Healthcare Reform: the Future of the Minnesota Comprehensive

Health Association

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.

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

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

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

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

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

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

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?

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