Minnesota’s health care exchange will take shape in the months ahead

Minnesotans with disabilities need to be informed consumers concerning the upcoming health insurance exchange and how it will affect them. […]

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Minnesotans with disabilities need to be informed consumers concerning the upcoming health insurance exchange and how it will affect them. The Affordable Care Act (ACA), which was signed into law by President Barack Obama on March 23, 2010, requires all people to have insurance.

To do this, web-based health insurance exchanges, either on the federal or state level, will be available to help people shop for insurance based on cost, quality and consumer satisfaction and to access financial support to pay for premiums. State exchanges also provide the opportunity to enroll for Medicaid and to facilitate smooth transitions from Medicaid to private insurance.

This will not only make navigating the world of health insurance more accessible to all Minnesotans, but proponents say it will foster a healthy competition between insurance companies and provide consumers with the best insurance coverage at a the fairest price.

Over a year ago Gov. Mark Dayton appointed members to the Health Insurance Exchange Advisory Task Force. There have been numerous subcommittees to look at governance, financing, adverse selection, navigators and brokers, tribal consultation, IT, individual eligibility, small employers, measurement and reporting and marketing. Basic principles have been adopted and the blueprint has been submitted to the federal government.

The exchange is on a tight timeline since open registration for the health insurance exchange begins Oct. 1, 2013. The start date for the exchange is January 1, 2014.

When the exchange goes into place, it could serve an anticipated 1.2 million Minnesotans. In 2011, state officials estimate that more than 490,000 Minnesotans lacked any health insurance and this will be a key target group for the exchange. In order to reach out to the uninsured, many of which are from diverse communities, navigators will play a key role. The concept is that they will be housed in organizations that are community-based and reflect the communities they serve. They will help explain insurance the options available under the exchange. The task force is grappling with how to define the role of the navigator versus the broker.

A key issue is what benefits will be covered by plans in the exchange. All plans are required by the Affordable Care Act (ACA) to cover mental health and substance use disorder treatment and to follow mental health parity. There will be a basic health plan and essential benefits. Task force members want to make sure that people currently on MinnesotaCare do not lose access to services they have now.

The final version of Minnesota’s health insurance exchange will be decided early during the 2013 legislative session. Dayton needs to have a bill passed by mid-March 2013 outlining and authorizing the Minnesota exchange. If this bill does not pass, Minnesota will be forced to use the federal exchange.

The U.S. Department of Health and Human Services postponed two deadlines till mid-December, including the date the states had to submit their proposals. But Minnesota officials are pushing ahead with the original schedule.

“I am delighted to submit Minnesota’s Exchange Blueprint application and confirm Minnesota’s intent to develop and operate a State-based Health Insurance Exchange,” Dayton wrote in a letter to HHS Secretary Kathleen Sebelius last month. “I strongly share your commitment, and that of President Obama, to ensuring access to affordable, high quality health care coverage for all Minnesotans.”

The exchange is not only a priority for the governor; it is also a priority for the incoming Minnesota House and Senate DFL majority. Senator Tony Lourey and Representative Tom Huntley currently serve on the Exchange Advisory Task Force and chair the Health and Human Services Finance Committees. There are other parts of the ACA that are positive for people with disabilities such as young people being able to be covered under their parents’ health insurance and not allowing plans to deny coverage for people with pre-existing conditions. Denial of insurance due to pre-existing conditions is been a problem for people with disabilities. Sometimes denial for minor conditions and too often, specific disabilities are targeted.

The exchange is already controversial. One often heard criticism is how it is supported, through user fees or taxes and that taxpayers don’t want to support a system they won’t use and are more than capable of shopping for their own health insurance. Another question mark is what types of coverage will be available, and whether those types of coverage will meet the needs of people with disabilities.

A potential increase in premiums is another concern when thinking about the exchange. According to Blue Cross Blue Shield of MN the estimated increase in premiums could be anywhere between 26-42 percent. But it’s important to note this is only an estimate and until the cost-sharing measures of the exchange are finalized, the prospects of increases are unknown. It important to note this is only an estimate and until the cost-sharing measures of the exchange are finalized, (low-income residents and small businesses will receive subsidies to make insurance more affordable), it is uncertain if insurance premiums will go up or not.

With all of the issues raised, the exchange proposal bears watching. Follow the discussion at: http://mn.gov/commerce/insurance/topics/medical/exchange/Exchange-Advisory-Task-Force/

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