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MNsure takes more heat in funding debate

Rep. Erin Murphy, DFL-St. Paul, lamented the repetitive nature of discourse around MNsure, saying both parties routinely fell into arguments over MNsure’s startup problems rather than noting the program’s “trajectory of improvement.” (Staff photo: Bill Klotz)

Rep. Erin Murphy, DFL-St. Paul, lamented the repetitive nature of discourse around MNsure, saying both parties routinely fell into arguments over MNsure’s startup problems rather than noting the program’s “trajectory of improvement.” (Staff photo: Bill Klotz)

It’s a high school teacher’s dream. Matt Dean is giving himself homework assignments and, frankly, wishes there were a bit more math on the sheets being passed around the room.

Rep. Dean, R-Dellwood, admitted as much during a Thursday hearing of his House Health and Human Services Committee, explaining his frustrations with MNsure, the state insurance exchange. Dean said he had taken to watching taped meetings of the MNsure board on Youtube, and thought there was a “disconnect” between board members’ relative calm and the frustration experienced by consumers, insurers and counties.

Dean’s remarks were occasioned by a presentation of MNsure’s preliminary budget for the next fiscal year. By law, that exchange budget must be approved and presented to the Legislature by March 15 of each year. Here, too, Dean found fault with MNsure’s accounting of its projected $94 million in costs for the fiscal year beginning July 1.

“This is sort of a coloring book version of a budget,” Dean said, comparing the 15-page document to a “five-inch thick” binder the committee would review for human services.

The criticism might not come as a shock, given the high level of scrutiny and cynicism most Republicans have for all things MNsure. But it’s hardly a promising start for a state entity that is seeking more state money and, almost assuredly, will need legislative approval for all budgets going forward.

Gov. Mark Dayton’s budget proposal calls for an appropriation of $11 million for the Department of Human Services (DHS) for its MNsure-related operations, with a slightly higher figure built into the base for each successive budget. That request is almost invisible within a $12 billion DHS budget request, but no element of MNsure goes unnoticed.

Chuck Johnson, deputy commissioner at DHS, said the funding would be “critical” to the exchange’s IT upgrades this year. Specifically, Johnson said the money would pay for work on back-end website construction to make it simpler for counties to change an enrollee’s information in the case of a “live event.” A new marital, parenting or employment status could alter someone’s eligibility for public programs — which are expected to account for 90 percent of total enrollees in 2016 — and counties have struggled communicating that data to MNsure.

“We ask for your support on that [appropriation],” Johnson said, “because we need that in order to make these improvements for public programs, for the counties and for the direction we want to go with DHS.”

Nearly two-thirds of MNsure’s fiscal year 2016 budget is directed at IT expenses, and just more than half is designated for “acceleration of IT development.”

MNsure applied for and received a $28 million “adjustment” to its federal grant, about 90 percent of the requested amount, Leitz told the committee. Leitz said continual federal grants show that authorities consider MNsure a “good investment,” though he warned that the most recent round of appropriations would probably be the final chance for states to tap federal money.

Both Leitz and Johnson spoke of changes in the exchange’s governance and decision-making process, highlighting increased input from counties and Mn.IT services.

The next-highest spending sector comes for various customer service outputs. Combined, expenses on navigators ($6.7 million), technical and call center support staff ($7.8 million) and other related operations are estimated to total $21 million next year.

Some $7 million of the budget is categorized as “administrative” spending, and more than $1 million is earmarked for executive salaries for board members and six full-time employees.

Rep. Glenn Gruenhagen, R-Glencoe, riddled Leitz with questions about salaries and bonuses for board members, suggesting they should give back any bonuses and be in line for a salary cut before asking for more state funding.

“I think people should take about a 25 percent deduction in their pay,” Gruenhagen said. “And then I’ll think about helping you out in some way.”

Leitz repeatedly took neutral positions when questioned about different ideas before the Legislature this session, including an elimination of the board, a move to the federal Healthcare.gov exchange or decoupling the agency from DHS; in each case, Leitz said he currently works on behalf of the board, and the board had taken no position on legislative proposals this year.

Rep. Erin Murphy, DFL-St. Paul, lamented the repetitive nature of discourse around MNsure, saying both parties routinely fell into arguments over problems MNsure experienced with its website launch and the lagging number of private marketplace customers compared to early projections.

“We have talked a lot about year one and year two [of MNsure],” Murphy said. “It appears to me we’re on a trajectory of improvement, and I think that’s important to note, since we’ve made an investment of time and tax dollars.”

Dean, who is carrying the bill that would fold Minnesota’s exchange into the federal system — provided the U.S. Supreme Court does not disqualify subsidies for those exchanges — argued the conversation is productive, helping the committee address its next step for MNsure. House Republican budget targets released earlier that week showed the majority caucus looking to cut some $1 billion from base-level spending on health and human services, and leaders suggested a large chunk of those savings could come through changes to MNsure.

“Our committee has to put a budget together,” Dean said Thursday. “We’re going to have to deal with this, and our public programs, and how we deal with people who we assist with buying health insurance is going to figure in in a big, big way.”


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