Minnesota

The Minnesota Commerce Dept. just posted their preliminary 2020 Individual and Small Group rate changes. The actual rate changes are pretty straightforward...a mere 1.6% average rate increase on the ACA Individual Market, and a 5.5% increase on the Small Group market.

Unfortunately, the actual effectuated enrollment for each carrier (which I use to calculate the weighted average) was provided in either the MN Commece website post or even in the currently-available raw SERFF rate filing forms, so I had to put together estimates based on last year's market share numbers, modified for 2019 based on the on-exchange portion of the total enrollment for the Indy market (for the small group market I just went with the straight 2018 shares).

Back in March, I noted that Democratic Minnesota Governor Tim Walz had put forth a pretty ambitious budget proposal, which included two pretty eyebrow-raising ACA-related funding proposals:

The Governor will take immediate action by creating a subsidy program to reduce by 20 percent the monthly premiums for Minnesotans who receive their insurance through MNSure. This subsidy will be applied directly against a consumer’s premiums. This proposal provides relief to Minnesotans with incomes over 400 percent of the federal poverty level do not qualify for the federal premium tax credit which helps lower the costs of health insurance premiums. Up to 80,000 people could participate in the program, reducing the out-of-pocket costs of their health insurance premiums.

About a month ago, I noted that new DLC Minnesota Governor Tim Walz rolled out an ambitious state budget proposal with a ton of awesome-sounding healthcare reform stuff, including:

Provide a 20 Percent Health Insurance Premium Subsidy

The Governor will take immediate action by creating a subsidy program to reduce by 20 percent the monthly premiums for Minnesotans who receive their insurance through MNSure. This subsidy will be applied directly against a consumer’s premiums. This proposal provides relief to Minnesotans with incomes over 400 percent of the federal poverty level do not qualify for the federal premium tax credit which helps lower the costs of health insurance premiums. Up to 80,000 people could participate in the program, reducing the out-of-pocket costs of their health insurance premiums.

Establish a Health Insurance Tax Credit

Minnesota's ACA exchange, MNsure, is among the better ones when it comes to data transparency. Here's some key data from their monthly board meeting on March 6th.

A couple of other interesting items of note:

  • It looks like MNsure's annual budget averages around $36 - $40 million per year, with between 50-60% of it coming from their 3.5% premium fee on exchange-based enrollments (I would think they'd spread the fee across off-exchange enrollments as well, as some other state exchanges do, for consistency's sake, which would reduce the amount of additional funding they need from the state Dept. of Human Services, but that's up to the state legislature, I presume).

Minnesota's new Democratic (pardon me..."Democratic-Farmer-Labor", or DFL) Governor, Tim Walz, has just posted his proposed state budget for the next fiscal year, and it includes some fantastic expansions & improvements to the healthcare system of Minnesota, including both state-level ACA enhancements and a push for a robust Public Option, along with other ideas.

The state House is also DFL-controlled, but the GOP holds a small majority in the state Senate, so I have no idea how much if any of this is politically feasible, but I love the roadmap:

The Minnesota ACA exchange, MNsure, wrapped up their 2019 Open Enrollment Period on January 13th, and recently released three big reports chock full of wonky healthcare data nerd goodness. I'm mostly going to just repost some of the key graphs/charts, but make sure to read the full reports for all the details:

The annual report is mostly full of inside baseball administrative info, but the first two reports have lots of stuff of interest to the average reader of this site:

First up, their January board meeting slideshow:

Things have been happening so quickly of late that I'm getting farther and farther behind on some important healthcare policy developments, particularly at the state level. There are two extremely important Public Option announcements which could be game changers if they make it through the legislative process.

Since I don't have time to do full write-ups on either one right now, I'll just present these summaries:

My friend and colleague Colin Baillio, policy director of Health Action New Mexico, has been working on this for a long time, and it looks like this project has finally entered the legislative stage:

LUJÁN APPLAUDS INTRODUCTION OF MEDICAID BUY-IN LEGISLATION IN NEW MEXICO

Immediately after the Colorado ACA exchange released their final 2019 enrollment numbers comes Minnesota's...via MNsure...

MNsure reaches record-setting sign-up numbers in sixth open enrollment period

  • 123,731 Minnesotans sign up for private health coverage

ST. PAUL, Minn.—MNsure reported strong numbers during its sixth open enrollment period, which ended Sunday. Nearly 400 more Minnesotans signed up for coverage than during the previous open enrollment period, which ended with 123,334 sign-ups.

Hmmm...just as with Colorado, MNsure's official numbers don't quite jibe with CMS's official report from last year, which put MN's tally at 116,358 QHP selections...nearly 7,000 fewer than MNsure's number.

REMINDER from MNsure.org...

