Minnesota House passes health exchange proposal

But Atkins said the average annual savings in health premiums for participants is projected to be $490. Some will save more while others earn too much money to qualify for tax credits for participants under certain income levels.

"Even the cheapest one will be a dramatic improvement over what most people in Minnesota currently have," Atkins said, explaining that provider networks would be bigger and deductions and co-pays smaller. He said the website would be like sites where travelers compare and purchase plane tickets or hotel reservations, offering a range of insurance policies for consumers to choose from after they've entered personal information.

The exchange will be governed by seven people appointed by the governor and subject to approval by the House and Senate. Its expected operating costs of $60 million a year would be covered with a fee on premiums of up to 3.5 percent. That's a key difference with the state Senate's health care exchange bill, which instead taps money from a state tobacco tax.

The Senate bill is due for a floor debate and vote on Thursday. Differences will be reconciled in a House-Senate conference committee, and lawmakers are on a tight timetable: A federal deadline requires the bill to be passed by the end of March, with enrollment due to start on Oct. 1.

Under the federal law, states had a choice of creating their own insurance exchanges or leaving the job to the federal government. Atkins said Minnesota's legacy of innovative health policy was incentive to design the state's exchange here instead of Washington.

A series of changes sought by Republicans in the House minority were mostly unsuccessful. Republicans tried but failed to make the exchange board's seats elected rather than appointed, to force the exchange's managers to obtain their own insurance through it, and to strip money from the bill for marketing of the exchange.

"For some of you this will be one of the biggest bills of your career," said Abeler, who voted for the bill in order to secure a spot on the conference committee where he said he hoped to improve the measure. "We could be looking back and saying, 'What did we do? We took away people's choices.' It's a great peril — this thing has to work in real life."

Some of Atkins' fellow House Democrats were unhappy with a late change to the bill, one that he pushed as an effort to entice insurers to participate. It would give each participating insurer the chance to sell at least two products on the exchange, rather than requiring all products to go through an exchange product screening process. That provision is not in the Senate bill.

Gov. Mark Dayton, whose administration has worked to help implement the exchange, acknowledged the risk involved.

"It's a big gamble," Dayton said during a Minnesota Public Radio call-in show. He added, "I'm sure there are going to be glitches. There has to be glitches with something of this enormity."