Posted: 03/01/15 17:36
by Dave Mindeman
I need to respond to an OP-ED in the Star Tribune by Keith Downy, chair of the Minnesota Republican Party and obvious MNsure critic.
It is a bit surprising that Downey and the MN GOP suddenly think of themselves as some kind of "savior" for MNsure - especially when they actively blocked its beginning, did nothing to work on the bill that brought it into being, have not bothered with helping in its evolution, and are still actively seeking to kill it with every opportunity.
So the idea of having the "cure" has to be viewed somewhat skeptically.
But at least, for once, Downey puts forward some actual remedies. Let's take a look....
1. Only 9 percent of MNsure enrollees actually bought the private coverages, and these enrollees don't need MNsure's failed technology to find their insurance. H.F. 5, authored by Rep. Tara Mack, R-Apple Valley, proposes waivers allowing enrollees to take their government subsidy to private-sector insurance exchanges, which already offer Obamacare-compliant private coverages and work perfectly. We should free these MNsure-locked customers to shop wherever they want! Using the federal exchange could also be evaluated.
Private plans have been key to MNsure's viability. And the horrible website has chased away most of the people that wanted to buy a private plan. But there is a flaw in the Mack bill. If we allow the federal subsidies to be used by the private sector, we will have a gigantic privacy issue. The exchanges and Fed website were designed to use data gathered from the IRS to determine those subsidies. One of the problems in forming these exchanges is how to keep that data safe and private. What the Mack bill does is potentially open that income data to insurance carriers, which to me would be a bigger disaster than software problems.
2. The 91 percent enrolled in government's MinnesotaCare and Medicaid programs, which have been available for years, were enrolled through the regular process and systems at the Minnesota Department of Human Services (DHS). They can continue to be. These enrollees do not need MNsure to get their coverage either!
Yes, many of them were eligible before. And many more became eligible with the Medicaid expansion. Except why were they not getting that coverage before? One of the reasons is that they didn't know about the programs or know that they were eligible. The MNsure exchange has been a valuable tool for determining all of that. Granted, the software has still made part of that journey into coverage a little tedious, but the overwhelming numbers of new MNCare and Medicaid recipients means that our overall uninsured rate has dropped by 40%. Would that have happened without MNsure? Maybe some of it - but it is hard to imagine Republicans signing onto new outreach programs to find them.
3.  Shut down the unnecessary MNsure bureaucracy and operations. S.F. 810, authored by Sen. Michelle Benson, R-Ham Lake, proposes an alternative nonprofit structure to manage Obamacare coverages, much like the Minnesota Comprehensive Health Association operated successfully.
I'm not sure how this is worded, but it is hard to imagine that we actually know what is unnecessary at this time. The MN Comprehensive Health Association is a favorite of Republicans because it only provided catastrophic coverage - few prescriptions or any preventive medicine. It was cheap insurance because it covered only the extreme health event. The MN GOP would love to bring that back.
4. Evaluate whether any components of MNsure's technology or operations could be salvaged by the DHS to improve the enrollment process for MinnesotaCare and Medicaid. If not, shut them down altogether.
We do have serious problems coordinating MNsure to our state health programs. Lots of improvement is needed here and they need to "talk" to each other much more efficiently. It might be better to have MNsure determine eligiblity for these plans and then turn over the files to MNCare or Medicaid from there. MNsure seems to have complicated matters with state recipients and that does need to be fixed.
Downey is good at listing complaints about MNsure - GOPers in general have made it a political sport. But his idea of "real" fixes is pretty shallow at best - and will make things more complicated at worst.
I am sure we would all like the MN GOP to be a partner in solving the MNsure problems, but Downey's words are no evidence of that.
Not in the least.