Insurance exchange changes the state health care game

ST. PAUL — John Borowicz has high hopes that a new state-run health insurance exchange will make buying coverage simpler and more affordable for his Plymouth-based business.

When he and his wife, Jackie Drury, bought Ovation Framing a year and a half ago, Borowicz set out on his own to find a good health plan for his six employees. It brought nothing but frustration.

“It was near impossible,” said Borowicz, who previously worked in corporate IT. “It’s a Byzantine and stupid system that doesn’t make any sense.”

Signed into law Wednesday by Gov. Mark Dayton, the exchange will represent a fundamental change in the health insurance marketplace for small businesses and for people who don’t get health coverage at work.

A key aim is to level the playing field for the little guy.

“If you’re overweight and 55 and have had a health condition, the plans basically can say we’re not going to insure you or they’ll cite you a really high premium,” said Lynn Blewett of the State Health Access Data Assistance Center. “With the new health insurance exchange, every individual will be part of a larger pool. It’s like having a large employer negotiating on your behalf.”

Early estimates are that 1.3 million people eventually will enroll in health plans using Minnesota’s exchange, which state officials call MNsure. That includes 300,000 uninsured Minnesotans and those who qualify for public programs such as Medical Assistance or MinnesotaCare, plus individuals and small businesses that may have coverage but want better options.

The MNsure exchange will launch on Oct. 1, allowing people using a website or phone call to make apples-to-apples comparisons among plans. Traditional insurance brokers as well as certified “navigators” working at county offices and community service centers also will be able to guide citizens through the process.

 

One-stop shopping

Minnesotans who earn too much to qualify for public health coverage may be eligible for federal tax credits or cost-sharing subsidies to reduce out-of-pocket costs. The sign-up process will automatically calculate that amount or determine eligibility for public health programs.

“That kind of one-stop shop has never been available to citizens before,” said Leslie Wolfe, a division president at Maximus, the lead contractor for building the exchange. “People can shop in a user-friendly way that helps explain things in ways that haven’t traditionally been explained.”

Even though lawmakers hammered out a blueprint for how the Minnesota-made exchange will be set up and financed, there are plenty of unknowns.

For one, consumers and small business owners won’t know for months what kind of plans insurance companies will offer and, more important, how much coverage will cost.

“There’s some concern about increases in premiums,” Blewett acknowledged. “It’s hard to know without seeing who shows up and how the insurance companies set their prices.”

Starting in 2014, when key tenets of the federal law championed by President Obama roll out, insurance companies will no longer be able to deny coverage to people who are already sick.

Insurers also will have to cover a basic set of health care issues, including maternity care and mental health coverage, and they won’t have the same freedom to set sky-high deductibles to offset premiums.

In Minnesota, where the exchange is estimated to cost $60 million a year to operate, insurers will kick in a 3.5 percent premium tax for plans sold on the exchange to help fund it. It’s a cost they may pass on to consumers even as they go head-to-head to compete for business.

The state’s private insurance companies stand to gain tens of thousands of new customers, however, and the major players have indicated that they are designing plans to sell on the exchange.

But with a May 17 deadline to get their exchange offerings to the state for review, some say they don’t have the needed lead time to get well-thought-out plans off the ground. Developing a new insurance product can take a year, said officials of Blue Cross and Blue Shield of Minnesota.

Insurance broker Mary Setter has spent the past year keeping her small-business clients abreast of activity at the Legislature and explaining how the Affordable Care Act and new insurance exchanges will affect them.

“Many of our clients won’t know if they’ll go on the exchange until they know what it looks like,” said Setter, of RJF Agencies in Brooklyn Park.

 

—Minneapolis Star Tribune

SportsPlus

Mower County

Austin Area Foundation announces community funded grants to a record 22 local nonprofit organizations

Mower County

Photos: Holiday revelers face the cold for Hometown Christmas

Albert Lea

Albert Lea theater to present ‘White Christmas’

Mower County

Nativity display open for another year

Mower County

In Your Community: Duplicate Bridge

Mower County

In Your Community: Mower County Senior Center

Crime, Courts & Emergencies

Convictions: Nov. 18-25

Mower County

MnDOT hosts public meetings in December to help guide Minnesota State Rail Plan

News

Female racing pioneer ‘Motorcycle Mary’ McGee dies a day before documentary on her is released

Business

Local stores have a lot to offer during the holiday season

News

Dementia research and support to continue in Minnesota after Congress passes legislation

Mower County

Cold snap continues into this weekend

Mower County

County submits first project to FEMA for reimbursement related to June flooding

Crime, Courts & Emergencies

APD investigating crash into house, possible stolen vehicle

Business

86th annual profit sharing held at Hormel plant

Mower County

Celebrating Miracles: Display documenting Eucharistic miracles coming to Austin

News

Tim Walz accepts turkey presentation as he eases back into his duties as Minnesota’s governor

Business

Joseph Company receives construction industry award

Mower County

Zonta begins annual anti-violence campaign

News

Judge halts cannabis license lottery that is precursor to Minnesota marijuana retail launch

News

Lawsuit challenges Minnesota abortion access in federal court

News

Netanyahu says he supports proposed ceasefire with Lebanon’s Hezbollah

News

Biden proposes Medicare and Medicaid cover costly weight-loss drugs for millions of obese Americans

News

Repealing no-fault divorce has so far stalled across the US. Some worry that’ll change under Trump