What's Going on in Minnesota's Healthcare Exchange?

April Todd-Malmlov, executive director of Minnesota's MNsure state healthcare exchange, resigned abruptly Tuesday. She announced her decision to leave her $136,000-a-year job during a closed door meeting with the exchange's top brass. The board immediately replaced her with an interim appointment from its ranks, and is now seeking a permanent replacement.

Todd-Malmlov has made headlines for going on a vacation to Costa Rica with state Medicaid director James Golden during MNsure's rollout. Problems with the exchange were growing worse as the two healthcare capos jetted off for the sunshine. That led to calls for resignations.

The resignation comes as the media had started to portray MNsure as one of the few state-level Obamacare success stories. But problems have persisted, leading Gov. Mark Dayton (D) to distance himself from the exchange's leadership. The resignation also comes just when MNsure needs stability, for those Minnesota residents who must sign up in December to keep their coverage going uninterrupted into the new year.

The Minnesota law that created MNsure put the exchange's leadership outside the appointment or review power of the state's governor and legislature.

The StarTribune notes the potential political problems for Gov. Dayton in Todd-Malmlov's sudden decision to leave her post:

The program could have political consequences in Minnesota and nationally. Gov. Mark Dayton ensured Minnesota was among the first to adopt President Obama’s health insurance overhaul, and Republicans have been relentless in trying to tie the governor to its rocky rollout.

Dayton signed the law that created the exchange, so tying him to it only seems fair.

Instability and rockiness could claim a different political casualty in Minnesota. Sen. Al Franken won his seat in controversial circumstances in 2008 -- Democrats essentially just kept re-counting the votes until Franken had a lead. Franken then went on to provide decisive votes in passing Obamacare. Every Democrat in the Senate essentially provided the decisive 60th that passed the unpopular law.