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Stakeholders try to make sense of health care reform

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A slew of stories are trying to make sense of how changes to health insurance will affect Minnesotans.

The Pioneer Press reports that 140,000 residents have received or will receive letters telling them the terms of their policies will change. State law prohibits insurers from cancelling policies unless they are going out of business, but many individual policy-holders are shocked to learn their premium prices may rise unless they switch plans.

So consumers have a choice. They can stay with the plan they have, or go shopping for a new one on MNSure, the state's health care exchange.

If they earn below $46,000 as individuals, or have household incomes less than $94,000 for a family of four, they will get tax credits to help make premiums affordable. If they earn more, they will feel the full impact of premiums for insurance that is federally mandated to cover people with pre-existing conditions, and costs associated with childbearing and mental health, for example.

The health law sets new standards designed to make health insurance affordable for people with annual incomes below $46,000 on an individual basis and $94,000 for a family of four. People with incomes above those limits will feel the full impact of increased premiums that come as insurance companies implement health law requirements. Health care reform also caps deductibles that can be offered with individual market policies at about $6,350 per person, or $12,700 per family in 2014.

MPR News reports the changes will affect about 62,000 members of Blue Cross Blue Shield Minnesota, 15,000 at PreferredOne, 50,000 at Medica and 19,000 at HealthPartners.

The StarTribune says prices will vary by geographic area. That's because there's lots of competition in the Twin Cities, and less in greater Minnesota. It's a particular problem in Southeastern Minnesota because the Mayo Clinic is expensive. Only Blue Cross and Blue Shield of Minnesota is offering coverage to many people with Rochester-area zip codes. Other Minnesota insurers have opted not to work with the Mayo Clinic.

“We are disappointed that more of them didn’t choose to offer plans down here,” said Bryan Anderson, a spokesman for Mayo. He said prices are high because Mayo patients are sicker and the approach is team-based. Anderson says prices are also higher around other academic health centers in Chicago, Los Angeles and New York City. Mayo has contracts with most insurers, he said, but they’re not offered on the MNsure exchange.

Medica recently agreed to offer plans to some people in Dodge and Olmsted Counties.

In announcing Medica’s arrival in the southeast, Commerce Commissioner Mike Rothman said in a news release, “Minnesotans, regardless of where they live…deserve choice when purchasing health insurance coverage. One we identified the opportunity, we worked swiftly to facilitate a solution with Medica on behalf of consumers to provide more choice and access to health coverage.”

Legislators, insurance brokers, providers are trying to help consumers make the best of what's proving to be a frustrating and confusing situation. Proponents of health care reform say it will get better with time. They are worried that healthy people will be discouraged from participating, and that will drive costs up for everyone else.

Forum Communications reports that MNsure top leaders are holding meetings around the state to clarify questions about price and other issues.

More than 40,000 people have visited the MNsure website, 19,000 accounts have been created and there are nearly 4,000 waiting to buy policies. Policies must be purchased by Dec. 15 for them to begin Jan. 1.

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