ST. PAUL —
The bill's House author, Rep. Joe Atkins, said the average Minnesota family should save $490 a year in health insurance costs by purchasing through the exchange. He said families with higher incomes would save little or no money.
"This is additional competition — the health care insurers will be competing for our business, rather than feeling like you never have any leverage to negotiate with a health insurance company," Atkins said.
Initial estimates put the yearly cost of operating the exchange at $60 million. The legislation covers that with a tax on premiums sold through the exchange of 1.5 percent in 2014, and up to 3.5 percent in 2015 and after.
Opponents of the current bill include the Minnesota Council of Health Plans, which represents nonprofit insurers, and the Minnesota Chamber of Commerce. Julie Brunner, executive director of the Council of Health Plans, said the premium tax is too high and would likely result in pressure on insurers to raise insurance rates across the board.
"We are in support of a state-based exchange, and we want this to be successful," Brunner said. "But we think this is a huge missed opportunity."
Under the bill, all insurance companies would be eligible to sell their products on the exchange in 2014. Starting in 2015, the exchange's governing board selects which companies can keep participating based on criteria that include affordability and value, quality, promotion of prevention and wellness, and other markers.
"It's quite broad and it leaves a lot of questions," Brunner said.
Republicans argued that the seven-member board that would oversee the exchange, to be appointed by the governor and confirmed by the Legislature, has too much power and not enough accountability to taxpayers.
Rep. Jim Abeler, R-Anoka — the lone Republican on the conference committee — pushed to give lawmakers more direct involvement in the budget of the exchange, but he said a provision creating a legislative panel to keep an eye on the exchange still lacked teeth.
"It's a blank check," Abeler said. "That's a lot of money we're spending every year with nobody scrutinizing it, nobody approving it. Nobody in the Legislature can say, 'No, you can't spend that.'"