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What is MNsure?

Amberg, Bill2

The state health insurance exchange is about to start operating when enrollment begins in October  and coverage begins January 1, 2014. To help clear up the questions many people have about this exchange, our Government Relations Counsel, Bill Amberg, MA, JD, provides an explanation of the program and how it will affect Minnesotans. 


Ensuring Everyone has Health Insurance

The Patient Protection and Affordable Care Act (PPACA), passed Congress and was signed into law by President Obama in 2010.  Most requirements of the new health care law are phasing in over a number of years.  But some, such as the requirement that insurance companies accept members with pre-existing conditions, for example, have already become law.

Because so many Americans do not have health insurance (some estimates are that there are over 40 million uninsured, out of a population of 315 million), the chief rationale underlying the historic health care law is that health care will become more affordable if uninsured people are enrolled in a health care plan.  The more people that are included in health insurance risk pools, the more widely risk is spread.  Also, uninsured citizens are more likely to use emergency room care — the most expensive care delivery point in our health care system.

To get more Americans insured, PPACA requires “health insurance exchanges,” to be created in all 50 states. These exchanges are essentially an on-line marketplace where individuals, small businesses and non-profits can buy health insurance.  States can choose to establish their own health insurance exchange, or can have one established by the Federal government for them.  All Americans will be required to have health insurance under PPACA, which will drive down costs. Citizens who do not have insurance by 2015 will be subject to fines.

MNsure Becomes Minnesota’s Exchange

23358032_BG1After quite a bit of debate, negotiation, and planning, Minnesota’s health insurance exchange proposal is now law.  The insurance exchange legislation consumed much of the health care community’s attention during the 2013 Minnesota legislative session. The exchange is called “MNsure.”  Minnesota is one of 17 states that has developed their own exchange.  The law allows individual or small businesses to compare the costs of various health plans and different types of health coverage benefits.

MNsure will cost between $50 and $60 million a year for the state to operate. This will be funded through user fees on plans sold through the exchange.  Health insurance providers whose health plans meet the minimum requirements established by the Legislature and the MNsure Board, will go “live” on the MNsure website on October 1, 2013.  Purchasing of plans will begin on January 1, 2014.  Up to 1.3 million Minnesotans are expected to purchase insurance through MNsure.

Preparing for MNsure

MNsure is currently establishing internal operating policies and the substantial amount of technical infrastructure that needs to be ready by October 1. They are also training community partners and insurance agents/brokers to create a customer service network that will provide one-to-one assistance. On the site, purchasers will find health plans from multiple insurers in a standard format so that they can compare coverage and costs side-by-side. Purchasers will be able to search for plans with specific features that match your health needs.  There will also be information about clinics, hospital and ambulatory surgical centers for purchasers to comparison shop.

The Impact on State Health Programs

So how will the insurance exchange affect State health care programs like Medical Assistance (MA) and Minnesota Care?  MNsure will not have an immediate or direct impact upon these State health programs.  However, under PPACA MnCare will morph into the “Basic Health Plan” in 2015.  This plan will grow substantially because PPACA requires health insurance for all Americans by then, and State health officials believe this will drive many Minnesotans without health insurance that have to high an income to qualify for MA into MnCare.  After MNsure becomes operational the MA program will function generally as it does now.

To get more information about MNsure, you can also visit their website for FAQs, patient stories, how it will work, and more. Have a question for Bill? Leave it in the comment section here!

Originally published: September 13, 2013

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