Minnesota

I'm not sure how this slipped by me, but in addition to Covered California already having launched their 2020 Open Enrollment Period yesterday, five other state-based ACA exchanges are already partly open as well. That is, you can shop around, compare prices on next year's health insurance policies and check and see what sort of financial assistance you may be eligible for:

I'm not sure when the other 7 state-based exchanges will launch their 2020 window shopping tools, nor do I know when HealthCare.Gov's window shopping will be open for the other 38 states, although I believe they usually do so about a week ahead of the official November 1st Open Enrollment Period launch date.

via MNsure:

Getting ready for MNsure's open enrollment period: what to know and how to prepare

  • Open enrollment runs November 1 through December 23, 2019

ST. PAUL, Minn. — The MNsure open enrollment period begins in less than one month. To ensure Minnesotans are prepared to shop and enroll in coverage starting November 1, MNsure is highlighting some important information:

Open enrollment is shorter this year — don't miss out on coverage

MNsure's open enrollment period for 2020 health and dental coverage will be seven weeks long — beginning November 1, 2019, and ending December 23, 2019. Minnesotans should note that open enrollment is shorter than previous years and all those who enroll during open enrollment will have a start date of January 1, 2020.

MNsure assisters are ready to help — schedule an appointment today

MNsure has a statewide network of expert assisters who can help Minnesotans apply and enroll, free of charge. The assister can be a navigator or a broker.

Back in July, I noted that the Minnesota Commerce Department announced the preliminary 2020 rate changes for carriers on the individual and small group markets. At the time, the weighted average increases were roughly 1.6% and 5.5% respectively, although the enrollment estimates for each carrier were estimates only.

Today, the MN Commerce Dept. announced the approved rates for 2020, and in both markets, they shaved average premiums down a couple of points. Here's the actual Commerce Dept. press release:

Commerce releases 2020 health insurance rates for Minnesota

Minnesota’s individual and small group health insurance market rates for 2020 reflect stabilized markets, according to information released today by the Minnesota Department of Commerce in advance of the open enrollment period beginning November 1.

Long-time readers may have noticed that, while I've obviously ripped on the Trump Administration a lot for the various ways they've screwed around with administration of the ACA over the past 2 1/2 years, there's a handful of actions they've taken which I haven't criticized them for...or at least, which I've been fairly circumstpect about being too critical about.

The biggest, and perhaps most surprising, of the latter is the Centers for Medicare & Medicaid (CMS) decision to shorten the offiical Open Enrollment Period (OEP) roughly in half, from three months (Nov. 1st - Jan. 31st) down to just six weeks (Nov. 1st - Dec. 15th). There's a couple of reasons for this.

First and foremost...the Obama Administration was already planning on shortening the period...it's just that they intended to make the change starting in 2018 instead of 2017. This is from February 2016, long before Trump even secured the GOP nomination:

MLR rebate payments for 2018 are being sent out to enrollees even as I type this. The data for 2018 MLR rebates won't be officially posted for another month or so, but I've managed to acquire it early, and after a lot of number-crunching the data, I've recompiled it into an easy-to-read format.

But that's not all! In addition to the actual 2018 MLR rebates, I've gone one step further and have taken an early crack at trying to figure out what 2019 MLR rebates might end up looking like next year (for the Individual Market only). In order to do this, I had to make several very large assumptions:

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

Pages