Just 27 days before the federal government requires a decision on whether Minnesota will move forward with a state-run health care insurance exchange, the House passed legislation Monday that would create a Minnesota Insurance Marketplace. States may choose to operate their own exchange or defer to a proposed federally-run exchange.
Sponsored by Rep. Joe Atkins (DFL-Inver Grove Heights), HF5 was passed as amended 72-58. It now moves to the Senate, where Sen. Tony Lourey (DFL-Kerrick) is the sponsor. The bill is scheduled for a floor vote there Thursday.
“It really is the most significant health reform that we’ve seen in Minnesota in 50 years,” Atkins said in describing the bill, which he anticipates will insure 300,000 currently uninsured residents and save $168 million per year in uncompensated care.
Several amendments were added on the House floor, including one offered by Rep. Patti Fritz (DFL-Faribault) that would prohibit insurance plans in the exchange from offering abortion coverage. The 71-58 vote came after Rep. Duane Quam (R-Byron) said that because federal funds cannot be used for abortions, any public dollars for abortions through the exchange would be the responsibility of the state.
Other adopted amendments would:
- allow a person using a federal tax credit or subsidy for insurance in the exchange to receive care from the doctor of their choice;
- make a navigator or in-person assistant personally liable for damages that result from the person’s acts or omissions when assisting participants;
- prohibit the exchange from sharing information outside the marketplace about whether an individual has used tobacco or owns a gun or has a firearm at home; and
- make breaches of data privacy a misdemeanor.
Under the timeline, insurance providers would have from April until October to design their marketplace offerings and get them approved by the Commerce and Health departments. Plans would then be uploaded to a Minnesota Insurance Marketplace website. Providers of the selected plans would begin enrolling consumers Oct. 1, 2013, with the help of community navigators and brokers.
Although Republican amendments were added, several legislators still opposed the bill.
“We have the most to lose but are going to be the first to jump in blindly and lead the way in the Midwest on this experiment,” Rep. Matt Dean (R-Dellwood) said.
But not passing legislation would have the same effect as relying on a federal exchange, Atkins said, which could mean higher federal premium withholding taxes; contacting help in Washington, D.C. rather than in Minnesota; and losing local control over protecting data privacy or choosing which plans are offered on the exchange.
Atkins credited several Republican members for contributing to the data privacy provisions in the bill. “Without their help, we wouldn’t have the sort of privacy protections in this bill that we do.”
“I appreciate Rep. Atkins’ willingness to take a few of our amendments and make this a little bit better,” but there has been no proof that some of the claims of family savings will actually happen, said Rep. Tara Mack (R-Apple Valley). Claims of some people’s premiums rising up to 29 percent have not been refuted, she added.
The bill still has room for improvement, according to one DFLer. It would require the most popular insurance plans sold by providers to be offered on the exchange, but the most popular is not necessarily the best, said Rep. Diane Loeffler (DFL-Mpls).