MNsure seemed headed for big changes and possibly closure when the Legislature opened in January. Now, it appears MNsure won't be changing much at all.
State lawmakers over the weekend agreed on a health and human services bill that falls far short of the changes some Democrats and Republicans had hoped to make to the health plan exchange.
Some Republicans wanted MNsure scrapped all together. They maintained it would be better for Minnesotans to shop for coverage at Healthcare.gov, the federal health insurance exchange than deal with the state exchange. MNsure had a disastrous rollout in 2013 but by most accounts its performance has greatly improved.
Calls for change, though, intensified in February after Legislative Auditor Jim Nobles ripped MNsure and its leadership for bungling the exchange's launch.
The DFL-controlled Senate and DFL Gov. Mark Dayton were unlikely to accept a plan to junk MNsure. House Republicans, however, did get language that requires the state to seek a federal waiver that would let eligible Minnesotans receive premium subsidies whether they buy a health plan on MNsure or directly from an insurer.
Right now the only way to get those tax credits is to buy coverage through MNsure.
The deal also requires MNsure to release premium rates at least a month prior to the beginning of open enrollment. MNsure has been releasing rates before open enrollment begins. Republicans and Democrats also signed off on forming a task force to look at future options for MNsure.
The negotiated changes underscore that MNsure is not working, said House Health and Human Services Finance Committee Chair Rep. Matt Dean.
"The final agreement I think that we have going to the governor right now acknowledges that there's major trouble with MNsure, that the current situation is not sustainable," said Dean, R-Dellwood.
In the state Senate, Sen. Tony Lourey, DFL- Kerrick, had sought to disband the MNsure board and make the agency into a state department led by a commissioner the governor would appoint subject to Senate confirmation. That failed, too.
Lourey, who helped develop the legislation creating MNsure, said he's all for getting rates to consumers earlier and thinks letting Minnesotans shop for tax subsidies through MNsure or on the commercial marketplace might be a good idea.
But he adds that it would be difficult to maintain the MNsure exchange with far fewer purchasers unless other major changes were made too.
"I'm not particularly optimistic that it would be approved" by federal officials, Lourey said. "If it were approved, I think we would have to talk about then how do we structure the financing of the exchange."
Lourey says one option might be to add a surcharge to all health plans sold. But that will have to wait until next year's legislative session.