In the Land of 10,000 Lakes, concern has been mounting that Minnesota’s state-run HIX is slowly sinking into insolvency exacerbated by downward revisions in projected enrollment and speculation that it could be supplanted by at some point.

Federal dollars that have kept MNsure afloat will evaporate by the end of 2015, which means it must then rely on fees from private health plan signups to find more stable footing and consider hiking those charges if financial and enrollment problems persist.

As such, there’s growing political pressure on state leaders to seek a resolution. Republicans have pounced on the exchange’s precarious financial outlook, though House GOP members have adopted a pragmatic outlook in their attempt to scrap MNsure. Their legislative proposal delays any switch to until 2017 and only in the event that the U.S. Supreme Court upholds subsidies for states that rely on the federal government to enroll their residents. Even Democratic Gov. Mark Dayton is open to the idea, asking the state legislature to study MNsure’s longer-term viability.

The state HIX claims that it’s still evolving right along with a nascent marketplace and “retooling expectations on the fly,” according to an Associated Press report. MNsure’s Board of Directors recently adopted and submitted to the state legislature a three-year budget plan described as “structurally balanced and based on and in line with data from two previous open enrollment periods.”

MNsure CEO Scott Leitz noted in a statement that “smart, thoughtful adjustments” were made to the exchange’s financial plan, which includes funding for robust customer service and IT improvements. The state HIX projects roughly 35,000 new enrollees through 2017, with a total head count of 130,000 between individual and SHOP enrollees by the end of the 2017 enrollment. As the number of uninsured residents declines, MNsure is expected to turn its attention to price-conscious shoppers who are seeking more affordable options.

All 14 state-run exchanges, many of which have encountered worse financial challenges than MNsure, face an uncertain future. “After the first year or two, getting the remaining uninsured is just going to get harder and harder,” Erin Trish, Ph.D., a postdoctoral fellow at the Schaeffer Center for Health Policy and Economics at the University of Southern California, recently told the AP. “We’ve already got the low-hanging fruit.”

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