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Tuesday Talk: MNsure Q&A

September 10, 2013 By Joe Sheeran, Communications Director

Look at that, turns out Minnesota’s health insurance exchange will deliver affordable coverage after all. So far, MNsure has the nation’s lowest insurance rates. However, a number of questions remain about how the exchange works, who qualifies, and what level of coverage Minnesotans should expect. Moreover, a number of folks who qualify for free or near free coverage on the exchange have no idea they do.

Today between 8 and 9:30, TakeAction Minnesota’s Health Care Program Manager Sarah Greenfield will join us to answer your questions about MNsure.

We also want to hear your thoughts: What do you expect from MNsure? What do you consider good coverage? Will you check out the exchange?

 

Post your comments or questions in the box below, scroll down to see the ongoing conversation, and use "refresh" to see new comments. 

Thanks for participating! Commenting on this conversation is now closed.

53 Comments:

  • Rachel says:

    September 10, 2013 at 7:31 am

    Good morning! This conversation is now open, Sarah will be joining us at 8. Feel free to post your questions ahead of time, and weigh in with your own thoughts.

    What do you expect from MNsure?

    • B. J. Marik says:

      September 10, 2013 at 8:46 am

      Please answer

      • K. Kalish says:

        September 10, 2013 at 8:52 am

        Her reply is under Kay Kessel’s question.

  • B. J. Marik says:

    September 10, 2013 at 7:49 am

    Will dental insurance be in this?

    • K. Kalish says:

      September 10, 2013 at 8:03 am

      That would be of most value to me.

    • Sarah Greenfield says:

      September 10, 2013 at 8:52 am

      Yes - sorry for the delay, my answer is buried in another dental question below. Dental is not one of the ten areas mandated “essential health benefits” however we are working to understand what dental coverage will be available.

  • K. Kalish says:

    September 10, 2013 at 8:01 am

    Can a person with insurance through his/her employer get coverage through an employer but cover other family members through MNsure rather than use the employer’s coverage?

    • Sarah Greenfield says:

      September 10, 2013 at 8:11 am

      Like a lot of things, that depends. If the individual coverage your employer offers YOU is considered affordable under the law (less than 9.5% of your household income) AND the employer offers family coverage, then your family members do not qualify for any subsidies on the exchange, no matter the cost of the family coverage offered.

      • K. Kalish says:

        September 10, 2013 at 8:22 am

        The employer coverage is now $1,500/month, leaving a take-home of $2,000/month.

        • Sarah Greenfield says:

          September 10, 2013 at 8:37 am

          Sheesh! Again, some depends on your overall household income and household size, but it sounds like you are in a range where it will be worth checking out MNsure. Once the actual site is up in October, the site will do most of these calculations automatically after asking you some questions. You can also feel free to contact me later at .(JavaScript must be enabled to view this email address) to try and walk through your situation more specifically.

  • Sarah Greenfield says:

    September 10, 2013 at 8:08 am

    Hello! This is Sarah Greenfield, the Health Care Program Manager at TakeAction Minnesota and I’m glad to be here this morning.

    • K. Kalish says:

      September 10, 2013 at 9:09 am

      Leaving now, but thanks for your help and information.

  • David Benson says:

    September 10, 2013 at 8:10 am

    My 15 year old son is currently enrolled in a $2000. deductible MCHA plan for $215. per month. Can I assume he will qualify for an exchange plan, and if so how might coverage and cost compare?

    • Sarah Greenfield says:

      September 10, 2013 at 8:18 am

      The question as to whether he qualifies for an exchange plan and any subsidies would depend on the family’s employer coverage and income level. This will be A LOT easier to figure out for the average person come October 1st. But for now you can get an idea by looking at some of the links under “find your cost” on the MNsure.org site. I will try to take a peek through as we move along here and offer a little more information.

      Overall, how are you finding the communication to you as an MCHA family about the coming transition?

    • Sarah Greenfield says:

      September 10, 2013 at 8:50 am

      You will have to check out mnsure.org after October 1st to know for sure, but for comparison’s sake I took a look at the rates released for a 25 year old living in the metro here: http://mnsure.org/hix/images/MNsureRates-Area8-25yrold.pdf. They could get a “platinum” for $151 a month before any subsidy, so I think that bodes well for you. (see http://mnsure.org/hix/calculators/f-and-i-cost.jsp for explanation of the metal levels).

