Local family's experiences
shows difficulties with MNsure
Wednesday, November 06, 2013 3:25 AM
I would like to offer my family's experience with MNsure as an example of how poorly the new system is working for those of us who have no employer-provided insurance. For years, we have had our own family plan through Blue Cross Blue Shield. Every year, the premium would jump about $90 per month, and we would often compensate by increasing our deductible. This year, due to the ACA, our premium will increase by about $280 per month. Our family of four will pay $892 per month for a "grandfathered" plan with no preventative care, no co-pays, and a $4,000 per person deductible.
Initially, we were eager to log onto MNsure to see the new plans, because we expected to receive a subsidy or tax break. The first thing we noticed on MNsure was that the rates were higher than our current plan, and the deductibles were higher still. After checking with our insurance agent, we discovered that it is entirely possible to purchase a cheaper plan outside the website, but you then are apparently not eligible for subsidies or tax breaks. We also learned that deductibles in the new plans can be misleading. For example, if a plan states that it has a $5,200 individual deductible, that deductible is only valid if an individual is purchasing it alone. If a family purchases the same plan, a deductible of $10,400 must actually be met before benefits kick in.
Cost is a huge issue, both on and off the MNsure site. As I understand it, Minnesota is no longer being considered as a whole for the purpose of calculating premiums and has instead been carved up into healthcare regions. A "Star Tribune" comparison recently found that a family of four in southeastern Minnesota will pay anywhere from $858.10 to $1,310.08 per month, while the same family of four living in the Twin Cities area will only pay $391.16 to $947.88. This seems to go against everything ACA proponents have been telling us about creating larger pools to spread out the risk and make rates affordable for everyone.
Choice is another serious problem in the MNsure system and in SE Minnesota in general. There are only two insurance companies who have ventured into the market in SE Minnesota - Medica and Blue Cross Blue Shield. When my family searched for a plan, we discovered that there are no Gundersen providers in the Medica network. Plus, the Medica plans don't allow you to go directly to Mayo Clinic either, relying instead on some of the Mayo Health System offshoots, such as Franciscan Healthcare. The only plan on MNsure that would fit my family's needs was a Blue Cross Blue Shield plan that still was not affordable.
So what about the help the government has promised? We expected to receive either a subsidy or tax break to help with our insurance costs. Instead, MNsure decided that while my husband and I do not qualify for help, our children are eligible for Medical Assistance. Once MNsure made that determination, it would not quote us any plans that included our children. The problem is, the MNsure site gives very little information about the process of applying for MA and whether or not we applied simply by inputting all our information. A call to Fillmore County Social Services did not clarify the situation, as the various social service agencies seem to have been kept in the dark about the workings of MNsure. We were further cautioned that even if our children qualify, there may not be any providers in SE Minnesota in 2014 for MA recipients.
Given the uncertainty of the situation, we feel that we have no choice but to cover our children under our grandfathered family plan, as we have always done - whether we can afford it or not. Frankly, we were shocked that MNsure wants to put our children on MA. It seems to me that instead of making rates affordable, the new system is just moving more people to government programs. I don't know how that can be sustainable without significant tax hikes and even higher insurance costs in the future.
I've been a lifelong Democrat, and I was even in favor of the ACA - until I saw first-hand the negative impact it will have on my family, friends, and neighbors in southeastern Minnesota. With a politically charged issue like this, it's very easy to automatically pick sides based on your political affiliation. However, I think the well-being of our state and our country demands that we cast those affiliations aside and become educated about how this law will affect us all.
Jennifer Slafter, and her husband, Steve, live north of Mabel and Spring Grove in Fillmore County.