Feds must move faster to greenlight Minnesota health premium savings

Minnesota consumers deserve an answer to an important question as soon as possible from U.S. Health and Human Services Secretary Tom Price.

Price's former Republican colleagues in Congress are repeatedly calling to give states more flexibility to innovate as a bipartisan group of U.S. senators weighs Affordable Care Act fixes this month. But Price's agency already has before it a pioneering Minnesota proposal intended to reduce 2018 individual market health insurance premiums by around 20 percent.

Will Price and this Republican administration back up the innovation rhetoric by greenlighting the "Minnesota Premium Security Plan" in time to deliver serious savings to shoppers here?

Time is dwindling for the agency to act, as MNsure CEO Allison O'Toole made clear during her testimony Tuesday before the Senate Health, Education, Labor and Pensions Committee hearing. O'Toole leads Minnesota's ACA online marketplace, where consumers who buy private coverage on their own can comparison shop and tap into new financial assistance under former President Barack Obama's health law.

O'Toole was called to Washington in part to talk about Minnesota's premium security plan, often referred to as "reinsurance," which was passed during the last legislative session to combat skyrocketing individual market premiums. The program brings down individual premium prices costs by using public funds to offset the care costs of consumers with expensive, ongoing medical needs. Right now, the individual market — which serves about 190,000 people in the state — is too small to affordably spread these costs under a traditional insurance model.

The Senate committee is assessing whether the federal government should help other states set up similar reinsurance programs. But first, Price's agency needs to sign off on the Minnesota reform in time for it to deliver discounts to consumers buying insurance for 2018. Open enrollment, the window of time when most people can buy insurance, begins Nov. 1.

That looming date fueled the urgency in O'Toole's voice Tuesday as she said the state needs an answer in days, not weeks, from Price's agency. The Minnesota fix is contingent upon federal approval, in no small part because it means that the federal government would contribute significantly to the program's annual price tag — $271 million. An additional crucial point: Federal approval also would protect the federal funding stream for the state's MinnesotaCare program for working families.

Insurers and state officials have to hit numerous information technology and communication deadlines in the weeks before open enrollment's Nov. 1 launch to ensure that consumers can buy on day one without a glitch. More important, consumers need to prepare if the discounted Minnesota premiums will not become a reality.

The state's congressional delegation has pressed Price for expedited approval. State leaders have done so as well, with O'Toole and state Sen. Michelle Benson, R-Ham Lake, meriting praise in particular for spotlighting this. The urgency was also evident this week in a statement from Jim Schowalter, president of the Minnesota Council of Health Plans. "We are nearly out of time. I am surprised no one in Washington, D.C., wants to be the hero who makes it happen,'' he said.

It has been an exercise in frustration trying to pry answers from Health and Human Services officials under Price's leadership. A spokesperson contacted this week would say only that the agency had a 180-day window — one that began June 30 — to approve the Minnesota program.

But an answer in December, November or even October simply doesn't work logistically for Minnesota. Price and his agency already have approved a similar reinsurance program for Alaska. They need to work harder to support Minnesota innovation instead of impeding it.