Governor Dayton and his allies are working to establish a health care "exchange" (HIX) in Minnesota. This is a central feature of the Patient Protection and Affordable Care Act (PPACA - aka "Obamacare").
Proponents say Minnesota must establish a HIX or the federal government will impose one on us. They predict that Minnesota's HIX will be a vibrant on-line "marketplace", akin to Expedia.com. It will allow comparison shopping, increasing our choices while decreasing our costs.
None of this is true.
Lawmaking is serious business. The facts - not the marketing spin - should be used to evaluate a proposed law, especially one with huge impact.
What do we know about the Minnesota HIX?
- It will be expensive. MN has already spent $150 million on its development, and the MN health department says it will cost at least another $56 million a year to run. If history is any guide, that won't be enough.
- The so-called "federal" exchanges do not yet exist. The PPACA provided no funding for them. At least 25 other states have said "no".
- The HIX will not be recognizable as a "marketplace". Plans and vendors in the HIX will be limited to the few approved by the state of Minnesota, and the PPACA. Many types of traditional insurance policies, such as "major medical" will be outlawed. All insurance policies on the HIX must include a long list of required, and costly, features.
- "The rules", rather than "Customer satisfaction" will dominate the HIX. Run by an appointed, unaccountable board of 7 members, they will be exempt from the Administrative Procedures Act (chapter 14) that permits the public to challenge their rulings. No public input allowed. (see ilne 3.36 in the bill)
So why are we so anxious for a Minnesota HIX?
We already have a marketplace in Minnesota. We have a small army of insurance agents working hard to help Minnesotans choose the best health care options to meet their needs. Every one of them loses his job if he does not satisfy customers.
The HIX serves government, not consumers. As a "marketplace" it is unnecessary and expensive to run. It will not bring down the costs of health insurance. In fact, the current HIX proposal will impose a "fee" of 3.5% on all health insurance sold in Minnesota, whether purchased in the HIX or not.
The HIX will be a marketplace of limited choices, with a handful of vendors, and a handful of plans, all very much alike, and all very expensive. Even the least expensive family plans permitted will probably cost well over $16,000 per year. If this is a "marketplace", then so is OPEC.
The HIX does have one vital function.
The PPACA requires the IRS to enforce the "mandate" that every citizen must purchase health insurance. The IRS has lots of expertise in tracking our income, but no way to ensure that we buy certain approved products.
Enter the HIX, which will provide the IRS with information to enforce the mandate. Because the mandate depends on the "health status" of enrolees, the HIX must also track their medical history. Medical records of enrolees will be on-line through the HIX, and available to any "authorized" state or federal agency. We already know that such databases have a poor track record of respecting our privacy.
To summarize: The HIX is expensive, unnecessary, and unaccountable. It is not a marketplace, but a tracking mechanism. It will drive up the cost of health insurance, and threaten our medical privacy.
The PPACA was rammed through Congress before our representatives even had time to read it. Many of the promises of the PPACA have already been broken, and some portions have already collapsed. The CLASS act collapse is a good example.
Governor Dayton and his allies are ramming the HIX through in the same way, in a big hurry, while warning of disaster if not approved. Will we fall for this again?
Minnesota has some of the best health care in the world, and the most generous citizens. There is no emergency here. Before we adopt a HIX, we must be shown that the value outweighs the costs.
Unless the benefits are clear, and clearly worth the costs, the answer should be "no".