Text: October 26, 2016The Honorable Mark B. Dayton116 Veterans Service Building20 West 12th StreetSaint Paul, Minnesota 55155via electronic deliveryDear Governor Dayton:Thank you for your letter regarding the unaffordable premiums facing over 250,000 Minnesotans. This is the worsthealthcare crisis many Minnesotans have ever faced. While affordability must be addressed, any solution mustinclude relief for those who will be without coverage on January 1, 2017. I have instructed House Committee Chairsto discuss a path forward with DFL counterparts in the Senate.Our caucus stands ready to find a solution, not only to skyrocketing premium prices but to the immediate and direproblem of Minnesotans losing their family doctors, the security of personal financial and health information onMNsure, and the uncertain customer service experience that awaits consumers next week.Access to Doctors and Specialists. The pain of double-digit premium hikes will be compounded by drastically fewerchoices. Minnesotans will be cut off from their family doctors, face extremely narrow clinic networks, and still beforced to pay thousands more every year. The loss of provider choice and access to familiar clinics are negativeconsequences of Obamacare and MNsure that must be addressed.Since the announcement of next year's plan offerings, legislators have heard from constituents all over the statefearful of losing their long-time, trusted physicians. At a recent listening session, legislators heard from a 61 year oldman who will be forced to leave his doctor of over 20 years. This disruption is a result of failed state and federalpolicies, and enrollment caps approved by your Department of Commerce.Due to the caps, Minnesotans in over fifty counties are forced to choose between a capped insurer and an insurer withan average increase of 67 percent. Once enrollment caps are reached, fifty-three counties will have just one choice. Inan additional five counties, the only options are insurers with enrollment caps. Once caps are reached, people in thosefive counties will have no choices.This is unacceptable and contrary to every promise you and legislative Democrats made when MNsure was launchedthree years ago. Once enrollment caps are reached, what options will exist for the approximately 20,000 Minnesotanswho purchase coverage on their own in those counties?As discussions move ahead for a Special Session, preserving Minnesotans' access to their current doctor andmaintaining multiple options in every county must be a priority.MNsure Operations. Despite claims that MNsure's operational and technological problems are a thing of the past,recent performance and federal reports indicate otherwise.Customers faced huge wait times and unhelpful advice just last December. 1 Further, my understanding is that theMNsure site is capable of handling fewer than 700 customers at a time. Given that limitation, the call center couldexperience volume that far exceeds last December's surge which caused massive delays. Details of how MNsure hasimproved to meet the demands of open enrollment are appreciated.Last month, the U.S. Health & Human Services' Inspector General reported serious flaws in MNsure's security andmade recommendations for improvement. The problems were so sensitive they are not completely detailed. WhileMNsure claims there is no longer an issue, the report notes that MNsure only partially complied with one finding, anddisagreed with two findings and related recommendations. The Inspector General maintained that all of its "findingsand recommendations are valid."I will not ask MNsure to reveal sensitive information. However, I request any additional information on the unresolvedfindings that MNsure can provide without further compromising the integrity of its website.We remain hopeful that your administration will put a good faith effort into the Republican-led 2015 law directingyou to seek federal waivers helping more Minnesotans access federal premium tax credits and allowing consumers toshop wherever is most convenient for them. After $400,000,000 spent, MNsure remains in technological andoperational disrepair, and it is both arbitrary and unfair to force Minnesotans to shop there.Enrollment Caps. I am concerned that the state is ill-prepared to administer enrollment caps approved by theCommerce Department. The department says it will monitor and enforce by collecting "biweekly enrollment data frominsurers" and meet with insurers and MNsure "weekly on enrollment data."This is woefully insufficient given MNsure's technological failings. MNsure's inability to manage enrollmentapplications and cleanly transmit them to insurance carriers has caused significant frustration for consumers and is anominous sign for the state's ability to manage caps.There are approximately 25,000 capped carrier spots for the 112,000 that are in need of new insurance and thousandsmore that want better options. If enrollment is only checked twice per week, it is likely that thousands of consumerswill end up in limbo.The Commerce Department stated it will take up to two days before a plan that meets its cap is removed from MNsure'swebsite. When the difference between a capped carrier plan and an uncapped carrier plan is as much as 20 percent, itis cruel to lead people to believe they have enrolled in a plan that is actually closed.If caps are exceeded prior to a plan's removal or the posting of a notice of no new enrollment, what will happen tothose customers? Similarly, if a customer's odds of securing a capped carrier plan are better by enrolling directly witha carrier, or if the MNsure website is unable to handle the capacity, will those enrollments be honored by MNsure sothe person can receive a federal tax credit?Given red flags raised and ignored prior to the October 2013 launch2 - which resulted in needless frustration andheadache - we hope history will not repeat itself three years later. If security flaws remain or MNsure is still incapableof accurately processing applications, it should not go live until those problems are resolved.I appreciate responses to these issues and questions at your earliest convenience. We will continue to keep you apprisedof progress made by our caucus and all legislative caucuses as discussions continue. House Republicans are preparedto work on solutions that provide relief and assistance for MinnesotansSincerely,Kurt DaudtSpeaker of the HouseMinnesota House of Representatives1 Snowbeck, Christopher, "MNsure says storm-related call-center shortage was a factor in Monday waits," Star Tribune,12/29/20152 Meitrodt, Jeffrey, "MNsure defects were no surprise," Star Tribune, 2/17/2015