Editorial: Clarify costs as health exchange advances

Published 9:27 am Tuesday, November 27, 2012

Gov. Mark Dayton is making good on his push to make Minnesota a leader in creating a health insurance exchange through which residents can shop for coverage. Look no further than last week.

Just as President Obama’s administration was extending a key deadline to give states more time to submit their exchange plans, Dayton sent a blueprint of Minnesota’s plan to the federal government and indicated the state will be seeking another almost $40 million in federal funds to build the exchange.

Obviously, the DFL governor wants the state to be a leader in this effort. And with his party taking control of the Legislature on Election Day, he realizes Republican concerns no longer amount to 2-year-old political roadblocks.

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Still, though, scores of questions remain about this exchange, and none is bigger than how — and who — pays for not just building it, but operating it annually and forever.

By this board’s calculations, Minnesota already has received $70.3 million in federal grants just to build the exchange. Throw in the $30-plus million about which Dayton expressed interest last week, and $100 million in public money will have been awarded to Minnesota since this summer.

And that’s just to build this exchange, which, by the way, is required to be unveiled 11 months from now and fully operational come December 2013.

So what are Minnesotans getting for what could be $100 million? And who pays its operating costs 13 months from now?

As previously noted, the questions about costs should not be seen as opposition. Rather, they need to be asked because so many parts of the federal Affordable Care Act did not undergo adequate due diligence prior to approval. With Obama re-elected, its implementation is inevitable, which makes it critical Minnesota knows what it is getting into as a leader on these exchanges.

Details provided last week remain somewhat scant, but the exchange sounds like a website modeled after Travelocity or Expedia, only it will sell health insurance. The governor’s office sees the exchange as a public-private partnership, and private insurers and various business interests have been part of the planning to this point.

State officials have said up to 1.5 million Minnesotans might use the exchange. News reports quote insurance companies as expecting about 500,000 individuals to tap it to buy their coverage.

Every entity involved wants to see an exchange that simply and clearly helps consumers shop for the best health coverage. But how you define “best” and then make the site actually work is still being addressed. Barring a change of deadlines, Minnesota has about a year to provide those answers.

— St. Cloud Times, Nov. 19

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