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 [email protected]