healthcare reform: the future of the minnesota comprehensive health association
TRANSCRIPT
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Healthcare Reform: the Future of the Minnesota Comprehensive
Health Association
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The History of MCHA• 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.
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Reasons Minnesotans Turn to MCHA
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
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MCHA Demographics• 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
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The New Marketplace: Does MCHA Fit?• 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
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MCHA Phase-Out Plan
• 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
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MCHA Transition Plan Timeline• Oct 1, 2013-Mar 31, 2014
Open 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
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Advantages of Changing Plans in 2014
• 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
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What MCHA Enrollees Should Consider Before Buying a Plan
• 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?
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Resources for MCHA Enrollees
• Health Insurance Agents• Can advise enrollees on what plan would be the best fit
for their needs.• www.myMCHAagent.com
• Community Navigators• Can help enrollees navigate through MNsure, but
cannot recommend a plan.• www.myMCHAnavigator.com • www.mnsure.org/images/AssisterDirectory.pdf