2. BHP and Other Affordability Strategies in MN

3. Minnesota Among the best policy (BHP, SBM, MA Expansion) Among the highest insured rate (95%) Lowest premiums Highest Deductibles

4. How does that wash out? We have MNCare, as well as expanded MA for kids/preg women. FOr those on HIX:

5. = ?

6. Analysis of 65 metro plans* Individual deductibles from $0 (4) to $6600 (11 over $6K), $0 (4) to $13,200 (14 over $12K) for Family Half are Aggregate Deductibles Premiums for a 40 year old from $140 - $323 (Benchmark premium = $183) * Bronze through Platinum, not including catastrophic or CSR

7. Commonwealth Definitions of Underinsurance You are underinsured if your plan’s deductible equal to or greater than 5% of income You are underinsured if your out of pocket spending, not including premiums, exceeds 10% of income (5% if under 200% FPL)

8. Between 200-300% FPL, over 70% of silver plans have a deductible of over 5% income (50% over 300% FPL) Between 200-300% FPL, over 90% of silver plans have a MOOP of over 10% of income (77% over 300% FPL) At 210% FPL, the premium plus ½ deductible is 15% of your income or more in 41% of plans

9. Old MinnesotaCare ProgramNew MinnesotaCare (BHP) effective January 1, 2014 Premiums Based on household income, up to $100 a month for childless adult Premium levels up to $50 a month Coverage Childless adults up to 200% (200-250% on “Healthy MN”), Parents, pregnant women, and children up to 275% Lawfully present immigrants Adults 138 - to 200% FPL. Lawfully present immigrants 0- 200% FPL (Children & pregnant women up to 275% FPL, and parents and childless adults below 138% FPL transitioned to Medicaid. Parents and childless adults 200-275% FPL onto MNsure for now) Copayments 10% of inpatient hospital charges up to $1,000 Plus other minimal copayments $1,000 hospital copayment removed, otherwise consistent with previous MNCare program Assets Asset test for non-pregnant adults of $10,000 for a household of one and $20,000 for a household of two Eliminates Asset test Waiting periods 4 month required period of uninsurance before eligible for MinnesotaCare 4 month uninsurance waiting period removed Benefits Includes cap on in-patient hospital coverage at $10,000 for childless adults $10,000 hospital cap removed Benefit set now meets EHB standard

10. Health Care Access Fund Established in 1992 with the creation of MNCare ​​ Over ½ of 2015 revenue projected to come from 2% provider tax BHP$ Next biggest chunk, projected to grow. 1% Premium tax, MNCare premiums and odds and ends make up the rest Pays for: MNCare, some MA expansion costs, a little medical education, health care access and quality improvement initiatives, admin.

11. Additional Affordability Strategies Keep MinnesotaCare Strong Expand MNCare up to 275-400% FPL Improve QHP quality through Active Purchaser and/or Plan Standardization Mind the profits – Hospitals, Carriers have growing reserves. Public program profitability is up.

12. For more information or to get involved, contact Sarah@ TakeActionMinnesota.org