Last week’s Supreme Court ruling affirming Affordable Care Act insurance subsidies is seen by many as making permanent this landmark approach to health care coverage. Interestingly, it comes just as Minnesota is set to examine — and possibly even scuttle — its state-based insurance exchange.

That’s significant not just for Minnesotans, but because our state has long been held up as a model for efficiency in administering public health programs.

Still, thanks to state legislation adopted this past session in St. Paul, MNsure is about to undergo a serious review as the state looks at it in connection with not just the federal exchange but MinnesotaCare and other public health programs.

Creation of the Minnesota Task Force on Health Care Financing was included this spring in legislation signed by Gov. Mark Dayton. The goal of the 29-member committee is to advise Dayton and the 2016 Legislature on how to increase access to and improve the quality of health care.

The panel is on a tight timeline. Its report is due Jan. 15. The group will be a mix of legislators, the governor’s cabinet, appointments and various state agencies.

In short, it sounds like the task force is charged with figuring out the best ways to get the most Minnesotans quality care under public health programs that are sustainable.

For example, long before the latest court ruling, one issue the task force was expected to examine was how MNsure and MinnesotaCare fit together.

The former, which certainly struggled to get off the ground, seems to have helped bring coverage to more Minnesotans, especially those eligible for public programs.

Meanwhile, the latter has long helped people who come in just above poverty levels yet still struggle to afford coverage. Its funding source — a tax on providers — is supposed to sunset at the end of 2019.

And, of course, don’t forget about Medicaid, the massive federal program that serves those at or below the poverty line.

All those public programs, while important, also require public resources. How much is Minnesota spending to run MNsure and MinnesotaCare? What’s the return on that investment? Is it sustainable? Or might some of those costs be lessened if the federal exchange, which is now functional, got involved?

Please don’t perceive those questions as opposition to MNsure or MinnesotaCare. Indeed, this board urged support for both in recent legislative sessions. Instead, those questions need to be asked and answered now — not only because of the Supreme Court ruling, but the state itself wants to know via this new task force.

St. Cloud Times

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