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Editorial: MNsure: 'We're still here'

After yet another legislative session in which there were calls to do away with MNsure in favor of Minnesota joining the federal health exchange, MNsure CEO Allison O'Toole and its public-affairs director Jeremy Drucker traveled the state this week to deliver a clear message.

"Nothing came of it. We survived again," O'Toole said in a meeting with the Duluth News Tribune Editorial Board. "We're still here. We're open for business. ... And it's the right thing. It was the right decision, especially right now given all of the uncertainty at the federal level. It really is the right thing for Minnesota."

Uncertainty, unease, and trepidation long have dogged health care in America, including when President Barack Obama pushed through his Affordable Care Act and, now, with President Donald Trump and his administration working — troublingly, with not nearly enough transparency — on a replacement.

Through it all, Minnesota making its own decisions and managing, as much as possible, in matters of health care and health insurance has served the state well, offering at least some locally focused control. Little has happened to alter that as a wise route, to suggest that relinquishing power to the feds could somehow better serve Minnesotans.

In fact, while computer woes and shoddy customer service marred MNsure's earliest days, such issues have been addressed, continue to be addressed, and have vastly improved. It's difficult to argue with Minnesota's approach considering its current 4 percent rate of uninsurance, the lowest in state history and the second best in the nation, according to O'Toole and Drucker.

"We're doing well. We had record enrollment. But we can always do better," O'Toole said.

That commitment to improvement has MNsure currently seeking proposals to improve its website and other information technology. Simpler navigation for consumers tops the wish list, as it should, and any updates or changes wouldn't take effect until 2018; MNsure learned the hard way not to rush such things.

The state exchange also is considering better ways of fielding consumer complaints. A contract with a firm that had been doing that work ended, making now an opportunity to look at whether a better option is out there.

MNsure also right now is preparing to begin offering subsidies to insurance carriers to help them offset high-cost patients. Providing about $500 million from state and federal sources is hoped to help lower rates for everyone else, stabilizing Minnesota's insurance market.

This "reinsurance" — approved by the Minnesota Legislature with federal approval expected this summer — hasn't been without controversy. Insurance companies are receiving public dollars, after all — lots of public dollars — without being obligated to lower rates.

"There are no guarantees with this," O'Toole acknowledged. "They are getting half a billion dollars over two years to help stabilize the market, which I think ultimately is good. We sure hope they do right by Minnesotans and bring rates down. ... I've always said I think the market needs to be stable and stabilized. So I think reinsurance is good. Let's see what the results are."

With the busy open-enrollment period more than four months away, one might think now is a slow time of year for MNsure. Hardly. Not when you're "open for business" and working to be better — including better than the federal exchange.

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