Minnesota’s Top Health Insurance Ranking Didn’t Include All Factors

With the federal approval, MNsure is planning to begin serving consumers on October 1, but the state must pass a final in-house security check the day before it goes live.

The federal analysis that proclaimed Minnesota’s health insurance premiums the lowest in the nation didn’t take into account factors that could have upped the cost.

National data released Wednesday found other states much higher than the average $144 monthly price for the cheapest low-tier plan on the MNsure health exchange. Similar coverage in Wyoming, for example, listed for $425.

At Wednesday’s governing board meeting, Minnesota exchange officials cheered the good news from the U.S. Department of Health and Human Services, which capped weeks of negative publicity for the fledgling exchange.

But the federal data, which were touted as an “apples-to-apples” comparison nationwide, didn’t fully take into account several factors that would have provided a fuller picture. There are also some uncertain factors that could affect the price of Minnesota coverage in the future.

Those factors include:
  • When MNsure released rate data in early September, it divided the state into nine areas, with varying premiums. The federal analysis released Wednesday only looked at the Twin Cities area, which has lower premiums. If the Rochester area, which in some cases had double the premium costs of the metro, had been included, the average costs would be higher. The federal government looked at statewide data for most of the other comparisons.
  • The continuation of Minnesota’s high-risk pool could have made coverage prices lower, Exchange Director April Todd-Malmlov said. The program’s uncertain future could have an effect on plan prices later on.
  • People on MinnesotaCare, a public health program for the working poor, weren’t included in the exchange population this year. If they had been, the premiums would likely be more expensive because the state knows that those populations tend to be sicker. Most also will likely join the exchange once the updated version of MinnesotaCare is implemented on the exchange.

The Pioneer Press did a more in-depth look at some of the comparisons here.

Coverage on the exchange, which is supposed to serve 1.3 million Minnesotans by 2016 as a marketplace to shop for and compare health insurance, lists plans by “metal” level: bronze, silver, gold and platinum.

In the Rochester area, an average monthly premium for a “gold” plan for a 60-year-old who earns more than $45,000 would be $512; the comparable metro coverage would cost $382.

Todd-Malmlov said even with Rochester’s higher prices, the dial wouldn’t have moved much if the feds had done a statewide comparison, since it was just one of nine zones.

“When you look at the rates across Minnesota, there are some variations, but they are also very tight,” she said. “I don’t really think that has a whole lot of impact.”

Todd-Malmlov credited Minnesota’s health care innovation and competition among carriers spurred by enhanced transparency for bringing the low rates.

“They put their best foot forward here,” she said of the carrier’s rates, which were negotiated with the state Commerce Department. “They want this business, so that’s nice to see.”

Todd-Malmlov was also happy to tell the board that MNsure passed two key tests from the IRS and the Centers for Medicare and Medicaid Services to connect to the federal government’s data hub, which will provide integral information for running the exchange.

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She said the latest IRS review, which looked at data security, was “very extensive.” Other state officials have said MNsure’s IT security systems will be the toughest in state government.

Over the past few weeks, MNsure has faced criticisms for accidentally revealing private information on insurance brokers, inadequately addressing communities of color in grant proposals and dealing with questions about the exchange meeting startup deadlines.

With the federal approval, MNsure is planning to begin serving consumers on October 1, but the state must pass a final in-house security check the day before it goes live, Todd-Malmlov said. The final federal hub will become operational on October 1, she said, so Minnesota will have to access it in real time.

“It’s always fun being dependent on others,” MNsure Board Chairman Brian Beutner said with a laugh.