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Health marketplace makes a big change

A crowd gathers outside the Minnesota Senate chamber Thursday while senators inside debate a health insurance marketplace.

ST. PAUL -- Sen. Tony Lourey endured 12 hours of debate on what he called the biggest change in the Minnesota health care system in decades.

Senators voted late Thursday 37-28 to approve Lourey's bill forming a Minnesota Insurance Marketplace, a mostly Web-based system for Minnesotans to buy health care insurance.

"Minnesotans for the first time to be able to shop on an apples-to-apples comparison for health care products," Lourey said as the marathon debate ended.

"Individuals will get more compressive coverage and pay less out of pocket," the Kerrick Democrat added.

Republicans disagreed.

"I know, Sen. Lourey, that you have the best intentions," Sen. Julie Rosen, R-Fairmont, said.

However, she said, the bill senators passed, similar to one representatives passed earlier, would be governed by a board without people with enough expertise in health care.

The marketplace, also known as an exchange, is required by federal law popularly known as Obamacare. If the state does not establish the marketplace, the federal government will.

"In this gamble, I am going to bet on the state of Minnesota," Lourey said.

"I think Minnesota can do a better job," added Sen. Rod Skoe, DFL-Clearbrook.

The Lourey bill funds the exchange, costing nearly $60 million a year to run, with existing cigarette tax proceeds. The House approved funding that would come from taking up to 3.5 percent of premiums charged in the marketplace.

The two bills head to a House-Senate conference committee in the next few days to work out differences. The goal is to get it on Gov. Mark Dayton's desk by the end of the month.

Support of the bill split mostly along party lines in the House and Senate, with most Democrats in favor and all but one Republican voting against the bills.

Sen. Bill Weber, R-Luverne, said that Democrats did not make changes needed to improve the marketplace.

"It is the beginning of the end of the greatest health insurance system," he said.

Because licensed insurance agents would not be allowed to be involved in the marketplace, those in charge "will not have a full comprehension of the insurance system," Weber said.

Sen. Paul Gazelka, R-Nisswa, said he is concerned that the marketplace would mean Minnesotans will have fewer choices of insurance policies. He also questioned Lourey's comments that insurance would cost less.

"This exchange bill establishes an extremely expensive government infrastructure that guarantees the creation of a super-agency with layers of bureaucracy between Minnesotans and their health care," Rosen said.

Sen. Lyle Koenen, DFL-Clara City, said the marketplace would give Minnesotans some insurance competition "so we can get some lower premiums and then, secondly, that a lot of those that qualify, it will be based on income, that there will be some help to pay those premiums and so it's a good way I think to make sure that many more Minnesotans are covered by health insurance."

Sen. Kent Eken, DFL-Twin Valley, said the type of insurance products available would expand.

"Whatever insurance (policies) offered in this exchange are going to be good quality products ... and so we want to make sure again that people are being provided with health care coverage that is good as well as affordable," Eken said.

Don Davis
Don Davis has been the Forum Communications Minnesota Capitol Bureau chief since 2001, covering state government and politics for two dozen newspapers in the state. Don also blogs at Capital Chatter on Areavoices.