Minnesota

Last week, Bernie Sanders posted the following video (click to view) on Twitter. It tells the tragic story of a young Minnesota man named Alec Smith with diabetes who died soon after after no longer being able to afford either health insurance or the insulin and other medical supplies needed to keep him alive:

Alec Smith died at 26 because he was rationing insulin that was too expensive. The greed of the pharmaceutical industry is killing Americans and it has got to stop. (with @NSmithholt12) pic.twitter.com/xmryYm0Enr

— Bernie Sanders (@SenSanders) November 21, 2018

The main point of the video is the horrific price gouging on insulin, and a new drug price control bill which Sen. Sanders is pushing for which would tie U.S. drug pricing to that of a half-dozen other countries.

It's a genuinely depressing story, and the proposed drug pricing bill is interesting and worthy of discussion.

This Just In via MNsure, Minnesota's ACA exchange...

More than 97,000 Minnesotans have signed up for private health plans through MNsure since the start of open enrollment
Open enrollment runs until January 13, 2019

ST. PAUL, Minn.—Today MNsure announced that over 97,000 Minnesotans have signed up for private health plan coverage through MNsure during the first two weeks of open enrollment.

MNsure's open enrollment runs until January 13, 2019. For coverage that begins January 1, 2019, Minnesotans must enroll by December 15, 2018.

“We are excited with our smooth start to open enrollment and that over 97,000 Minnesotans have signed up for private health plans,” said CEO Nate Clark. “With rates decreasing from 7 to 27 percent across the state, we encourage Minnesotans to visit MNsure.org to see if they can save.”

BY THE NUMBERS—

MNsure, Minnesota's ACA exchange, posted a Week One enrollment update yesterday, and while it's generally positive, there's not much in the way of the key data I'm always seeking:

MNsure Update on First Week of Open Enrollment
November 8, 2018

ST. PAUL, Minn.—MNsure CEO, Nate Clark, issued the following statement recapping the first full week of open enrollment:

“This year’s open enrollment continues to go smoothly with consistently low wait times throughout the first week. With lower rates across the state, we have seen a steady stream of Minnesotans signing up for health coverage. We encourage Minnesotans to visit MNsure.org to see if they are eligible for exclusive tax credits that could lower their monthly premiums.”

This year to date, MNsure has renewed more people into coverage than ever before. Open enrollment figures will be released next Wednesday (11/14) at MNsure’s public board meeting at 1 p.m.

By the numbers 
As of end of day, November 7 

Renewing or Changing Coverage Through MNsure

ST. PAUL, Minn.— MNsure is reminding Minnesotans that are currently enrolled in a private health plan through MNsure that they have the option of renewing into the same plan or selecting a new plan during the upcoming open enrollment period beginning November 1. With rates declining across the state from 7 to 27 percent, MNsure recommends that private health plan enrollees use our new comparison tool to find a plan that fits their needs.

Below is a brief guide to assist consumers with coverage options this open enrollment:

Keeping the same plan

Minnesota, currently entering their second year of their official reinsurance waiver program to help keep unsubsidized premiums down, announced their preliminary 2019 rate hikes way back in June. At the time, the carriers were looking at roughly an 8% average reduction in rates next year...although they would be dropping prices by more like 15% if not for the ACA's individual mandate being repealed and the expansion of #ShortAssPlans.

Today the Minnesota Dept. of Commerce posted the approved 2019 premium changes, and there's been some dramatic reductionsfor three of the five carriers offering policies in the state. Group Health and Medica were approved as is, but Blue Plus was told to drop their rates a whopping 27.7% instead of the 11.8% they were planning on. Ucare was shaved down from a 7 point reduction to 10 points, and PreferredOne (which only sells individual market policies off-exchange and only has 300 enrollees anyway) was knocked down from a 3-point reduction to 11 points.

This just in via email...

MNsure again giving Minnesotans more time to shop for health coverage for 2019
Minnesotans will have an extra month to shop for coverage again this year

ST. PAUL, MN--Today MNsure announced the dates during which Minnesotans will have time to shop for 2019 health coverage. Open enrollment will begin on Nov. 1, 2018, and run through Jan. 13, 2019. This is nearly a month longer than the federal open enrollment period that runs from Nov. 1 to Dec. 15. As a state-based marketplace, MNsure has authority to supplement the upcoming federal open enrollment period with a special enrollment period to give Minnesotans more time to shop.

"Shopping for health coverage is a complex process, and Minnesotans rely on the free in-person assistance offered by MNsure’s assister network," said acting CEO Nate Clark. "This year our assisters face additional challenges given the amount of change coming to Minnesota’s Medicare plans. The extra time to shop will ensure that all MNsure consumers who need it will get that vital assistance."

Well this is a nice surprise! Yesterday the Minnesota ACA exchange, MNsure, issued a press release a day ahead of the public posting of requested 2019 individual market insurance rate changes, advising people of the various ways they have to keep their premiums down via ACA tax credits, shopping around and so forth. I was immediately concerned that they might know something I didn't...perhaps they were expecting a batch of double-digit rate hikes as has happened in so many other states the past few years?

Well, today the Minnesota Commerce Dept. did release the preliminary 2019 rate requests, and I'm pleasantly surprised to report that for the second year in a row, Minnesota carriers are actually asking for rate decreases:

So, I just received the following press release from MNsure (Minnesota's ACA exchange)...

Tax Credits Through MNsure Can Help Lower Proposed Premiums for 2019
June 14, 2018

DULUTH, Minn.—Preliminary health insurance rates proposed by Minnesota health insurance companies will be available on the Minnesota Department of Commerce website on Friday, June 15.

Private insurance companies set premium prices, and the Minnesota Department of Commerce regulates those companies. Final, approved 2019 premium rates will be available by October 2, and the 2019 open enrollment period begins on November 1. Minnesotans shopping for health insurance through the individual market may be able to reduce premium costs in three ways:

1. See if you are eligible for tax credits only available through MNsure

 

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.

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