Healthcare Reform: the Future of the Minnesota Comprehensive Health Association

1. Healthcare Reform: the Future of the Minnesota Comprehensive Health Association

2. 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.

3. 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

4. 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

5. 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

6. 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

7. MCHA Transition Plan Timeline • Oct 1, 2013-Mar 31, 2014Open 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, 2014MCHA closes enrollment to all new applicants • Oct 15-Dec 7, 2014Open enrollment for 2015 coverage • Dec 31, 2014 MCHA expected to close

8. 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

9. 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?

10. Resources for MCHA Enrollees • Health Insurance Agents • Can advise enrollees on what plan would be the best fit for their needs. • www.myMCHAagent.com • Community Navigators • Can help enrollees navigate through MNsure, but cannot recommend a plan. • www.myMCHAnavigator.com • www.mnsure.org/images/AssisterDirectory.pdf