Healthcare reform the future of the minnesota comprehensive health association
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Healthcare Reform: the Future of the Minnesota Comprehensive Health Association - PowerPoint PPT Presentation

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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.

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The history of mcha
The History of MCHA Health Association

  • 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
Reasons Minnesotans Turn to MCHA Health Association

  • 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
MCHA Demographics Health Association

  • 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
The New Marketplace: Does MCHA Fit? Health Association

  • 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
MCHA Phase-Out Plan Health Association

  • 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
MCHA Transition Plan Timeline Health Association

  • 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

Advantages of changing plans in 2014
Advantages of Changing Plans in 2014 Health Association

  • 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
What MCHA Enrollees Should Consider Before Buying a Plan Health Association

  • 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
Resources for MCHA Enrollees Health Association

  • 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.