Legislation creating a state health insurance exchange in compliance with the Affordable Care Act, is just a few short stops away from being presented to the Governor for his signature.  Last week, the bill, House File 5, was passed by both the House and Senate. 

The bill passed the House on Monday by a 72-58 margin.  On Thursday, the Senate version was passed by the full Senate by a 37-28 margin.  The votes were pretty much along party lines.  One Republican, Rep. Jim Abeler of Anoka, voted for the bill.  Two Democrats, Rep Laurie Halverson of Eagan, and Sen. Terri Bonoff of Minnetonka, voted against the bill.

Now that the bill has passed both bodies in somewhat different versions, it will go to a House and Senate Conference Committee of ten members.  There the differences between House and Senate bills will be discussed and voted upon to create a single version of the bill.  This conference committee report will then be returned to the House and Senate for final passage.  A conference committee cannot be amended and must be voted either up or down.  Given the previous votes in the House and Senate, passage is pretty likely.

The ten members of the conference committee are as follows:  From the Senate; Sen. Tony Lourey  - Kerrick, Sen. Kathy Sheran - Mankato, Sen. Jeff Hayden - Minneapolis, Sen. Barb Goodwin - Columbia Heights, and Sen. Jim Metzen - South St. Paul.  From the House;  Rep. Joe Atkins - Inver Grove Heights, Rep. Tom Huntley  - Duluth, Rep. Tina Liebling - Rochester, Rep Dan Schoen - St. Paul Park, and Rep. Jim Abeler - Anoka.  With the exception of Rep. Abeler, all the conferees are Democrats.

While there are some differences in the bills relating to the role of insurance producers and their compensation, I am confident these can be addressed is a satisfactory manner.  The major differences in the bills continue to be the funding of the exchange and the selection process for qualified health plans to be sold through the exchange. 

The Senate is advocating general revenue funding from the state's tobacco tax while the House continues to support a 3.5% surcharge on policies sold through the exchange.  The surcharge is very similar to the funding source of the federal exchanges that will be creating in 30 states.  It is also strongly supported by the progressive groups who helped the Democratic bill authors draft the original legislation. 

Selecting plans for sale within the exchange would be up to the Exchange's board of directors in the Senate.  This seven member board would be appointed by the governor.  In the House, each health plan qualified to write insurance through the exchange would be able to submit two health plans for each metal level so long as one of the plans is their most popular in that category.   We prefer the House version.

Once again, the health insurance exchange is on a fast track.  Conferees are hoping to complete their work and have a bill ready for the House floor by Thursday.  The Senate could then take up the bill early next week. 

Dominic Sposeto

MIIAB Lobbyist