01/16/13 - CCHF Testimony on SF 1 - Minnesota Insurance Marketplace Act

MN Senate State and Local Government Committee

January 16, 2013

Testimony from Twila Brase on SF 1 – Minnesota Insurance Marketplace Act

Testimony begins at 2:05:15 into the video.

Twila Brase: Madam Chair, members of the board, my name is Twila Brase.  I am President of Citizens’ Council for Health Freedom. 

We’ve long been opponents of the health insurance exchange so this is probably not news to anybody around the table here.  What I want to do is I want to explain particularly what this is about. I think it is just important to understand the structure that is being created which is a little bit hidden within the bill.  The bill title says that this is a marketplace but according to the bill on line 2.21 the marketplace is created as a board and I think that that has been stated here. Just the fact that we keep talking about a marketplace is problematic to our organization because it is actually a state board. 

Furthermore, just to make sure that you understand exactly how much this is not a marketplace, it says that it has a dedicated state government account on line 9.31, it gets state appropriations, it must establish agreements with state departments, has to report annually to the legislature, has to establish an appeals process, and is not allowed to ever go away, although I know that language has changed a little bit but is still really not allowed to go away. 

So this is not a marketplace yet the bill exempts this board from rulemaking and still continues to exempt the board from rulemaking.  And even the new language that Senator Lourey has put out still exempts it from rulemaking because the first year, even though they have to put out and they have to ask for public comments, [the public does not] get to do what rulemaking allows with public comments.

In other words, in rulemaking, if you put in 25 letters, the department is required to hold an administrative hearing.  In expedited rulemaking, which is what he is offering instead after the first year, there is not even expedited rulemaking in the first year.  With expedited rulemaking, only if it mentions in the statute that the public is allowed to have input, like 100 letters, then an administrative hearing is allowed. 

In other words, the reason why the Health Department has been doing expedited rulemaking without the 100 letters and without opportunity for the public to have an administrative hearing is because they know our organization and some others could actually get an administrative hearing and it would slow them down.  So what we really have here still is no rulemaking the way rulemaking is meant to be to give the public meaningful opportunity to object to what is happening here. 

Now, the other thing of course is that [the board] is exempt from the Government Data Practices Act.  That means the Tennessen warning, which tells people whether they have to give data or not.

Sen. Pappas, Chair: Ms. Brase, that’s not in our jurisdiction. 

Twila Brase: I understand that. I am trying to create what the structure is.  Here’s what is particularly interesting about that is if you understand what the structure is.  In [the packet] is a diagram of the structure. If you look at the bill despite the fact that it never actually mention it, the exchange that is enabled through the bill would establish the largest ever data system for the purpose of tracking individuals and sharing data.  Now even though data is not part of the jurisdiction, the structure is part of the jurisdiction. 

So the structure is actually a board and a board that has all this money, 50 to 60 dollars of money, and it has all this authority to run the IT infrastructure and the IT infrastructure, as soon as you see the diagram, will show all the places that the infrastructure goes to share data, where they get all the data, from all the different state agencies, from the federal government and from other entities.

Above and beyond that, this IT infrastructure that is being created here that will be under the governance of the board is then allowed to connect to what I would consider “the mother of all IT superstructures” which is the Federal Data Services Hub.  The Federal Data Services Hub is being created by the federal government as the place to go for the sharing of information.  It is going to go to Homeland Security, it is going to go to SSA, it is going to go to the IRS. 

In short, what this bill does is it enables Minnesota to connect to the federal IT superstructure for what writers in the USA Today recently called “the largest consolidation of personal data in the history of the republic.”  And note that once this structure is set up, the federal hub and the state arms, because this bill is just creating the Minnesota arm into the superstructure, can be used for all sorts of things above and beyond health data or insurance.

Finally, I wanted to let you know Senate file 1 establishes the federal government as the controller and you do not need to look any further than line 2.6 which says that this marketplace is whatever the ACA says this marketplace is, including amendments to come and regulations.  That means whoever is governing the marketplace has got to follow the ACA and regulations and amendments in the future. 

Our organization does not support this.  We do not support building this superstructure.  We know that there has been absolutely no consent, we’ve been told by the IT people they are prepopulating the exchange with everybody’s information so we realize this is all about the IRS having access to all this information to enforce the compliance with the mandate by both employers and insurers.  We oppose what’s being created but we wanted you to understand because people said “what is the exchange?”  It’s not really a board; it’s really this huge IT infrastructure that will be under control of the board that is going to meet quarterly, which I think is kind of amusing, although it can meet more.   It’s 50 to 60 million dollars and 70 employees. This is a really big deal but the really big deal is to understand that it is the largest data sharing system in the history of this country and it will be the largest data sharing system in the history of this state.

End Testimony.