Health care discussed at legislative meeting
A few years after the Affordable Care Act came into play many are still trying to understand the impact it is making on a person’s life.
“What I’m hearing is that the small group market is stabilizing,” said Dist. 24 Sen. Vicki Jensen (DFL-Owatonna) during a discussion on health care issues at the Elks Lodge in Owatonna on Saturday. “I believe once we get through these couple of years of claims with those people that are going to be in that pool it will stabilize too.”
She also appeared at Out to Lunch in Waseca and The Coffee Shop in Faribault. Joining her in Owatonna were Denise Robertson, Southeast Minnesota Coordinator for Health Access Minnesota who helps people enroll in the MNsure program and Peter Brickwedde, Assistant Commissioner of Government and External Affairs for the Minnesota Department of Commerce.
The Affordable Care Act regulates all different groups for health care, but Jensen said the reason the individual market is being discussed is because it is the section where people had the least amount of access if they were sick.
It is estimated that approximately 5 percent of people buy their own health care insurance without assistance from an employer.
In Minnesota, 90 cents out of every $1 has to go toward health care. At first, the state tried to make projections about who came into the individual markets that weren’t in them before, because they didn’t have access. People with higher claims are now in the market.
According to a stat sheet that Jensen provided those attending Saturday, in 2013 it cost $283 per health care claim. After information was gathered, that cost jumped to $417 per month in 2014.
Prescription drugs, especially brand name drugs, are the major drivers of increasing that cost, Jensen said.
Robertson stated that after the first couple of years that MNsure came into effect, rates are starting to be more in par with what they should be.
MNsure is Minnesota’s marketplace where individuals, families and small businesses can shop, compare and choose health insurance coverage that meets their needs. MNsure is the only place a person can qualify for financial help that can lower the cost of a monthly insurance premium.
“Because of the procedures of MNsure – long wait lines, computer problems – people didn’t bother signing up under MNsure to see if they qualified for a subsidy. Our rates were so low anyway, why would they need to bother with MNsure,” she said. “Now this year when finally the rates are catching up, we’re starting to deal with what the rest of the country is. This year they are coming, applying and qualifying for a subsidy.”
She added as the rates are rising we are bringing more people into the marketplace. “Ideally, everyone should be using whatever is available and we’re finally getting a clearer picture,” she said. “We had a lot of people come to us in a big panic because rates were literally doubling. After they saw us, they were paying the same as last year. As the rates increase, the subsidies increase.”
Robertson said she ended up being part of the individual market and it impacted her for at least a year. She was married, got divorced and then paid into Consolidated Omnibus Budget Reconciliation Act (COBRA), but later stopped because she couldn’t afford it. She couldn’t qualify for any public programs and because of a pre-existing condition any policy she purchased was at least $800 a month.
“I wouldn’t be able to eat if I paid $800 a month,” she said.
She was hospitalized in November and then the next year she had no insurance. Robertson stated she went a year without insurance because she couldn’t afford it. “It was the longest year of my life,” she said.
The Affordable Care Act passed, and it changed some of the qualifications and Robertson said she was able to qualify for Minnesota Care, found a better job and is now under employer-sponsored coverage. “The nice thing about the Affordable Care Act is it lets people move up and down the system.”
Robertson said a major challenge is education. “This is a whole new health care system. It is just way different than it was before,” she said.
Brickwedde mentioned that the individual markets and the small group markets are coming together. “One of the things we are working at in the commerce department is trying to get ahead of that issue so that individual market rates don’t continue on that upward trajectory, but rather stabilize.”
He said that the major thing he has been hearing is that costs are going up and that people are having trouble affording the health care. “That’s the key question we really, as a state, have to wrap our arms around to make sure that care that people are getting is also affordable,” he said. “It is good to have insurance. If you can’t afford it because the cost of the care is so high, then you still have a problem we still have to solve.”
Jensen is hoping that with knowledge and more transparency on claims, the state can tackle why these issues are happening. “Changes like this is incredibly impactful because it hits you right in the pocket book with things you don’t know for sure,” she said.