department of Human Services agreed. She said more than 90 percent of the people going through MNsure enroll in the state-sponsored coverage.

"I think it is very wrong to say the exchange is bogged down by enrolling people in public programs," said Jesson, who also serves on the MNsure board. "We should have no wrong door so that we're taking care of the needs of all people in Minnesota who need access the health care whether they need access to the [qualified health plans] market or one of our public programs."