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Continued: Insurance exchange will force choices

“Comparing premiums is pretty easy,” said Robert Krughoff of Consumers’ Checkbook, a Washington, D.C.-based nonprofit that provides plan comparison tools for federal employees. “But trying to decide, say, between a plan that has a $200 deductible and $10,000 out-of-pocket limit and another that has a $1,000 deductible and $3,000 limit is a mind-boggling question for consumers. It’s mind-boggling for brilliant economists.”

And yet some local consumers said they already have a pretty good idea of the trade-offs they will make.

Dylan Fresco, an independent artist, said his priority is a lower deductible. He would pay a higher premium if he could find a plan on the exchange with a deductible lower than his current $5,000. The Minneapolis man said he worries all the time about one injury forcing him to pay the full deductible of his current plan and exhausting his bank account.

“I’m OK with copays,” he said. “I’m all right with throwing down $30 to see a doctor. But having that sense that, if one thing happens, I’m out such a large chunk of money, it leads to more worry and concern.”

Terri Adams of St. Paul just wants any insurance as soon as possible for her 17-year-old son, Malik Curtis, to provide preventive care and cover him in the event of an accident. Adams has insurance due to a disability through the federal Medicare program but can’t afford premiums to cover her son.

The expansion of public benefits under the health care law should qualify him for a state-subsidized health plan with premiums that Adams can afford. For now, she worries every time Curtis, a tailback for the St. Paul Central High School football team, carries the ball and disappears into a crowd of tacklers.

“They all pile on him so I don’t barely see him,” Adams said.

The last event with such sweeping scope and impact on the health care of so many Americans was the 2006 launch of the Medicare Part D prescription drug benefit for seniors. But Part D was phased in gradually. Seniors went from having no prescription drug coverage to discount cards before they had to go online and select Part D drug coverage plans.

The process also was a bit simpler, said Jean Wood, executive director of the Minnesota Area Agency on Aging. Seniors basically wanted to know which plans covered their drugs at the lowest cost; whereas people using MNsure will have to weigh the premiums of plans with other costs and coverage limits and the doctors that are in the plans’ networks.

Heidi Stokes and her family already sense the complexity of decisions ahead, even as they cross their fingers that Obamacare will deliver as advertised.

With all three family members dealing with long-term, chronic illnesses, they set aside nearly $22,000 each year to buy insurance. They drive cars “until they drop,” take short vacations in fear of a medical crisis and have put less money into retirement savings.

The couple, both 54, own a small production studio business in the downtown Minneapolis Warehouse District, Aaron/Stokes Music and Sound. They provide medical coverage for their employees even though they can’t get on the plan themselves.

The two must wade through a number of options once the exchange launches: Will they include themselves in small-group coverage? Continue to buy a separate family plan? Or will their employees be better off shopping MNsure themselves with a company contribution?

The couple is hopeful for the new world, yet wary.

“We will do anything — make any sacrifice — to pay for insurance,” Brad Stokes said. “All I know is something had to be done.”

jackie.crosby@startribune.com • 612-673-7335

jeremy.olson@startribune.com • 612-673-7744

 

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  • Brad Aaron, son Christian, and wife Heidi Stokes have been uninsurable for years and pay a huge portion of their salaries to be part of the state’s high-risk pool.

  • Heidi and Brad Stokes are hopeful about having insurance choices. “It has kept us alive. Without it, you are just one bad illness from being out on the curb.”

  • MNsure Plan Comparison

    Here’s a comparison of insurance plan costs on the MNsure exchange, using a hypothetical 30-year-old metro-area man who doesn’t smoke and wants a midlevel Silver plan. In general, higher premiums mean lower deductibles. Copays, coverage levels and doctor networks also vary and are key considerations.

    Blue Cross and Blue Shield of Minnesota

    Two Silver Plans

    Premium Range: $172.21-$187.93

    Deductible Range: $1,900-$3,000

    HealthPartners

    Two Silver Plans

    Premium Range: $147.28-$150.96

    Deductible Range: $2,500-$2,750

    Medica

    Four Silver Plans

    Premium Range: $187.03-$220.52

    Deductible Range: $1,300-$2,200

    PreferredOne

    Six Silver Plans

    Premium Range: $136.69-$159.45

    Deductible Range: $3,500-$4,400

    UCare

    Two Silver Plans

    Premium Range: $180.45–187.99

    Deductible Range: $1,900-$3,800

    There is also financial help available below certain income thresholds.

    • $15,282 or less qualifies for Medical Assistance

    • $22,980 or less qualifies for MinnesotaCare

    • $45,960 or less qualifies for sliding-scale subsidies on premiums

    Source: Minnesota Department of Commerce

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