Minnesota

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.

For 2017, unsubsidized enrollees on the Minnesota individual market faced massive rate hikes averaging 57%. It was so bad that the only way they could convince some carriers to participate in the market was to allow most of them to put a cap on how many people they'd enroll (with the balance being shunted over to Blue Plus, the HMO division of BCBSMN). This resulted in a massive initial surge of enrollment, as it was on a first-come, first-serve basis...but also left off-exchange and unsubsidized exchange enrollees high and dry.

In response, the state scrambled to pull together a $300 million package to help supplement premiums for those folks...knocking a flat 25% off of their premiums for 2017. This helped ease the problem in the short term, but the larger issue still loomed going forward.

Of the 31 states which have expanded Medicaid under the Affordable Care Act, only a handful issue regular monthly or weekly enrollment reports.

I noted in February that enrollment in the ACA's Medicaid expansion program had increased by around 35,000 people across just 4 states (LA, MI, MN & PA).

It's early June now, so I checked in once more, and the numbers have continued to grow. I have the direct links for 5 states now (including New Hampshire)...

Of the 31 states which have expanded Medicaid under the Affordable Care Act, only a handful issue regular monthly or weekly enrollment reports.

I noted in February that enrollment in the ACA's Medicaid expansion program had increased by around 35,000 people across just 4 states (LA, MI, MN & PA). By the end of March, the numbers in these 4 states had gone up by another 19,300.

It's the end of April now, so I checked in once more, and sure enough, the numbers continue to grow:

You may have noticed that among my 16 recommendations for repairing/improving the ACA, I foolishly failed to include one of the most important/obvious ones: Reinsurance. I didn't include it for two reasons: Partly because, quite frankly, I simply forgot about it and feel bad about myself now.

So far, two states (Alaska and Minnesota) have already established their own state-based reinsurance programs; in both cases, it was done as an act of sheer desperation...and, in both cases were put through in a bipartisan fashion (both states have GOP-held legislatures, but Minnesota's Governor is Democratic while Alaska's is Independent):

Alaska: Approved *unsubsidized* 2017 indy mkt rate hikes: 7.3%

There was a time, just a few months ago, when it looked like Alaska, which had already suffered from massive rate hikes the past 2 years due to their unique healthcare situation, might have a complete catastrophe on their hands with a third year of massive individual market rate hikes.

Of the 31 states which have expanded Medicaid under the Affordable Care Act, only a handful issue regular monthly or weekly enrollment reports.

Back on February 28th I noted that ACA Medicaid expansion enrollment across three states (Michigan, Louisiana and Pennsylvania) had grown by about 35,000 people since mid-January, to 667K, 406K and 716K people respectively.

Today, a month later, I decided to take another look at all three states, along with Minnesota (which I forgot to check last month). Sure enough, enrollment has continued to grow in all four, albeit at a slower pace:

NOTE: I have to attend a field trip with my kid this morning so won't be able to post about the Minnesota results until around noon, but here's an overview:

There are only 2 states which still haven't announced their final 2017 Open Enrollment Period totals: Vermont and Minnesota. Vermont isn't likely to have anything too noteworthy to say (I've confirmed ~29K QHPs...they'll probably top out at ~30K), but Minnesota has a very special situation.

Minnesota confirmed ~106,000 QHP selections as of January 10th, so they probably tacked on another 5K - 10K during the last 3 weeks of open enrollment, for a total of perhaps 115,000. This would be impressive already, since they only enrolled 83.5K people last year.

However, they're also wrapping up (even as I type this) an 8-day Special Enrollment Period piggybacked onto the end of January, and those who enroll during this SEP could receive a 25% discount on their premiums depending on their income. Here's the backstory.

Last week I posted an exclusive story over at healthinsurance.org regarding attempts by the Minnesota Republican-held legislature to sneak in a nasty amendment which, had it passed and been signed into law, would have given insurance carriers the right to offer policies which cover, basically nothing whatsoever.

The story ended on a happy note a few days later, as the massive negative backlash caused the state GOP to yank the amendment from the bill in question just before it went to the final vote. Awesome!!

However, I never really explained exactly what bill the pulled amendment was attached to in the first place. I should have written up a full entry on this, but have been swamped all week due to the political insanity and rapidly-changing situation on everything, so here's the basics:

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