For most Americans who purchase health insurance on their own, the window to buy coverage for 2017 slammed shut on Jan. 31. But Minnesotans struggling with hefty premium increases and, until recently, political gridlock over state aid to provide relief caught a crucial break thanks to an oft-maligned consumer ally — MNsure, the state-based insurance shopping website still rebuilding trust after its troubled launch.
Minnesotans who buy private insurance in the individual market — meaning they don't get insurance through their jobs or public programs such as Medicare — have until Feb. 8 to decide which plan is best for them and their families. That's a week more than consumers in most states, and Minnesotans ought to take full advantage of the extra time to get through heavy online traffic and busy call centers. More important, there's time to learn more about Minnesota's just-passed automatic 25 percent premium reductions as consumers consider what level of coverage to purchase for 2017.
Months of wrangling over premium assistance would have forced Minnesotans to rush vital household budget calculations before MNsure stepped up. It wasn't until late January — five days before the previous open enrollment deadline — that Gov. Mark Dayton and Republican lawmakers enacted an agreement to provide 25 percent discounts on insurance for those who don't qualify for federal assistance through MNsure. Open enrollment is the time frame to sign up for private insurance for the coming year. Few exceptions are made beyond this, though those who qualify for publicly funded programs can sign up throughout the year.
Republican legislative leaders merit praise for pushing for an open enrollment extension given the premium relief stalemate. They urged Dayton to petition federal officials, who set national open enrollment dates, to do so. Dayton did, but Minnesota's request was rejected first by the departing Obama administration and then by the new Trump administration.
MNsure CEO Allison O'Toole and her team merit credit for creatively pursuing another path. The extra week isn't technically an extension, but a "special enrollment period" due to exceptional circumstances — the late date at which state premium relief became a reality.
Whatever the name, Minnesotans benefit from this heads-up work. That's true even if they don't buy insurance through MNsure. Insurers such as HealthPartners and Blue Cross Blue Shield matched the extension for consumers wishing to buy directly from them. That the MNsure move had this influence on the Minnesota market, one with clear benefits to patients, should be duly noted by policymakers.
MNsure has been in Republican lawmakers' cross hairs since its 2013 launch. But the open enrollment flexibility almost certainly would not have been possible had Minnesota not built its own website and instead relied on the federal healthcare.gov. The few other states that have publicly announced extended sign-up deadlines — Colorado and California — also built their own online marketplaces.
Rather than reflexively including MNsure's demise in health reforms, it's worth remembering that flexibility and state control were key reasons why so many health care and business lobbies championed a state-run insurance marketplace and continue to do so. Expected congressional changes to the Affordable Care Act are likely to push further reforms back to the states. This new reality calls for a fresh look at MNsure and its potential role in launching Minnesota-made solutions.