Last chance: MNsure Open Enrollment Period Ends this Sunday, January 13
January 10, 2019

ST. PAUL, Minn.—Minnesotans have until midnight on Sunday, January 13, to secure health insurance coverage through MNsure for 2019. Those who enroll by the deadline will have coverage that begins February 1.

"MNsure is the only place to get financial help to save money on your monthly premium," said MNsure CEO Nate Clark. "More than half of all MNsure enrollees are receiving tax credits."

Minnesotans can see if they qualify for financial help, while also comparing medical plans side by side, by using MNsure's plan comparison tool.

MNsure has extended Contact Center hours in the days leading up to the final deadline:

Minnesota's ACA exchange, MNsure, last reported having enrolled over 113,000 people in Qualified Health Plans (QHPs) as of the first December 15th deadline, putting them just 3,300 enrollees behind last year's final total of 116,358 QHPs.

However, MN is one of the states sticking with an extended deadline this year, which means their 2019 Open Enrollment Period is still going on through January 13th...and they just reported having broken last year's total with 11 days remaining for Minnesotans to #GetCovered:

There is Still Time to Get Covered—MNsure's Open Enrollment Period Ends January 13
January 3, 2019

So, it's over, right? Well...not quite. The 2019 ACA Open Enrollment Period officially ended last night...but only in 43 states. In the remaining seven (+DC), Open Enrollment hasn't ended yet2019 ACA Open Enrollment is still ongoing for nearly 10% of the population!

  • In Massachusetts, open enrollment runs through Jan. 23rd, 2019 for coverage starting February 1st

ALSO...

Massachusetts isn't the only state running their own ACA exchange which has a lot to brag about today: Minnesota's exchange MNsure just posted this:

MNsure Reports More Than 113,000 Private Health Plan Sign-ups Following First Deadline
December 17, 2018

ST. PAUL, Minn.—Following the first deadline for 2019 coverage, 113,000 Minnesotans have signed up for private health coverage through MNsure. Saturday, December 15, was the deadline for coverage beginning January 1. Minnesotans have until January 13 to sign up for coverage starting February 1, 2019.

“We are excited that more than 113,000 Minnesotans have already signed up for comprehensive coverage through MNsure.org during our smoothest open enrollment to-date,” said MNsure CEO Nate Clark.

Since the start of open enrollment, MNsure's Contact Center has fielded nearly 80,000 calls. In addition, there have been 1.2 million visits to MNsure.org and more than 175,000 plan comparison tool sessions.

Minnesota's ACA exchange, MNsure, released a mid-period enrollment report a few weeks back, putting their total at over 97,000 QHP selections through November 14th.

They just updated that tally for me: 104,162 signups as of EOD 12/6.

Last year, MNsure broke 100,000 enrollments as of 11/23 and 101,626 as of 12/15, which should have put them at right around 100,900 QHP selections as of 12/06/17. That means the current total is around 3.2% ahead of the same point last year.

It's important to note that unlike most states, Minnesota's 2019 Open Enrollment Period doesn't end on the 15th (although you do have to sign up by then in order to have coverage start on January 1st); Minnesotans still have until January 13th to enroll (anyone who enrolls after 12/15 will have their coverage kick in on February 1st instead).

 

Last week, Bernie Sanders posted the following video (click to view) on Twitter. It tells the tragic story of a young Minnesota man named Alec Smith with diabetes who died soon after after no longer being able to afford either health insurance or the insulin and other medical supplies needed to keep him alive:

Alec Smith died at 26 because he was rationing insulin that was too expensive. The greed of the pharmaceutical industry is killing Americans and it has got to stop. (with @NSmithholt12) pic.twitter.com/xmryYm0Enr

— Bernie Sanders (@SenSanders) November 21, 2018

The main point of the video is the horrific price gouging on insulin, and a new drug price control bill which Sen. Sanders is pushing for which would tie U.S. drug pricing to that of a half-dozen other countries.

It's a genuinely depressing story, and the proposed drug pricing bill is interesting and worthy of discussion.

This Just In via MNsure, Minnesota's ACA exchange...

More than 97,000 Minnesotans have signed up for private health plans through MNsure since the start of open enrollment
Open enrollment runs until January 13, 2019

ST. PAUL, Minn.—Today MNsure announced that over 97,000 Minnesotans have signed up for private health plan coverage through MNsure during the first two weeks of open enrollment.

MNsure's open enrollment runs until January 13, 2019. For coverage that begins January 1, 2019, Minnesotans must enroll by December 15, 2018.

“We are excited with our smooth start to open enrollment and that over 97,000 Minnesotans have signed up for private health plans,” said CEO Nate Clark. “With rates decreasing from 7 to 27 percent across the state, we encourage Minnesotans to visit MNsure.org to see if they can save.”

BY THE NUMBERS—

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