The state’s powerful Democrats have a lot at stake in the success of the one-stop health insurance marketplace for Minnesotans that opens in October. They championed the legislation to create the health insurance exchange to be known as MN sure and passed it without a single Republican vote.

Republicans say it will increase costs, limit choices and threaten privacy.

Democrats defend it as a cornerstone of the federal Affordable Care Act, “Obamacare,” that’s intended to make it easier for people — including Minnesotans who now are uninsured — to get coverage.

We’ll see. In the meantime, when it comes to effects and performance of the exchange, the people who passed it and will run it should be under distinct pressure to tell it as it is, and not as partisan loyalties advise. Much work remains to be done on a tight timeline. With their credibility on the line, the Democrats who support it will be inclined to defend the system they created. Where Minnesotans’ health, physical and economic alike, is concerned, it will be important to separate reality from politics.

When service begins, individuals and small businesses can use the web portal at mn.gov/hix or a call center to purchase coverage for 2014.

“The issue of whether it’s working will be an ongoing conversation,” Kate Johansen of the Minnesota Chamber of Commerce told us. “Folks are already saying not to expect a perfect system, so the question is what should we expect?”

Beginning next year, the federal health care law requires almost all Americans to have health insurance, and state exchanges are intended as a key resource for consumers who have lacked coverage in the past, the Pioneer Press’ Christopher Snowbeck reported. Exchanges also are expected to promote competition among health insurers, to help push costs down.

Snowbeck reported last week that there are mixed signals about how much competition there might be when Minnesota’s exchange opens, with three health insurance companies saying they have decided not to compete in portions of the new Minnesota marketplace, at least for policies that cover 2014.

April Todd-Malmlov, executive director of MNsure, told us companies that opted not to participate in portions of the exchange — two smaller companies and UnitedHealth, which doesn’t actively sell policies to individuals and small employers in Minnesota — will “not have much of an impact on the competition.”

Opting in, however, is Minneapolis-based UCare, which met a late-May deadline to seek approval for exchange products, perhaps providing a boost in competition for individuals who buy their own health insurance policies, Snowbeck reported.

The Minnesota Commerce Department has said that nine companies are seeking approval to sell in the individual and/or small employer marketplaces. Rates are scheduled to be made public Oct. 1.

Competition will be fostered not only by the carriers who participate, Todd-Malmlov said, but by the information about them that MNsure will provide.

“We’ll have apples-to-apples comparisons on things that we’ve never had before,” she said, including plan benefits, cost and customer satisfaction. “When you make that kind of information that comparable and that transparent, it will drive competition among carriers.”

Considerations for carriers include initial “pent-up demand,” with the assumption that people who sign up right away might be sicker individuals with bigger medical bills that pose greater risk for insurers.

Insurers, like the MNsure staff, face an aggressive timeline.

Competition, cost containment and customer service are the promise of the health exchanges. As we learn more, we’ll expect candor from the concept’s champions.

— St. Paul Pioneer Press, June 8