  • Annalise McGrail says:

    September 10, 2013 at 8:16 am

    Communication and education about MNsure is inevitably a bit complicated. What are some ways in which communication can better be facilitated, so that individuals are prepared to take advantage of the exchanges come October?

    • Sarah Greenfield says:

      September 10, 2013 at 8:23 am

      I’d love to turn that question back to you and the group. What kind of platforms and information do you wish you were hearing?

  • Joe says:

    September 10, 2013 at 8:18 am

    We know MNsure is an online tool, but for folks who need a little more guidance choosing a plan, will there be “real” people they can talk with to help pick the best plan for themselves and their families?

    • Sarah Greenfield says:

      September 10, 2013 at 8:25 am

      Absolutely - the call center is already live, and folks there will be able to help you through many questions. But there will also be “Navigators” in communities around the state, based in organizations you may already know. They can provide more in depth in-person assistance.

  • kay kessel says:

    September 10, 2013 at 8:21 am

    Will there be dental coverage for low income folks and someone struggling with addiction?

    • Sarah Greenfield says:

      September 10, 2013 at 8:44 am

      “Substance use disorders” are one of the ten areas of benefits that the ACA includes as “essential health benefits.” Carriers do have more flexibility than the term “essential health benefits” would imply to swap a bit among the ten categories in terms of quality of benefit, so it is important to double check for those benefits that are essential to you. But overall the floor should be higher than it currently is for mental health and addiction services. It should also be easier to compare what is actually covered with new streamlined descriptions of coverage - more complex than a US RDA label on food, but that’s sort of the idea.

    • Sarah Greenfield says:

      September 10, 2013 at 8:45 am

      Sorry - and as to your and others’ dental questions - dental is not one of the ten mandated coverage areas. We are trying to establish what sort of dental coverage will be available.

  • David Brauer says:

    September 10, 2013 at 8:22 am

    Received a somewhat surprising note from BCBS saying because our family HSA was in force before ACA was passed in 2010, our policy is grandfathered in for 2014. (I had assumed because our HSA did not comply with some new ACA mandates we’d have to get a new policy.) My question is: is this grandfathering only good for 2014, or does the grandfathering extend into future years for those of us with pre-2010 policies (assuming the insurer still offers)? Thank you.

    • Sarah Greenfield says:

      September 10, 2013 at 8:27 am

      The grandfathering question is interesting - while I work on your answer, I’m curious who else out there has gotten any notices like this?

    • Sarah Greenfield says:

      September 10, 2013 at 8:32 am

      Grandfathered plans can be reassuring, because you know what they cost and you’ve had them already. On the other hand, they are exempt from the new requirements for coverage, and some carriers may be promoting them for that reason. For example, free preventative care without co-pay or deductible, or the 80/20 “medical loss ratio” that would require the carrier to repay you if they spent less than 80% on medical care vs. admin. It’s worth asking directly how your plan differs from ACA requirements. I am not sure of a year limit on grandfathering - if someone else is, please jump in.

      • David Brauer says:

        September 10, 2013 at 8:47 am

        Thank you Sarah!

  • diana says:

    September 10, 2013 at 8:50 am

    i am interested in the deductables for the various plans and how they will deal with prescription drug coverage.

    • Sarah Greenfield says:

      September 10, 2013 at 9:05 am

      Diana, see the link in my answer to Rick below. Prescription drug coverage is included in the essential benefit package. However as today, you will still have a choice of higher or lower deductibles and co-pays related to higher or lower premiums, and even within the mandated benefit areas, some plans will be richer in one vs. another.

  • Rick says:

    September 10, 2013 at 8:50 am

    Hello:
    I hope I didn’t overlook this question, but if I didn’t, I’d like to know if a person qualifies for any subsidy, what income verification is needed? I’d also like to know, will one be able to include or exclude types of coverage like Pharmacy Coverage, Maternity, Mental Health etc.,

    • Sarah Greenfield says:

      September 10, 2013 at 9:01 am

      For most people income verification should occur “behind the screen” via the IRS and Social Security. If your income cannot be verified, many people will be presumptively qualified for whatever public coverage or tax credit they would receive based on the income you say you have, and then required to submit verification at a later date. In some cases you may need to provide other verification before qualifying for a tax credit, again only if your income couldn’t be verified through IRS or Social Security.

