In Washington, a vote on repeal-and-replace was postponed this week.
A bill to scrap the state's health exchange, MNsure, in favor of the federal version is being debated in St. Paul.
Clearly, "It is time to pay attention to this because it's going to have a big impact on Minnesotans," as MNsure CEO Allison O'Toole said in an interview late last week with the Duluth News Tribune editorial board. "We know most Minnesotans interact with their health insurance (later in the year) around open enrollment. That's going to be too late. It's time to pay attention now."
O'Toole was in Duluth as part of a swing through the state, alerting residents that big changes are afoot and that their effects on all of us and our health insurance can be influenced by how effectively and intelligently we advocate.
The argument for doing away with MNsure now seems a bit mistimed. Yes, the exchange was plagued by computer glitches, not enough customer-service reps and other issues early on. And yes, two biggie insurance carriers, including Blue Cross Blue Shield, dropped out of the exchange, resulting in a lack of options for consumers that demands to be addressed and fixed. But improvements have been made. By many accounts, MNsure is finally finding its footing. Arguments in favor of its local control rather than the far-off decisionmaking in D.C. that would result with moving to the federal exchange remain as compelling now as when the federal legislation first was passed.
"We are four-plus years into this and people are really starting to understand and reap the benefits of it," O'Toole said. "We are talking about, right now, dismantling a program and a system that has produced record historically high (health-insurance) enrollment for our state: 96 percent of Minnesotans are now covered."
In addition, Minnesota led the nation last year with a 45 percent bump in new enrollees, O'Toole reported. And an increasing number of them, 68 percent now, are receiving tax credits that average about $7,500 statewide.
But then Minnesota long has been a leader nationally in delivering health care and health insurance, another argument for maintaining MNsure.
What federal lawmakers come up with to replace the Affordable Care Act remains to be seen. A Republican plan released this month needs more work. That became clear when the Congressional Budget Office crunched the numbers and reported it would result in the uninsured rate nearly doubling by 2026.
At least four Congressional House committees are working on the measure this week. They can give it the tweaks it needs to meet Republicans' and President Donald Trump's stated goals of improving health care access at a lower cost to consumers.
While that work is happening, what can all Americans do?
"Keep reading, and I think they should contact their legislators and tune in to the debate. Their health care is at stake," O'Toole said, offering some pretty sound advice. "Let's not go backwards for Minnesotans. Let's make it better."
That can start by paying attention.