No compromise yet for MNsure, MinnesotaCare

By Don Davis
Forum News Service
ST. PAUL - Minnesota legislators have spent hours debating the future of MNsure and MinnesotaCare, but remain far from a compromise needed to end the 2015 legislative session.
Republicans who control the House want to spend $1 billion less on health-care programs than Democrats in charge of the Senate. The major difference comes with the GOP’s proposal to eliminate MinnesotaCare, the 23-year-old program providing state-subsidized health insurance for the poor.
A second argument is about how to reform MNsure, the controversial state website that sells health insurance.
Differences showed up Friday when a House-Senate conference committee examined the issues, but made no decisions.
“I do not think we should rush to solve the problem until we have more information,” Human Services Commissioner Lucinda Jesson said about the future of MinnesotaCare.
Rep. Matt Dean, sponsor of the House health and human services bill, said MinnesotaCare needs to change soon because a tax on doctors and other health-care providers that funds the program is going away. However, Jesson said, that does not happen until 2019, giving policymakers plenty of time to find the best solution.
“We do have a balanced budget to sustain MinnesotaCare over the four years of our budget projections,” said Sen. Tony Lourey, D-Kerrick, sponsor of the Senate version of Dean’s bill.
He said there is no reason “to throw into chaos” low-income people who depend on MinnesotaCare.
Lourey added that it is not a good idea to hurry to find a solution before this legislative session adjourns May 18. “There isn’t a big rush in the next couple of weeks to dismantle something that has been so helpful.”
But Rep. Nick Zerwas, R-Elk River, said the House has been discussing the issue all year, so the issue was considered before the House drew up its plan.
“It isn’t very genuine” for Lourey to say the issue has not been debated, Zerwas said.
Dean, R-Dellwood, said that when the provider tax disappears, MinnesotaCare funding would compete with education and other state programs instead of enjoying dedicated funding like it does now.
The House and Senate propose different futures for MNsure, which provides Minnesotans with a mostly online way to buy health insurance.
Lourey’s bill would turn MNsure into a state department instead of the current independent agency. Dean would tweak MNsure operations, with the intention of turning its operation over to the federal government in 2017.
Sen. Julie Rosen, R-Vernon Center, proposed folding MNsure into the Human Services Department. After two years, the Legislature could change how MNsure is governed or the job would fall to the federal government under her plan.
Republican health funding negotiators Friday were skeptical that MNsure can right itself after two years of turmoil such as difficulty getting computers to work properly.
Rep. Tara Mack, R-Apple Valley, expressed her frustration: “$200 million has been invested and we are so far from many of the promises being delivered.”
MNsure serves nearly 62,000 people who buy health insurance privately, 120,000 who are on state-funded medical programs and 38,000 MinnesotaCare recipients. MNsure CEO Scott Leitz said he expects private plan enrollments to double by the end of 2017.
While the conference committee technically can decide what happens with health programs, the negotiators likely will receive guidance - or orders - about how to proceed from the governor, House speaker and Senate majority leader.
The health care funding bill and one for education spending appear to feature the largest Republican-Democratic split, disputes that could threaten ending legislative work on this time year.
Negotiations on resolving differences in proposals about how to spend more than $40 billion in the next two years were not planned for most of the weekend, although high-level talks could be held Sunday afternoon or night. Conference committees are to resume Monday.