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MNsure has missed big on one of its original selling points: getting more small businesses to offer insurance to employees. The government-run marketplace was expected to cover 155,000 people in small group plans by next year. That number was 1,405 earlier this month. Insurance agents who connect small firms with coverage say several factors are at play, including a MNsure system they call slow and cumbersome. Steps that still can’t be done online are burdensome. (Snowbeck, 5/24)

MNsure survived the legislative session without major changes. Some Republicans wanted to scrap the state's health insurance exchange altogether and some Democrats wanted to make it a state agency. (5/22)

A Kansas Senate committee has reviewed a proposal to impose a new fee on insurance policies sold through an online marketplace set up under the federal health care overhaul. But The Topeka Capital Journal reports that representatives of insurance companies and the Kansas Chamber of Commerce provided testimony against the bill to the Ways and Means Committee. (5/22)

Hospitals, insurers, doctors, unions and pharmaceutical companies spent a record $19 million trying to sway Beacon Hill lawmakers last year, a reflection of the industry's political and economic muscle and a rapidly changing health care landscape. ... The group that spent the most on health care lobbying last year was the Massachusetts Association of Health Plans, which represents 17 insurers providing coverage to more than 2.6 million Massachusetts residents. It reported spending more than $1 million. MAHP President Lora Pellegrini said the industry has faced a number of challenges, from grappling with last year's failed launch of the new Health Connector website to the implementation of a 2012 law designed to overhaul the state's health care payment system. (LeBlanc, 5/23)