Democrat Plots Major Changes To MNsure Oversight

ST. PAUL, Minn. (AP) — A chief architect of the state's health insurance exchange is moving to dismantle its board, a major change to MNsure oversight that may give Democrats a path to head off larger changes that Republicans want.

MNsure is currently a quasi-private entity governed by an independent seven-member board that controls the exchange's budget. Expected to be formally introduced on Thursday, the bill from Sen. Tony Lourey would make MNsure a state agency like the Department of Transportation or Department of Human Services, whose commissioners are appointed by — and answer to — the governor.

The change in structure would also give state lawmakers the final say on MNsure's budget, an olive branch to Republicans who have sought a larger role in overseeing the exchange's finances after its rocky year one rollout. And it comes from Lourey, a Democrat who helped lead the effort to set up the exchange.

Lourey, DFL-Kerrick, said his proposal is not an indictment or criticism of MNsure.

"It makes it accountable to the governor, the Legislature and, most importantly, the public that it serves," Lourey said in an interview.

Democratic Gov. Mark Dayton and House Republicans on Wednesday both signaled a willingness to consider restructuring MNsure's governance.

Though he said turning MNsure into a full-blown state agency would be a big change, Dayton said he's open to any changes that aren't "just trying to trash MNsure and push it over the brink."

House Republicans, who gained a majority in the November elections, have offered their own ideas to improve what they see as a failing organization. Rep. Tara Mack, an Apple Valley Republican who chairs the House committee handling health care policy issues, welcomed the idea of moving MNsure under state government's wing.

"It sounds like Lourey is kind of recognizing ... that what we've had is not working and is not delivering the best product," she said. "I think that gets us all moving in the same direction."

Republicans have also previously called for adding an insurance industry representative to the exchange's governing board

Mack said that although Lourey's bill may be a positive fix, she insisted she and other Republicans won't back off their calls for other larger changes to Mnsure.

Mack has proposed asking the federal government for a waiver that, if granted, would allow Minnesota residents to get subsidies for private health plans no matter where they're purchased. Currently, those subsidies can only be accessed through MNsure.

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