Allison O'Toole is stepping down as chief executive at the state's MNsure health insurance exchange to work at a nonprofit created by Andy Slavitt, the former UnitedHealth Group executive who held a key health care job in the Obama administration.
O'Toole announced her decision at the start of a Wednesday meeting in St. Paul where the MNsure board named Nate Clark, the current chief operating officer, as acting CEO.
When it was launched as part of the federal Affordable Care Act (ACA) in 2013, MNsure stumbled badly out of the gate with widespread technology problems that outraged consumers and made the exchange a target for Republican attacks. The exchange saw operational improvement and enrollment growth during O'Toole's tenure, but now faces uncertainty as opposition to the health law persists among Republicans at the federal level.
"We're coming off our most successful open enrollment period, helping more Minnesotans than ever before," O'Toole said. "Obviously, that helps our financial position right now. But given the high degree of regulatory uncertainty, we will need to manage our resources with extreme vigilance."
The ACA called for new state-level online marketplaces that are run by the government to provide an option for individuals who don't get employer coverage. Minnesota was in the minority of states to launch its own exchange, which connects many consumers with income-based tax credits from the federal government.
Exchanges across the country face challenges going forward, since the landmark tax bill passed last year by Republicans and signed into law by President Donald Trump eliminates in 2019 tax penalties in the ACA for individuals who lack health insurance. The Trump administration also is pushing rule changes that might let insurers sell policies with limited benefits, a shift that could concentrate individuals with health problems in the insurance market governed by ACA rules.
"We're in the midst of commenting on some of these regulatory proposals that are continuing to undermine the market," O'Toole said Wednesday. She praised bipartisan efforts in Minnesota to stabilize the individual market.
O'Toole is taking a job as director of state affairs with the United States of Care, a new nonprofit with headquarters in Washington, D.C., and Minneapolis that's pushing for better access to quality, affordable health care. Slavitt is the group's board chair. Previously, he was a prominent executive at Minnetonka-based UnitedHealth Group before leading implementation of the health law at the federal Centers for Medicare and Medicaid Services.
