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In the past, Dayton has said his administration has the authority to move forward on an exchange, a process that he has delegated to a broad task force charged with making recommendations and studying its implementation.

Dayton: Legislation could be needed on exchange

Gov. Dayton and legislators called for establishment of a Minnesota health insurance exchange Monday. (Staff photo: Peter Bartz-Gallagher)

After moving forward with an executive task force to implement the state’s health insurance exchange required by the federal health law, Gov. Mark Dayton said Monday that legislation could be necessary to fully implement any eventual plan.

In the past, Dayton has said his administration has the authority to move forward on an exchange, a process that he has delegated to a broad task force charged with making recommendations and studying its implementation.

But on Monday, Dayton said it could take legislative to bring the plan to fruition and avoid having the federal government take over and install its own. The administration says the question of whether a bill would be absolutely necessary remains unanswered, though, but three states (Mississippi, Rhode Island and Indiana) are proceeding without legislation.

“We believe we have the authority to move forward,” Dayton said at a Capitol news conference, joined by Commerce Commissioner Mike Rothman, whose department has taken a lead role in exchange efforts. Absent a bill this year, though, the administration’s goal will be to move forward enough to satisfy federal guidelines and continue implementing the full exchange plan — with legislation, if necessary — next year.

Dayton said his administration has yet to study the finer legal points at the heart of the issue and has not yet discussed with the attorney general whether legislation is absolutely necessary. Regardless, he said he hoped Republicans would join the effort.

“There isn’t a Democratic or Republican health care. There isn’t a Democratic or Republican sickness,” he said. “It’s just a shame they weren’t willing to work with us.”

From the beginning House and Senate Republicans have refused to take part in the exchange task force, saying it will function as a rubber-stamp for the administration and saying that the Legislature was the proper venue to consider exchange structure and implementation.

Some Republicans, notably Senate Health and Human Services Chairman David Hann, had previously threatened to go to court over what they saw as executive overreach. Those plans were later tabled, though. Still, Republicans in the Legislature have said Dayton was overstepping his authority in implementing an exchange and have said they intend to exert legislative oversight this session in one way or another.

Dayton’s comments, though, could give Republicans significantly more oversight of the exchange than they would have had if the administration pressed on without a bill. Both DFLers intending to introduce exchange bills in the next week, Sen. Tony Lourey and Rep. Joe Atkins, said they have yet to find any willing Republican co-authors, although some have told them they’d like to see the bill before making any decisions, they said.

With more oversight, though, potentially comes a more complex political calculus. Under the federal health law, absent a state-run exchange, the federal government would implement one by 2014. That threat  has led Republicans in other states and a host of industry and business interests to get behind the idea of implementing an exchange at the state level even if they oppose the federal health law in general.

Hann, for his part, has been a staunch opponent of the health exchange and the law, something he considers unconstitutional. In the House, Health and Human Services Reform Chairman Steve Gottwalt, had a bill last session that would have moved forward on an exchange but it died in his own committee thanks to protests from its more conservative members.

Dayton’s comments came at a news conference during which he presented recommendations and a broader report from his health insurance exchange task force. Those recommendations are intended to provide guidance for the legislation Lourey and Atkins will introduce in the coming days. The task force will continue it’s work, Rothman said, as the process moves forward.

Atkins said the initial bill this week will likely provide the “25,000-foot” view of what an exchange might look like, which is intended to satisfy the federal government that the state is making sufficient progress, a requirement by Jan. 1, 2013. Additional legislation on more specific parts of the exchange will be needed in the future and even into next year, he said.

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