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Health act working way through Leg.

The Minnesota Insurance Marketplace Act must be signed by March 31.

Lawmakers are ironing out the details of Minnesota’s new marketplace for health coverage — an exchange that’s expected to have almost a million Minnesota users in its first year.

The new health insurance exchange, which should be operable in October, will offer an online setup where people can compare premium rates and sign up for health plans.

February committee meetings in the state Senate and House of Representatives will focus on hammering out the details of the exchange’s financing and oversight.

With two months to sign the bill before the federal deadline, the Minnesota Insurance Marketplace Act is not flying through the Capitol with full compliance.

Rep. Greg Davids, R-Preston, is one of two Republicans co-authoring the bill. He said he wouldn’t vote for it at this point, but he wants to work with his colleagues at the Capitol to get it to where he would.

“They’re going to have to clean it up,” he said, “or I’m going to pull off it.”

Last session, the health exchange discussion didn’t last long because of Republican critics. Now, with a Democratic-Farmer-Labor-controlled Legislature and a governor who backs the plan, the bill is on track for passing.

“I’m not fighting the fight to get rid of it because it’s the law of the land,” said Jim Abeler, R-Anoka, co-author of the bill. “So now my work is to try to make it so it causes minimal amounts of harm and maybe the benefit that people hope for.”

Lawmakers agreed in January that they’d rather take the state’s approach to changing Minnesota’s health insurance system instead of having the federal standard plan implemented in the state — a rule under the federal Affordable Care Act signed by President Barack Obama in 2010.

“We think we could do a little better job of running it than having the federal government do it for us,” said Rep. Joe Atkins, DFL-Inver Grove Heights, author of the bill.

Davids agreed and said he would rather call a 612 area code than a 202 area code for health care.

“We’ve dealt the cards already, and I think we’ve done the right thing by the state taking control of this,” Sen. Jim Metzen, DFL-South St. Paul, said at a Senate committee meeting Wednesday. “We’re all players in this. We’re all going forward, so let’s try to make it better. Let’s all work together.”

Lynn Blewett, director of the University of Minnesota’s State Health Access Data Assistance Center, a program to help states monitor rates of health insurance coverage, said a lot of people think everyone will have to purchase through the exchange, which she called a misconception.

“Most of us get our health insurance from our employers who work on our behalf to get the best deal in the market,” Blewett said. “If I work for a large employer, like the University of Minnesota or the state of Minnesota, they have a lot of leverage in the market, and I don’t have to go out and negotiate my own premium.”

Atkins said at a committee meeting Friday that participating in the exchange is completely voluntary.

“If a Minnesotan doesn’t want to participate in this, they don’t have to,” he said.

The reason exchanges are set up is so individual buyers, and workers of a small business with 50 employees or less, can get the advantages large employers and their employees already get, Blewett said.

This targeted group of insurance buyers is called the “small group” market, Atkins said.

“Twenty-somethings are anticipated to be one of the largest users of the exchange,” he said.

When the exchange is fully operational in 2016, Atkins said it’s estimated that almost 1.3 million people would use it — including 300,000 individuals who are uninsured now.

Critics of the exchange say the health plans will pass the fees on to insurance customers by increasing their premium rates, making coverage more expensive for everyone.

How it stands now, the bill calls for health plans sold through the exchange to withhold 3.5 percent of their total premium rates.

Minnesota has received $110 million in federal grants so far to create the health exchange.

The federal deadline for signing the bill is March 31, so lawmakers have two months to hash out the exchange’s details.

“People think we walk up to the table and we’ve got all the answers, and really we don’t,” Atkins said.

Health insurance coverage from the plans purchased through the exchange are required to begin Jan. 1, 2014.

There are House hearings to discuss more details about the exchange scheduled for Tuesday and Wednesday in the Health and Human Services Policy Committee.

There is also a Senate meeting Monday in the Health, Human Services and Housing Committee and one in the Senate Committee on Taxes for Thursday.

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