Minnesota

2018 MIDTERM ELECTION

Time: D H M S

 

The Basic Health Program is one of the more obscure provisions of the Affordable Care Act. Very few people outside of the healthcare wonk community know anything about it...unless they live in Minnesota or New York State.

The short version is that it's an optional low-income healthcare program designed for people at the income tier just above Medicaid expansion...138% - 200% of the Federal Poverty Line, or between around $16,600 - $24,100/year for a single adult. In most states people in that income range would be expected to enroll in heavily-subsidized ACA exchange policies. In New York and Minnesota, however, they've instead set up Basic Health Programs (BHPs) for this population instead.

via Christopher Snowbeck of the Star-Tribune:

Positive Blue Cross results trigger rebates to consumers
It is legally required to return about $30 million of its 2017 profit to subscribers.

After three years of losses in the state’s market where individuals buy health insurance, Blue Cross and Blue Shield of Minnesota made so much money last year that it has to give some back.

The Eagan-based carrier, which is the state’s largest nonprofit health plan, disclosed last week that it expects to provide $30 million in consumer rebates as required by rules in the federal Affordable Care Act (ACA).

Analysts said that Blue Cross likely isn’t alone in having overshot with rates last year, since insurers across the country have been struggling to figure out how much premium revenue they need to cover the cost of medical bills in the individual market.

In Minnesota, rebates driven by big margins are a surprising cap to a year that started with fears that mounting losses would cause a market collapse.

Huh. This is kind of odd.

Minnesota's 2018 Open Enrollment Period was a month longer than the official half-length period pushed by HealthCare.Gov, but was still over 2 weeks shorter than it had been in prior years, ending on January 14th, 2018. Even so, they reported a slight increase in year-over-year policy enrollees, ending OE5 with 116,358 QHP selections.

Typically, you'd see the official QHP selection number drop off noticeably by the end of the first quarter...usually by around 13% or so. Roughly 10% of those who select policies don't ever actually pay for their first monthly premium, and another 2-3% generally drop off after only paying for the first couple of months.

Now that the 2018 Open Enrollment period is officially over in every state +DC, I've started compiling more detailed demographic breakouts of the data on a state-by-state basis. The official CMS report from the Assistant Secretary for Planning & Evaluation (ASPE) report should be released at some point in the next couple of weeks, but until then, I'll have to settle for whatever reports I can patch together from some of the state-based exchanges.

So far I've dug up final (or near final) data for six states: Colorado, Connecticut, Idaho, Maryland, Minnesota and Washington State. Collectively, these states only represent about 890,000 2018 exchange enrollees, or roughly 7.5% of the 11.8 million total, so I have no idea how representative they are nationally, but it's all I have to work with for the moment.

The type of demographic data available varies greatly from state to state, but a major data point available from all six of them also happens to be one of the more interesting points, especially this year, given the " CSR Silver Loading" gambit available in most states this year.

 

If you look at The Graph for the 2018 Open Enrollment Period, you'll notice that in addition to the large green section (Qualified Health Plan (QHP) selections across the 39 Healthcare.Gov states) and the smaller blue section (QHP selections across the 12 State-based exchanges), there's a much smaller burgundy slice at the top labelled "BHPs (MN/NY only). This represents around 820,000 people in Minnesota and New York only who are enrolled in Basic Health Plans, or BHPs.

This just in via email...

MNsure ends open enrollment with record number of signups

116,358 Minnesotans enrolled in private health plans through MNsure for 2018 health coverage

ST. PAUL, Minn.—Today MNsure announced that a record number of Minnesotans in the individual market signed up for health coverage through MNsure during open enrollment, breaking the previous year’s record of 114,810. Despite an open enrollment period three weeks shorter than 2017 and significant challenges stemming from the federal level, MNsure enrolled more Minnesotans than ever. Thirty percent of MNsure enrollees were new this year.

*According to these numbers, MNsure beat out last year's enrollment total by about 1.3%...impressive in its own right. But it's actually better than that, because the official 2017 Open Enrollment number according to CMS was only 109,974 people...which means that officially, MNsure has actually outperformed last year by 5.8%!

MNsure, Minnesota's ACA exchange, has just posted their latest official enrollment numbers. It's only a minor update from this unofficial 110K figure a week ago, but every enrollment counts.

111,667 QHP selections bumps them up another 1,667, with 5 days left to go for Minnesota residents to #GetCovered for 2018. It's worth noting that enrollment in MinnesotaCare, MN's name for the ACA's Basic Health Program, has actually dropped slightly since the last hard number update I confirmed back in mid-November (93,049).

A couple of weeks ago I reported that MNsure, Minnesota's ACA exchange, had achieved 108.5K QHP selections, putting them within 1,500 enrollments of breaking their all-time record set last year.

Yesterday they issued the following press release:

Minnesotans benefiting from tax credits averaging over $7,000 per year
January 2, 2018

ST. PAUL, Minn.—With just under two weeks left in the 2018 open enrollment period, MNsure is reminding Minnesota residents of important money-saving tax credits. The statewide household average for tax credits is around $7,000 per year. Approximately 62 percent of enrolled households are receiving tax credits.

“Minnesotans are saving an average of over $7,000 per year from tax credits when purchasing coverage through MNsure,” said Allison O’Toole, MNsure CEO. “This is real money for Minnesota families, and can help make the unaffordable, affordable.”

Just yesterday MNsure issued an unofficial tally of 106,000 QHP selections through 12/19. Yesterday also happened to be their December deadline for coverage starting in January, although their Open Enrollment Period still runs through January 14th.

