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“No other carrier wants to work in this area partly because the Mayo Clinic is becoming too expensive,” Rochester broker Woxland said. “That’s what irritates people.”
Mayo spokesman Bryan Anderson deflected the criticism, saying the giant system of hospitals and clinics finds itself at the “nexus” of a host of issues with the Affordable Care Act as new rules take hold next year.
Mayo not only is located in a rural area, Anderson said, but it draws sicker patients as an academic medical center. And Mayo’s team-based approach to medicine is different from traditional medical models in which doctors get paid for each treatment.
“We’re not unique across the country,” Anderson said, noting that prices are also higher around academic centers such as UCLA Medical Center in Los Angeles, New York’s Mount Sinai and Northwestern University’s Feinberg School of Medicine in Chicago.
Mayo has contracts with most insurers, he said, but they’re not offered on the MNsure exchange.
“We’re committed to working with health insurers to increase access to the Mayo Clinic,” he said. “We are disappointed that more of them didn’t choose to offer plans down here.”
It may take time
Cynthia Cox, a policy analyst with the Kaiser Foundation, said there hasn’t been enough time to tease apart the reasons for disparities across regions, which are happening across the country.
There’s a correlation between the number of insurance offerings and population density, but a competitive provider market plays a role as well, she said.
A New York Times analysis recently found that 58 percent of counties served by the federal exchange have just one or two insurance companies and that those in rural areas and small towns are paying for it.
But Cox and others point out that time will tell how competition and premium prices will shake out.
“We might not see this new level of competition that the law hopes to achieve immediately,” she said. “It might be something that happens down the road.”
The stated premium prices don’t account for discounts many residents with low and modest incomes will get through tax credits and more generous publicly subsidized health coverage. And that those who already are sick likely are seeing less sticker shock, no matter where they live.
But a big fear is that price and lack of options will keep healthy people away from the exchange — the very thing needed to keep prices low next year.
So for now, brokers like Woxland are doing more research on policies sold outside of the exchange, writing their representatives, and trying to hold steady in the face of angry clients and no good answers.
“They blame me, or the insurance company, or the Mayo Clinic or the Obama exchange,” Woxland said. “It’s a little bit of all of that.”
Jackie Crosby • 612-673-7335