Insurance exchange
A diverse board of directors should improve prospects for success

Legislation signed by Gov. Mark Dayton on Wednesday marked a critical step toward creating a homegrown online insurance marketplace and putting more power in the hands of consumers when it comes to health insurance.

But the next steps will be crucial in ensuring the exchange’s success. Much of that burden will fall on the shoulders of Gov. Dayton, who will appoint the majority of the exchange’s board of directors.

A linchpin of federal health reform, the state-based exchange will provide an online marketplace where consumers and small businesses can compare and shop for insurance coverage. It’s expected to affect about 1.3 Minnesotans, or about one in five state residents.

Advocates claim it will allow Minnesotans to save significantly on premium costs, but opponents fear it will result in a bloated government bureaucracy that will be harmful to consumers. The Minnesota Chamber of Commerce is among those critical of the legislation signed by Dayton, saying that business-oriented suggestions were swept aside.

Much of the concern stems from the process that produced this bill. For two years, this important issue was virtually untouched by legislators. And now what has been described as the biggest change in health insurance since the 1960s has been signed into law halfway through this session. The rapid turnaround has some questioning whether legislators had enough time to fully appreciate the consequences.

Given that environment, it’s important for Dayton to choose representatives who are not only knowledgeable but also bring a diversity of views to the exchange board. A mix of opinions will help ensure that policies are thoroughly vetted with the consequences of each decision weighed before policies are adopted. That said, the board must also be able to work well together and develop acceptable compromises.

The timelines for the next steps are incredibly ambitious. The exchange board must hold its first meeting within 60 days of the bill’s enactment and a series of other daunting tasks lie ahead including the completion of a complex information technology infrastructure. In addition, health plans must submit the products they want to sell in the marketplace for regulatory review and the state has to launch a public relations blitz explaining to consumers what the exchange can do for them.

It’s critical that the folks appointed to oversee this process understand the issues but remain open to ideas that may be out of the box. Staffing the exchange board with the state’s best thinkers will help reassure stakeholders and ensure that the process does not go off track or become bogged down by politics in what has the potential to be a highly-charged political football.

Even so, the concept — putting more power into the hands of consumers and making health insurance available to all — is worth the effort. Minnesota’s reputation as a national health care leader provides some confidence that the state will find a way to make this work. But Dayton can strengthen that trust by wisely choosing board appointees who will live up to the challenge.


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