Health ReformPolicy & Law

Minnesota Legislature Passes Major Healthcare Exchange Bill by Close Vote

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By a very narrow vote of 37-28, actually closer than I would have anticipated, the Dem-controlled Minnesota Senate gave the state the go-ahead to create its own online exchange in advance of the required implementation under the ACA. Apparently, debate was very emotional and marathon — lasting over 13 hours. That’s the amount of time it took Sen. Rand Paul to deliver his now famous filibuster during a recent cabinet nomination process. All of this doesn’t include the multi-committee trajectory and debate the bill took to get to the floor for a vote.

Minnesota becomes one of the few states to take the lead in the development of its online healthcare coverage exchanges — a provision of the ACA that would come to fruition one way or another. If the state would not have been able to set one up, the federal government would have essentially taken over the process. (The government’s language here is “the creation of a federally-facilitated state-run exchange.) Because of the bill’s passage in the Senate, Minnesota will no longer have to consider what could have been after spending millions of dollars into providing the electronic infrastructure for such an undertaking.

Predicatably, Republicans decried the measure, citing budgetary concerns and the ability of a few in making decisions for many — in this case, almost 10 percent of the state’s population. Senate Democrats lauded the exchange provision as an enhancer of access.

“I’m very concerned,” said Sen. Julie Rosen, R-Fairmont, who made the first attempt to amend the bill. “We are creating the most powerful board in the state of Minnesota, and if we don’t have measures to keep them accountable going forward, we will be back.”

Sen. Scott Dibble, DFL-Minneapolis, questioned Republican nostalgia for the current health insurance system. An estimated 9 percent of Minnesotans are uninsured, he said, including two of his siblings. And Dibble said his husband, a small-business man, struggles to cover the high cost of insuring his workers.

The next step will be determining the rates of coverage at which the participating insurers in the exchange will set.

image: MN House Healthcare Debate/Courtesy Strib

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