Many in Minnesota's high-risk health insurance pool find new plans

  • Article by: JACKIE CROSBY , Star Tribune
  • Updated: April 4, 2014 - 9:04 PM

The state program is winding down operations with the launch of Affordable Care Act.

Almost 62 percent of Minnesotans who had relied on the state’s safety net insurance pool have found better health care coverage on MNsure or the individual market, far exceeding goals, officials at the organization said Friday.

The high-risk pool is winding down operations and will close for good at the end of the year. Under the Affordable Care Act, such pools are less necessary because insurers now are required to provide coverage even to those who are already sick.

About 9,000 people remain enrolled in the program, down from about 25,000 when open enrollment began under the new health law.

Executive Director Kirby Erickson, a semiretired health care executive, announced Friday that he is stepping down as leader of the organization, and longtime Operations Director Peggy Zimmerman-Belbeck will take over. Erickson will remain as a consultant.

The organization, commonly known by its acronym MCHA, for the Minnesota Comprehensive Health Association, operates one of the nation’s oldest and largest high-risk pools. It was formed 35 years ago to provide coverage to people with pre-existing conditions.

Before the launch of the new marketplaces last October, about 35 states operated similar programs that provided coverage to about 220,000 Americans.

In Minnesota, enrollees pay hefty deductibles plus a premium, bringing the cost to as much as 25 percent more than the average cost of a similar health plan. Insurance companies also are assessed a fee to fund operations, which gets passed on through premiums to individuals and businesses.

Zimmerman-Belbeck, who previously worked at Medica for 16 years, has overseen operations at MCHA since 2000.

The organization spent the past year preparing its enrollees for upcoming changes, but had expected certain subsets of its members to stay put.

But during open enrollment that started on Oct. 1, Zimmerman-Belbeck said the pool saw decreases “across the board” of its membership. She did not know how many people shopped on MNsure, the state’s insurance marketplace, or found policies by working with a broker.

‘Premium rates were a plus’

“We were very surprised — pleasantly surprised,” she said. “There were some really great rates from the new plans … so for some people even if they have to spend more out of pocket, premium rates were a plus for them.”

One of many unknowns for insurance companies in the inaugural year of the new markets created by the Affordable Care Act was how many people in the high-risk pool would seek out coverage. These often are the sickest of the sick, and as a group rack up the highest medical bills.

While some states closed their high-risk pools last year, Minnesota chose a longer transition through the end of this year.

For insurers, the more people that moved out of the state program in the first year, the better. That’s because the federal law provides a financial safety net to help insurers absorb the cost and risk of covering this population during the first few years of the law’s implementation.

Zimmerman-Belbeck said she’ll spend the next few months trying to work with remaining enrollees to prepare them for the next open enrollment period, which begins Nov. 15.

Among those who still get coverage through MCHA are those who had organ transplants or were in the middle of treatment during the open enrollment period.

Meanwhile, MNsure released updated enrollment figures, saying that about 175,000 people have enrolled in a plan, a MNsure spokesman said Friday.

The agency is in the early stages of sorting through 36,000 forms of those who had trouble enrolling by the March 31 deadline. About 95 percent of those who signed up for a private plan have paid their first month’s premium, MNsure officials say.

Jackie Crosby • 612-673-7335

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