ST. PAUL, Minn. (AP) — All of the Republicans seeking to oust Democratic Gov. Mark Dayton regard Minnesota's problem-ridden health insurance exchange as an unmitigated disaster, but they differ on what they would do about it if they were elected.
The fissure on health care became apparent this week when Republican businessman Scott Honour strongly advocated replacing the state-run online marketplace, MNsure, with one managed by the federal government. His four main rivals flinched at the idea of relinquishing state control, with Rep. Kurt Zellers and former Rep. Marty Seifert unequivocally ruling it out as a possibility if they win.
It's a major contrast point in a GOP nomination battle that has seen few so far. Democrats waiting to see who will emerge as the fall challenger are also keeping tabs on the debate, mindful that it's easier for Republicans to criticize the current system than to present a viable alternative.
In an interview Friday with The Associated Press, Honour said that trying to repair MNsure, which cost tens of millions of dollars to construct, would amount to "an open-ended bailout" that doesn't seem worth it. He also said he doesn't see the likelihood of a sudden reversal of the federal health care law, which mandated that Americans carry health insurance and led to online exchanges where people could shop for plans.
"MNsure is Obamacare," Honour said. "What we were doing with MNsure was duplicative from day one. We can move over to the federal exchange. It's there, it works — not as well as I would want but that's their problem. It certainly works better than MNsure, and it's available to us."
He said other Republican governors — Wisconsin's Scott Walker, Texas' Rick Perry and South Carolina's Nikki Haley among them — went the federal route instead of putting state time and resources into individualized marketplaces.
Minnesota was among 14 states that opted to build their own exchanges rather than default to federal control. But MNsure struggled from the moment it launched Oct. 1, as customers encountered a glitch-laden website and confusing, often contradictory information about their insurance options.
As problems mounted, callers to the agency's helpline faced waits that frequently stretched past an hour. By last month, MNsure executives acknowledged that some enrollees would be forced to sign up via paper application ahead of the March 31 end of open enrollment. A recent independent review sketched out several options for fixing the website, including the most drastic choice: essentially rebuilding it from scratch. MNsure officials are likely to decide soon which route to take.
Zellers, a former House speaker, responded most aggressively to Honour. He told the AP that the approach could spell more hassle for consumers by "throwing them from a small abyss into the big abyss." He's not swayed by arguments that conservatives elsewhere left it up to the federal government.
"I'm not running to be the governor of another state," Zellers said. "I'm not running to be Scott Walker-lite or Rick Perry-esque."
Zellers hasn't laid out a formal health care plan, but he said would push first for MNsure's outright repeal. He said he would seek tax incentives people could use to shop for insurance of any kind, moving away from Minnesota's current system of allowing policies only from not-for-profit companies. His proposal is predicated on winning federal waivers, which are far from certain.
Seifert said Honour's idea of swapping control probably won't sell with voters, particularly those who will decide the GOP nominee against Dayton in an August primary.
"They would view it as moving from political frying pan to political fire when you move from a state bureaucracy that is fundamentally flawed and doesn't work to a federal bureaucracy that is fundamentally flawed and doesn't work," Seifert said.
Like Zellers, Seifert said he would let more companies into the Minnesota marketplace, including for-profit companies, and make dramatic membership changes on MNsure's appointed governing board.
Restructuring the board and remodeling MNsure to make it less complicated for users is the direction state Sen. Dave Thompson would go, said his running mate state Sen. Michelle Benson. She said pushing Minnesota into the federal stream is harder than it sounds because some insurance providers are under contract with the state for the next year.
"Until we have a sitdown with everybody at the table to design the path, I don't think we should be making radical moves," Benson said.
Another candidate, Hennepin County Commissioner Jeff Johnson, said whatever approach Minnesota lawmakers take, they must be careful not to punish people who did access coverage through MNsure.
"By the time a Republican governor takes office in 2015, MNsure will have metastasized like a cancer in our health care system. People will depend on it," Johnson wrote on his campaign's Facebook page. "At that point, we should stop focusing on pushing new people into MNsure and strengthen the ability of the private market to compete with non-subsidized health care."