MnSURE: Minnesotas Health Care Exchange

MnSURE will help small businesses provide affordable health care choices to their employees as it is estimated that 160,000 small business employees will obtain insurance through the exchange.
Background:
The Affordable Care Act directed states to create a health care exchange accessible by individuals, families and small businesses. If a state fails to create an exchange then all Minnesotans wishing to purchase insurance through an exchange will have to go through the Federal Exchange on January 1, 2014. The Minnesota Exchange will provide individuals and businesses access to lower premiums by leveraging competition between insurance providers.

What is an exchange?
An exchange is an online marketplace where businesses and individuals can find an apples-toapples comparison of coverage options. The Exchange will be able to determine an applicants eligibility for tax credits, cost sharing assistance, and public health care programs. The Exchange will also place coverage options in a standardized format to allow applicants to compare the levels of coverage offered by different plans. As directed by the ACA, all plans offered through the Exchange must cover the benefits prescribed in the essential benefits set. Therefore, the plans in the Exchange will all contain coverage for the essential core of most applicants health care needs.

What does this mean for Minnesota?

A Minnesota exchange will cost less than participation in the federal exchange for all parties involved. Insurance companies will pay less in the premium withholds, and consumers will receive coverage delivered at a lower cost. Minnesota has a historic opportunity to move its health care system forward, by providing opportunities for health insurance to roughly 300,000 Minnesotans who dont currently have coverage. Minnesotans are already paying for the uninsured through uncompensated care. Therefore, the Exchange provides cost-efficient coverage to this population and provides savings to all Minnesotans. The Exchange saves Minnesotas small businesses on the premiums employers pay for their employees health insurance. This savings will allow job creators to put their money back into their businesses and their communities. It is estimated that 160,000 small business employees will take advantage of the health care Exchange. The Exchange will serve about 1.3 million people statewide; that is one out of every four Minnesotans who will utilize the Exchange.

When will the Exchange be available?

All exchanges have to be operational by January 1, 2014. There also must be a threemonth open enrollment period October 1, 2013. Before open enrollment there must be a sixmonth time period for the plans to formulate rates and for plans to be approved. This creates a March 31 deadline for the legislation to pass an exchange into law.

How will the Exchange operate?

Insurance Agents - Insurance agents are able to participate in
the Exchange process by operating as brokers, where they will still be paid through the same process as they currently are through the private market.

independent external auditor are all charged with overseeing the Exchange activities. Oversight for the board is expansive, which enables the public to observe the activities of the Exchange and will ensure that it is operating in a way that is best for Minnesotans. to give their permission to the data sharing components. If the consumer is uncomfortable at some point, they may simply not give their permission to move to the next phase.

Oversight - The Legislature, the federal government and an

Data Privacy - At each step the consumer has the opportunity

Who is on the Health Care Exchange Board?

The Exchange is governed by a seven member board: three members from consumer groups, three health experts and the Commissioner of Human Services, all of whom are appointed by the Governor and confirmed by the Senate. The Exchange will be regulated by the Department of Commerce and is established as an agency under the Executive Branch. The members of the board are subject to a conflict of interest provision in which no member can serve on the board within one year of being employed or having some other financial tie to an entity that is selling products on the Exchange.

State v. Federal As a national leader in health care, Minnesota

already has data on cost, quality, provider networks, etc. The federal government does not have this data and they will not have it for their exchange. What this means for the average consumer is that a Minnesota Exchange will contain provider network information (People want to know which doctors they are going to be able to see) and could include provider quality ratings (which doctors are best for diabetes, asthma, etc). Knowing ahead of time what doctor is available on which network is very important for the rural areas where a doctor may be as far as an hour away in one network, but right next door in another.

How will we pay for it?

A Minnesota Exchange will be funded through the same mechanism used by the Federal Exchange, which is a certain percentage of the dollars paid for premiums sold on the Exchange that is withheld from the insurance company. In the first year, the premium withhold will be no more than 1.5%. For subsequent years, the Exchange is allowed to assess up to 3.5%. However, under the Minnesota exchange, the withhold is projected to decrease over time. Because of the work our State has already done in health care, Minnesota is able to operate the Exchange in a more cost-efficient manner than the Federal government can.

2013 HEALTH CARE EXCHANGE UPDATE