Can the exchange come to the rescue?

When Joanne Boyer logs on to MNsure to pick new health insurance, the screen will be blurry — because cataract surgery is one of the medical needs she put off because of her current plan's high costs.

"I've been holding off for two years," she said, "not seeking medical treatment I need."

Joanne, 60, and her husband don't have workplace benefits because they are self-employed, and no private insurers would sell them affordable coverage because of Joanne's breast cancer diagnosis five years ago and her husband's ulcerative colitis as a young man. So the state's costly high-risk plan for people with chronic conditions has been their only option lately.

The St. Louis Park couple's status as insurance untouchables is changing, though, because the Affordable Care Act requires MNsure plans to take all comers — no matter what conditions they have.

Joanne believes the couple could save $80 per month in premiums and gain superior coverage. So now maybe she can get her blurry eye fixed — not to mention the breast exams, skin cancer checks and colonoscopies her doctor urged.

JEREMY OLSON

At 27, Andi Cheney doesn't have many medical needs, but she hardly feels like a "young invincible," the term for healthy twenty-somethings who forgo insurance.

"For what I'm worried about, a catastrophic bike accident, I don't have $4,000 to cover a hospital stay," she said.

Andi, an administrator for Bedlam Theater, is part of a Twin Cities' arts community in which many artists and musicians are self-employed and have to buy coverage.

MNsure's one-stop shop will help, she said. "A lot of my friends are baristas and independent contractor-type artists. They're looking forward to having options laid out."

Andi wants a plan that includes her doctor and has decent prescription benefits.

"I've switched doctors so many times that I'd like to not have to any more," she said.

JEREMY OLSON

Chris and Heidi Gegax each have an individual health insurance plan, and so do their 8- and 6-year-old girls. While that might sound like a ton of insurance for one south Minneapolis family, consider that the adults' plans each have $4,000 deductibles and the girls' plans have $3,000 amounts.

"If we were in a car accident, that's $14,000," Heidi said.

While that was the trade-off for $525 in monthly premiums that they could afford, the family is optimistic the MNsure exchange will offer a better plan that doesn't nickel and dime them with copays and so much cost sharing.

"We're paying all the time," Heidi said.

As the cost of parenting young soccer players/swimmers/pianists increases, they are hoping MNsure can help them find reliable, affordable coverage they can keep.

"We shop online all the time — Amazon, eBay, Craigslist," Chris said. "We're always looking to find the best price."

JEREMY OLSON

Gabriel Keller and his business partner, Lars Peterssen, already know a lot about the MNsure exchange, even though the website isn't available yet. They've downloaded plan details from the insurers, pored over premium rates and had weighty talks about whether shopping the exchange will be a good deal for their business.

"I can't decide if it'll be our savior or make things worse," Keller said.

The number of options with MNsure makes Keller dizzy: Reduce the premiums, but possibly settle with a plan with less coverage or without Mayo. Consider paying for workers to shop for their own coverage through MNsure.

"We don't mind paying for the health insurance we have, we just don't know what it all means," Keller said. "We're waiting for Oct. 1 ... that's it in a nutshell."

JACKIE CROSBY

At Moonstone Farm in Montevideo, some 125 miles west of the Twin Cities, Audrey Arner and husband Richard Handeen live an active life full of organic food. They long ago stopped farming corn and soybean on their 120 acres, which also meant giving up some government subsidies.

These days, they work with the Land Stewardship Project and earn a living off a perennial landscape garden, vineyard and rows of perennial grasses that feed beef cattle.

"We haven't done much more than get our annual physical," she said. "But if an accident would happen or some catastrophic illness, we need to be covered."

Farmers are often asset-rich but cash poor. Arner said she's grateful the Land Stewardship Project fought to ensure farmers would be eligible for federal tax subsidies on the MNsure exchange and for continued coverage through the state-subsidized MinnesotaCare program. She hopes MNsure will provide better choices.

"I think it'll make it easier to wade through the options with greater clarity," she said. "I feel like I'll be able to make a more intelligent and informed decision."

JACKIE CROSBY