    • Sarah Greenfield says:

      September 10, 2013 at 9:02 am

      As to the areas of coverage, those you mention are all included in the 10 mandated areas of “essential health benefits” coverage. See here for more info: https://www.healthcare.gov/what-does-marketplace-health-insurance-cover/. There may still be variation in coverage levels of one area vs. another among carriers and plans though.

  • Joe says:

    September 10, 2013 at 8:54 am

    Minnesota 2020 has written that even with MNsure and new health care reforms coming on line, millions of Americans and thousands of Minnesotans will remain uninsured for a variety of reasons. http://bit.ly/17UKaXL What more can we do to extend medical coverage to these folks?

    • Sarah Greenfield says:

      September 10, 2013 at 9:08 am

      This is a really important question. At TakeAction Minnesota we believe that a universal coverage or “single-payer” system is the right answer. But we still need an immediate answer to the question for the immediate term. What do others think?

  • Judy says:

    September 10, 2013 at 9:06 am

    Rates for a silver plan in the Rochester market are twice that of the same metal level plan as in the metro area.  Why is that?

    • Sarah Greenfield says:

      September 10, 2013 at 9:10 am

      That’s a very good question. Those decisions are made by the insurance companies. The Department of Commerce may require some justification based on how much the insurer expects to spend in those areas, so it should relate to the cost of provider networks etc. of the area, but I can’t answer definitively.

      • Joe says:

        September 10, 2013 at 9:14 am

        Other than the MNsure board and some of the mandates in the ACA, are there any safeguards that prevent insurance companies from jacking up rates in the future? What collaboration will insurers and medical providers likely pursue to keep costs down and provide quality care.

  • tom larsen says:

    September 10, 2013 at 9:14 am

    “Non Profit” status does not prevent CEO’s from talking Huge salaries ($880k + benefits for UCare, for instance). Board members earn something like $4000/ per hour.

    I refuse to be extorted in this way to have healthcare. Is there a public option in the “Exchange?” or have we exchanged one complicated immoral system for another. \?

    • Sarah Greenfield says:

      September 10, 2013 at 9:30 am

      There is not a “public option” in the exchange, though that is definitely something we fought for back during federal passage of the ACA, and it is something a state could consider doing in the future.
      I agree with your sentiment, though I will say that I still choose to enroll myself and my family in my employer-sponsored coverage and pay may share etc. I think the ideal path would be to create a system where everyone is in and profit is out, but I strongly believe that everyone deserves equal access to what ever imperfect/immoral/insufficient system we have right now, and I think the ACA makes steps to let more people in “in the meantime” while we continue to fight for the bigger reforms we want.

      • tom larsen says:

        September 10, 2013 at 9:35 am

        Putting up with the “immoral” is not an option. GENERAL STRIKE!

        • Dan says:

          September 10, 2013 at 10:44 am

          I am also disappointed that there was no “public option” included in the ACA, thanks in large part to Rahm Emanuel dismissing the idea out of hand as being too hard to sell to Congress.  The problem with protesting the ACA is that anybody who refuses to pay for health insurance will face fines.  I could be wrong, but some of those fines may be more than you’d pay for coverage, depending upon your income level.  Looks like they have us by the short ones.  I certainly hope Minnesota’s system gets refined and improved as time goes on.

  • Larry S says:

    September 10, 2013 at 9:14 am

    I’m also asking about the stunning rate difference in area 1 versus metro. I’m on Medicare but still am a supporter of fixing our healthcare system. Area 1(SE MN) has good medical facilities and I can’t believe that our costs are double yet the rates are. Why was the State broken into areas? As a supporter of universal healthcare I believe if an insurance company wants to bid it should bid for the whole state. This rate discrepancey will turn people off about the new system and frankly why shouldn’t it. This is a big mistake!

