Healthcare Reform: the Future of the Minnesota Comprehensive Health Association

The History of MCHA Created by the state legislature in 1976 to give Minnesotans with pre-existing conditions access to health insurance. One of the first and one of the largest high-risk insurance pools in the country. Regulated and Directed by the Minnesota Department of Commerce and an eleven-member board of directors.

Reasons Minnesotans Turn to MCHA They have a pre-existing health conditions and: Used up COBRA or continuation benefits Employer doesn’t offer health insurance Employer doesn’t offer spousal or dependent coverage Works part-time or are self-employed Age 65 or older and not eligible for Medicare

MCHA Demographics Currently insures approximately 26,000 enrollees Median age is 52 Nearly a quarter of all enrollees have a mental health diagnosis Most Common Mental Health Diagnoses: – Depression – Anxiety – PTSD – Obsessive Compulsive Disorder – Bipolar Disorder – Substance Abuse

The New Marketplace: Does MCHA Fit? Guaranteed Issue: The Affordable Care Act guarantees everyone, regardless of a current or past health condition, a health insurance plan. Two-year Board of Directors planning process The need for MCHA is disappearing. MCHA will cease operations on 12/31/14

MCHA Phase-Out Plan Legislators Passed the Minnesota Insurance Marketplace Act in 2012 Commissioner of Commerce & MCHA Board given authority to develop a phase-out plan Agreed on a fifteen-month wind-down

MCHA Transition Plan Timeline Oct 1, 2013-Mar 31, 2014 Open enrollment period for all new health plans individual and small group) Dec 15, 2013 Last day to enroll in new plans for Jan 1, 2014 effective date Jan 1, 2014 MCHA closes enrollment to all new applicants Oct 15-Dec 7, 2014 Open enrollment for 2015 coverage Dec 31, 2014 MCHA expected to close

Advantages of Changing Plans in 2014 No annual maximums No lifetime maximums No-cost preventive care: i.e.: mammograms/well visits Affordable plans (MCHA premiums are 18% higher) No denials for pre-existing conditions Tax subsidies through MNsure for below 400% FPL Expanded access to medical assistance Expanded benefits under MinnesotaCare

What MCHA Enrollees Should Consider Before Buying a Plan Is your doctor or clinic in the plan’s network? Are your medications covered under the plan’s approved list of prescription drugs? Are you eligible for a tax credit through MNsure? What level coverage works for you: Bronze, Silver, Gold, Platinum? By changing plans for Jan. 1, 2014, you will avoid paying two deductibles. Does the plan cover care/services you are currently receiving and do you need pre-approval? Does this plan fit with your future needs?

Resources for MCHA Enrollees Health Insurance Agents Can advise enrollees on what plan would be the best fit for their needs. Community Navigators Can help enrollees navigate through MNsure, but cannot recommend a plan.