Lawmakers split on MNsure changes as campaign fight looms

For as much as Minnesota Republicans despise MNsure, they love to talk about it. They've written letters, legislation and plenty of campaign literature since even before the insurance marketplace went live in a problem-plagued 2013 rollout.

This legislative session, they are again taking aim. Republicans have passed measures to slice MNsure's operating allowances, alter its leadership structure and phase out the state exchange altogether. Their goal is to put Minnesota into a federally run marketplace beginning in 2018.

As Minnesota lawmakers get ready to negotiate a possible end-of-session deal, both sides agree the three-year-old health insurance exchange need fixing. But they have radically different approaches that will be tough to reconcile.

And the rhetoric around the latest efforts is as hot as ever. Take this recent exchange between state Rep. Tina Liebling, DFL-Rochester, and Rep. Greg Davids, R-Preston.

"I would characterize this bill as a bill that's mainly meant to kill MNsure, kill it again, hit it with a bomb, throw it in a hole and dump water on it and just do the very definition of overkill I would say," Liebling said.

"I'm not sure I would agree with my good friend from Rochester, Representative Liebling's characterization that we're trying to kill something. It's dead. It is dead," Davids responded. "What it has done to Minnesotans is unconscionable."

Here are some basics: MNsure grew out of the federal Affordable Care Act, or Obamacare as it soon became known. It's an online portal where people shopping for private insurance can compare prices and enroll for coverage. Most people on publicly subsidized programs also go through MNsure. But most Minnesotans don't interact with MNsure because they get their coverage through an employer.

Many states opted against creating their own systems and instead had their residents enroll through the federal system. Several states like Minnesota that did build an exchange have struggled through one technological flaw after another, leading some to give up.

MNsure was a campaign issue in 2014, with ads slamming Obamacare and Gov. Mark Dayton's support of the legislation.

State senators are the only ones around the Capitol who haven't faced voters since MNsure's launch. Minority party Republicans are eager to make it an issue in this fall's campaign, with all 67 Senate seats and 134 in the House on the line.

A coincidence of the calendar makes that task easier, said Sen. Michelle Benson, R-Ham Lake.

"With open enrollment coming so close to the election, I don't think it will be hard to remind Minnesotans that they shouldn't trust one-size-fits-all-government solutions," she said.

Democratic incumbents won't be able to escape blame, she added. "They have had four years to fix it. They didn't listen to anybody when it came to reform, when it came to managing budgets, when it came to serving consumers. This is theirs. They own it. They want it this way."

But the DFL senator who had a lead role in creating MNsure says his party has been open to modifications, just not the breakup Republicans are after.

Killing MNsure would be a mistake and it won't happen, said Sen. Tony Lourey, DFL-Kerrick. He said a health care task force convened last year opposed taking that step.

"We met for hundreds of hours, bipartisan, the A-team of the health care community across the state of Minnesota," he said. "It wasn't agnostic on whether the federal exchange was the right course for Minnesota, it was a resounding vote that it is not the right course for Minnesota. It would dismantle too much of that makes Minnesota the healthiest state in the nation."

The sharp politics around MNsure have obscured points of common ground, such as instituting a new steering committee to oversee and prioritize technology changes to the program, Lourey added. There's also a joint push to undo liens on estates against people accessing subsidized coverage since MNsure took effect.

"When we find issues, we're serious about fixing them," he said. "Certainly there is much work that needs to be done. We stand ready toward work that."