    • Sarah Greenfield says:

      September 10, 2013 at 9:24 am

      That’s an interesting proposal Larry. Geographic area, age, and tobacco use are pretty much the last three criteria which insurers can still charge some groups more than others. Under the ACA there are limits to how much rates can differ for those groups, which is progress, but on the other hand because insurers can no longer just cut people out entirely for their health status, or charge them more based on health status, they may use these “allowable” rate increases more consistently.
      But you raise the point that perhaps a state could consider further limiting the rate-increases by geographic area. I’m not sure if that’s possible or what the impact would be overall, but it is an interesting question.

    • Joe says:

      September 10, 2013 at 9:29 am

      Do the higher premiums have anything to do with the fact that there are only two plans being offered in that area? And are the factors about health demographics that Sarah mentioned one reason for the lack of competition?

  • Jayne says:

    September 10, 2013 at 9:14 am

    I have been checking out MNsure for quite some time and I like that they seem to be updating the website and the applications within it.  Do you think it will all be ready on Oct. 1st as we will definitely be buying a new policy on the exchange?

    • Sarah Greenfield says:

      September 10, 2013 at 9:20 am

      I do believe it will be ready. All the indications I’ve seen so far from MNsure and the administration are that they are very focused on developing the IT infrastructure to make this work, and that we are in as good or better position than the rest of the country to have a successful launch, despite having been delayed a bit in our implementation efforts initially by the Pawlenty administration and then by 2 years of an anti-ACA legislature. But I think the Dayton administration managed to do a lot of preparation through the Exchange Advisory Committee prior to passing the bill this year and I am hopeful.

  • Sarah Greenfield says:

    September 10, 2013 at 9:17 am

    So the Affordable Care Act for the first time defines an “affordability limit” for health coverage. It’s tied to your income, so people who make more are expected to be able to pay a higher percent of income for insurance, up to 9.5%. Up to a certain income level, assistance is available if you can’t find coverage for that amount, and then assistance drops off. On the one hand, this is progress to define any affordability limit as a country, but for many people it will still feel high. What do you think is affordable? Is it a dollar amount? A level of coverage? Do you have affordable access to health care now?

  • Jayne says:

    September 10, 2013 at 9:20 am

    I had a question as to whether MNsure is going to post the phone number for the consumer call center more widely than what I’ve seen so far.  It’s on the MNsure exchange site but I think it should be advertised in the newspapers, etc…

    • Sarah Greenfield says:

      September 10, 2013 at 9:25 am

      I hope so and I think so! I’ll do my part: the call center is live and the number is: 1-855-3MNSURE (1-855-366-7873)

  • Jayne says:

    September 10, 2013 at 9:27 am

    We are self-employed and do NOT have access to affordable health care now.  Our premiums can eat up about 30% of our income each year!  Honestly even 9.5% would seem to be a blessing.

    • Sarah Greenfield says:

      September 10, 2013 at 9:37 am

      I hear similar stories from many self-employed folks and I think that population may benefit a lot from this new system. But I would love to hear what you actually find when you check it out in October.

  • Sarah Greenfield says:

    September 10, 2013 at 9:38 am

    I’m going to sign off, but I wanted to add to my last answer that I think all of our experiences are going to be so valuable to share: whether we like what we find or still can’t find affordable coverage or have trouble navigating the system. Research shows that the uninsured tend to think other people like them are also uninsured, so if they hear positive stories they may be more likely to check it out for themselves. On the other hand, negative experiences contain valuable info about what needs to be improved. At TakeAction we collect stories and anecdotes for that reason, and I believe there will be ways for you to give feedback directly to MNsure as well. But I’d like to invite all of you who check out MNsure after October 1st to let me know your experience at .(JavaScript must be enabled to view this email address), and thanks for your participation today!

    (I’ll try to check back later to answer some remaining questions as well)

  • Dan says:

    September 10, 2013 at 11:02 am

    “Dental is not one of the ten areas mandated ‘essential health benefits’...”
    Whew, what a relief to find out that teeth are non-essential and that neglecting their care won’t affect my overall health.  Now, when I go to the store to buy a toothbrush, it’ll finally make sense why they’re not called teethbrushes.

  • Joe Knopick says:

    October 2, 2013 at 7:20 pm

    on the form where it asks you the amount of money recieved bi-weekly, do they want the gross amount or the net amount that you actually take home?