Today they updated the number officially, including the final mid-season deadline:

Private health coverage enrollments through MNsure top 108,500 following first deadline

Total enrollments for 2018 now 12.5 percent ahead of where they were this time last year

ST. PAUL, Minn.—Following the first deadline for 2018 coverage, 108,540 Minnesotans have enrolled in private health coverage through MNsure. Yesterday, December 20, was the deadline for coverage beginning January 1. Minnesotans have until January 14 to sign up for coverage starting February 1, 2018.

Last year after the first deadline, MNsure had 96,540 enrollments, putting this year 12,000 enrollments ahead of last year at this time, or 12.5 percent.

Not an official enrollment update report but close enough (via email from MNsure):

December 20, 2017

Today is the last day for Minnesotans to sign up for health coverage beginning January 1

ST. PAUL, Minn.—Today is the last day for Minnesotans to sign up for health coverage beginning January 1, 2018. Over the last few days, and including the start of today, MNsure has been very busy. Yesterday, there were over 50,000 MNsure.org sessions and MNsure fielded over 5,000 calls. Today is off to a strong start as well, with nearly 21,000 MNsure.org sessions and over 2,200 calls.

To date, MNsure has enrolled over 106,000 Minnesotans in health coverage for 2018 and the average tax credit for Minnesota families is over $7,000 a year.

MNsure.org will remain available for consumers to shop until midnight and the contact center will remain open till midnight as well. Any calls on hold at midnight will be answered.

If Minnesotans do not apply for health coverage by midnight tonight, they can still get coverage beginning February 1, 2018 if they apply by January 14, 2018.

This Star Tribune article from Friday night puts Minnesota's ACA exchange total at 101.6K, only slightly higher than the 100K figure claimed in a KXRA article from over 3 weeks earlier. I'm not sure what happened there--either the KXRA article had the earlier number wrong, or MNsure only enrolled 1,600 people between 11/24 - 12/15, which I find difficult to believe.

Regardless, that's still another 1,600 or so added to the tally. They only need 16,028 more between now and January 14th, although the official ASPE report for OE4 put Minnesota's QHP number at just 109,974, so I'm not sure where the other 7,680 enrollees went. Huh.

MNsure optimistic about sign-ups as deadlines approach

MNsure continues to make progress on enrollment goals for 2018, officials said Friday, as the state’s health insurance exchange nears a deadline next week for January coverage.

Not an official update, but I just saw this from KXRA's Voice of Alexandria:

(St. Paul, MN) -- More than 100-thousand Minnesota residents have enrolled in the state's MNSure health insurance purchasing exchange. And about 50-thousand families are expected to get average tax credits of 72-hundred dollars to help pay for their coverage. Credits are higher in southeast and southwest areas. MNSure C-E-O Allison O'Toole says they can make the difference between "unhealthy and healthy" for thousands of people -- and yet, she says too many residents are not taking advantage. The open enrollment for MNSure runs through January 14th -- and O'Toole says that for at least a couple years, the tax credits will remain in place regardless of what happens to Obamacare in Congress.

That's the enitre article...it's dated yesterday (11/24), so I'm assuming the 100K figure was as of Thursday evening (Thanksgiving, Nov. 23rd).

Breaking out of Minnesota:

More than 91,000 Minnesotans have Enrolled in Private Health Plans through MNsure for 2018

November 15, 2017

ST. PAUL, Minn.—Today, MNsure announced 91,623 Minnesotans have enrolled in private health plan coverage for 2018 through MNsure.

The numbers reported include new consumers, renewing consumers who have come back and shopped for a new plan for 2018, and renewing consumers who are continuing their previous plan for 2018.

"Our first two weeks have gone very smoothly," said CEO Allison O'Toole. "MNsure's enrollment is looking strong out of the gate. This year, we renewed twice as many people into coverage than last year, and we're also seeing a steady stream of new consumers."

By the Numbers

Press release from MNsure, Minnesota's ACA exchange:

MNsure update on first week of open enrollment

ST. PAUL—MNsure CEO, Allison O’Toole, issued the following statement recapping the first full week of open enrollment:

“The first seven days of this year’s open enrollment period have gone smoothly. We are off to a strong start and doing a steady business of enrolling Minnesotans in health care coverage. Market disruptions last year— including a large jump in premiums, a major carrier pulling out of the market, the first year of enrollment caps as well as other factors—drove large numbers of consumers to our doors in the first few days of last year’s enrollment period. This year, we are seeing a much steadier flow of traffic to the website that is more in line with what we would expect. Call wait times have been consistently low throughout this first week.”

This year, MNsure renewed more people into coverage than ever before. Open enrollment figures will be released next Wednesday at MNsure’s public board meeting.

In a year when every state's 2018 Open Enrollment situation is messy to say the least, Minnesota's is far more so:

  • Last year they were facing massive rate hikes, especially for unsubsidized enrollees (yeah, I know, I know, don't say it), and came very close to having all of their carriers bail
  • In response, they agreed to let most of them put a maximum enrollment cap on a First Come First Serve, with Blue Plus (BCBSMN) agreeing to take the "overflow".
  • However, the unsubsidized individual market enrollees were royally screwed, so the state legislature and governor slapped together a special, one-time 25% premium rebate specifically for them. The money came directly out of other portions of the state general fund, I believe. MNsure, the state exchange, also added an extra 8-day special enrollment period for these folks to jump in and get in on the rebate.

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