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Continued: Cost of MNsure insurance may leave target group no better off

  • Article by: JEREMY OLSON , Star Tribune
  • Last update: February 11, 2014 - 5:47 AM

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For Jamie Ward, the idea of remaining uninsured is tempting because her two preschoolers are covered by Medical Assistance, which has more generous eligibility standards for children than for adults.

“Really, they’re the ones that I worry most about falling and scraping something or breaking something,” she said.

The family’s financial pinch started five months ago, when Ward left her job to stay at home with her children. Her husband is an apartment maintenance man, but his employer doesn’t cover the premiums for the health plan it offers.

MNsure’s website gave the Wards hope, telling them they qualified for a tax subsidy to reduce the cost of premiums for plans they could purchase on the exchange. Later they learned that was incorrect.

Families generally qualify for subsidies when premiums eat up more than 9.5 percent of their household income; the Wards’ income put them just above that threshold.

“We would be in the red every month,” Jamie Ward said. “We don’t live a very luxurious lifestyle. We’re not going out to eat all the time, not going to movies all the time. But we’d have to make some cutbacks to make it work.”

‘It’d make me feel better’

Some analysts believe that incentives in the federal law aren’t strong enough this year to persuade the uninsured. The “stick” that enforces the mandate to have health insurance is a penalty that, in the first year, caps at $285 per family or 1 percent of household income (whichever number is higher).

“The monetary value isn’t a big enough stick to change somebody’s purchasing pattern” in 2014, said Geoff Bartsh, vice president of state public programs for Medica, the Minnetonka-based insurer with plans for sale on MNsure. But he added: “To the extent that people just generally like to follow the rules, I think the mandate will be somewhat impactful.”

Bartsh said Medica is gaining few customers through MNsure who were previously uninsured. It is picking up customers who couldn’t buy private coverage because of their medical histories and instead paid for the state’s expensive high-risk insurance program.

Health Access MN, on the other hand, has conducted MNsure outreach events at public libraries and homeless shelters and has almost exclusively worked with uninsured people to get them enrolled.

“We get a number of people who are coming in purely because of the mandate, and they’re realizing they are eligible for a public program and that it will be much more affordable than they had anticipated,” said John Freeman, lead navigator for the agency.

The Wards, however, discovered that insurance would cost more than they anticipated, $347 a month. They could drop their cable television service but, they say, that would just be the start of cutbacks to pay for premiums.

Jamie Ward could use health insurance. She has asthma, and has been rationing the inhaler medication that was covered under insurance from her old job.

“It’d make me feel better if I did have insurance,” she said.

But, she added, “It’s definitely on the table for us to not have insurance and just pay the fee. That’s probably a wiser financial decision if you do the math.’’

Jeremy Olson • 612-673-7744

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  • Coverage of MNsure health insurance launch

    Monday July 28, 2014

    Star Tribune coverage of MNsure, Minnesota's new health insurance exchange.

  • Jamie Ward and her husband, Wesley, are trying to decide whether to buy insurance on MNsure and give up some comforts, or forgo coverage for themselves and hope they will get through the year healthy, paying out of pocket for any medical needs.

  • « It’s definitely on the table for us to not have insurance and just pay the fee. That’s probably a wiser financial decision if you do the math. »Jamie Ward, above, one of many uninsured Minnesotans who would struggle to pay for health coverage on MNsure

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