Minnesota reguÂlaÂtors and inÂsurÂers scramÂbled FriÂday to figÂure out how to imÂpleÂment President Obama's ofÂfer to let conÂsumÂers keep plans that don't meet the fedÂerÂal health care law, and whethÂer to try.
In the words of one Minnesota inÂsurÂance exÂecÂuÂtive, Obama threw a "big monÂkey wrench" into an alÂreadÂy unÂcerÂtain marÂketÂplace this week when he deÂcidÂed that conÂsumÂers could choose to hang onto exÂistÂing poliÂcies for anÂothÂer year.
"The worst-case sceÂnarÂiÂo," said Medica's Geoff Bartsh, "is that this creÂates a bigÂger mess, and peoÂple will roll through now to the end of the year, forÂget to eithÂer reÂnew or make a covÂerÂage deÂterÂmiÂnaÂtion and are stuck on Jan. 1 withÂout covÂerÂage, even if they have it today."
Obama's Thursday anÂnounceÂment left it up to state inÂsurÂance comÂmisÂsionÂers to deÂcide whethÂer they will temÂpoÂrarÂiÂly alÂlow inÂsurÂers to exÂtend covÂerÂage for plans that don't comÂply with the fedÂerÂal health law. And even if the Minnesota Department of Commerce deÂcides to grant the opÂtion, it's unÂclear whethÂer the inÂsurÂance comÂpanies will do so.
OfÂfiÂcials at the Department of Commerce didn't proÂvide a timeline on a deÂciÂsion. ComÂmisÂsionÂer Mike RothÂman isÂsued a stateÂment sayÂing the aÂgenÂcy was "workÂing quickÂly" to reÂspond to the president's anÂnounceÂment and that its goal was to proÂvide more choice and afÂfordÂaÂble opÂtions.
About 140,000 MinÂneÂsoÂtans have plans that fall short of the health law's reÂquireÂments.
InÂsurÂers spent a year creÂatÂing new plans based on the more strinÂgent rules of the AfÂfordÂaÂble Care Act. StartÂing in 2014, inÂsurÂers can no longÂer deny covÂerÂage for pre-exÂistÂing conÂdiÂtions, and have to covÂer a long list of basÂic health care needs, such as childbirth, menÂtal health care and preÂscripÂtion drugs.
For many peoÂple who are sick and who qualÂiÂfy for tax credits, the new poliÂcies unÂder Obamacare are welÂcome reÂlief. But inÂsurÂance carÂriÂers fear that if young and healÂthy peoÂple deÂcide to hang onto their curÂrent plans, the pricÂing asÂsumpÂtions to spread the cost of medÂiÂcal covÂerÂage among more peoÂple no longÂer work. The reÂsult, they warn, would be a destabilized inÂsurÂance marÂket and soarÂing preÂmiums.
Most curÂrent poliÂcies don't even meet the reÂquireÂments of the new "bronze level" plan ofÂfered on the law's inÂsurÂance exÂchangÂes. Bronze plans ofÂfer the lowÂest preÂmiums and highÂest out-of-pockÂet costs.
"These chanÂges will have a very proÂfound imÂpliÂcaÂtion for the marÂket, not just in 2014 but in 2015 and beÂyond," said Scott KeeÂfer of Blue Cross and Blue Shield of Minnesota. "There's a real long-term isÂsue loomÂing here."
Sue Abderholden, exÂecÂuÂtive diÂrecÂtor of Minnesota's National AlÂliÂance on MenÂtal IllÂness, wastÂed no time sharÂing her disÂapÂpointÂment in e-mails to Gov. Mark Dayton and the comÂmerce comÂmisÂsionÂer.
"These poliÂcies that didn't meet the new standÂards, I'm guessÂing a fair perÂcentÂage didn't covÂer menÂtal health and subÂstance aÂbuse treatÂment," she said. "We don't think, frankÂly, that conÂtinuÂing disÂcrimÂiÂnaÂtion is a good iÂdeÂa."
She notÂed that some counÂties in the state have alÂreadÂy set budgÂets exÂpectÂing that inÂsurÂers would shoulÂder more costs of caring for those with menÂtal illÂness.
"If you're a man, you know you don't need maÂterÂniÂty care," Abderholden said. "But with one in four adults exÂperiÂencÂing menÂtal illÂness in any givÂen year, who knows if it's going to hapÂpen to you. EsÂpeÂcialÂly young peoÂple. We've had famiÂlies go into bankÂruptÂcy and face huge bills to pay out-of-pockÂet for this treatÂment."
MeanÂwhile, conÂfuÂsion reigns aÂmong conÂsumÂers. At Medica, the call cenÂter was "getÂting slammed" on FriÂday, a day afÂter Obama's anÂnounceÂment.
"It's a big monkÂey wrench," Bartsh said. "People don't know what to do. They don't know what it means to them. The hard part for us is we still don't have the aÂbilÂiÂty to anÂswer a lot of their quesÂtions yet."
Jackie Crosby • 612-673-7335