BHP and Other Affordability Strategies in MN

Minnesota

• Among the best policy (BHP, SBM,

MA Expansion)

• Among the highest insured rate

(95%)

• Lowest premiums

• Highest Deductibles

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

= ?

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

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)

• 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

  Old MinnesotaCare Program New MinnesotaCare (BHP) effective January 1, 2014

PremiumsBased on household income, up to $100 a month

for childless adultPremium 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)

Copayments10% of inpatient hospital charges up to $1,000

Plus other minimal copayments

 $1,000 hospital copayment removed,

otherwise consistent with previous MNCare program

AssetsAsset test for non-pregnant adults of $10,000 for a household of one and $20,000 for a household of

twoEliminates Asset test

 Waiting periods

 

4 month required period of uninsurance before eligible for MinnesotaCare 4 month uninsurance waiting period removed

BenefitsIncludes cap on in-patient hospital coverage at

$10,000 for childless adults

$10,000 hospital cap removed 

Benefit set now meets EHB standard

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.

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.

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