After two years of failure and a lack of accountability, Senate Republicans today proposed several significant reforms to the MNsure health insurance system. The ideas range from changing the makeup of the current MNsure Board, to completely changing the delivery model of public and private health insurance products offered through Minnesota’s exchange.

A new delivery model proposed by Senator Michelle Benson (Ham Lake) would restructure MNsure to reflect the reality that 91% of the people served in the program are eligible for public programs, and only 9% are taking advantage of private insurance products through the exchange (SF 810).

The exchange software would be repurposed, administered by the Department of Human Services and used by the counties to determine eligibility for public programs. The state would not lose its investment in software, the counties would finally receive the modernized system they were promised and the public would receive better customer service throughout the enrollment and insurance process.

Minnesotans not eligible for a public program would receive insurance through a non-profit entity similar to the Minnesota Comprehensive Health Association (MCHA). This new entity would have a new governance structure and still offer access to the tax subsidies available under the Affordable Care Act (ACA).

“MNsure has been serving two masters and it’s time for that to stop,” said Senator Benson. “Everyone knows the system needs strategic change to meet the needs of Minnesotans. This plan refocuses the state and counties on serving people in need, while setting up a much smaller organization to handle private insurance. Governor Dayton needs to know that more spending is not a strategy.”

Another package of reforms was introduced by Senator Julie Rosen (Fairmont) and includes many of the ideas originally proposed by Senate Republicans during the debate on the MNsure health insurance system legislation in 2013. The reforms promise greater accountability over MNsure by adding insurance expertise to the board of directors and adding a conflict of interest provision for board members. It would also require the MNsure budget to be approved by the legislature and prohibit money from the Health Care Access Fund to be used to fund MNsure.

“As we head into the second full year of MNsure, it’s time for everyone to focus on common sense changes to the system,’ said Senator Rosen. “This package brings accountability and transparency to MNsure and we look forward to a robust discussion of everyone’s ideas during the 2015 session.”

SF 153 also includes these MNsure reform measures:

• The Commissioner of Commerce to publish new insurance premium rates on October 1 of every year, adding transparency to the system.

• Any increase in premium taxes to fund MNsure must be approved by the legislature.

• Background checks are required for all MNsure health insurance system navigators and in-person assisters.

• All health plans that meet the requirements of the ACA must be offered for sale through MNsure.

• All rules adopted by the MNsure Board must be approved by the Legislative Oversight Committee.

• Requires MNsure to complete an independent third-party audit and review of all costs.

• Requires MNsure to report the number of previously uninsured Minnesotans received health insurance from the exchange.

A third Republican bill authored by Senator Carla Nelson (SF 349) also opens the MNsure health insurance market place to more companies and products, allows Minnesotans to purchase insurance across state lines and puts in place better IT controls and testing.

“MNsure must allow all carriers and products that meet the federal and state requirements to be offered in the exchange – consumers deserve more choices,” added Senator Nelson.