Minnesota Health Insurance

Health insurance in Minnesota

● Minnesota has a state-run health insurance exchange: MNsure.

● Open enrollment for 2021 health plans in the Minnesota Health Insurance Market (MNsure) runs from November 1 to December 22, 2020.

● Five carriers offer medical insurance in Minnesota's individual market; four of them offer plans in Minnesota's health insurance market. For 2021, the proposed rate changes range from a decrease of 1.4% to an increase of 7.1%.

● More than 117,000 people signed up for the 2020 coverage through the Minnesota exchange.

● Minnesota adopted the ACA's Medicaid expansion in 2013, providing Medicaid coverage to adults with incomes up to 138% of the federal poverty level (in 2020, $1468 per month for an individual, $3013 per month for a family of four).

● In Minnesota, the duration of the short-term health insurance plan is limited to 185 days.

● More than a million Minnesota residents have Medicare coverage.

This page is dedicated to helping consumers quickly find health insurance resources in the state of Minnesota. Here you will find information about the many types of health insurance coverage available. You can find the basics of Minnesota's health insurance market and the next open enrollment period; a brief overview of Medicaid expansion in Minnesota; a quick look at the availability of short-term health insurance in the state; statistics on state-specific Medicare rules; as well as a collection of Minnesota health insurance resources for residents.

Minnesota's health insurance marketplace

Minnesota market registration uses a state-run exchange: MNsure. In 2017, state lawmakers voted to convert MNSure into a federally managed marketplace, but the legislation was blocked by then-Governor Mark Dayton.

MNsure is a place where people can buy individual/family health insurance. This is a valuable service for people who are not eligible for Medicare or employed by a company that provides group health insurance. Medicaid enrollment can also be done through MNsure, although enrollment in certain types of Medicaid (for the elderly, disabled, etc.) takes place through the state's Medicaid office.

Minnesota Open enrollment period and dates

For 2021 coverage, the open registration runs from 1 November to 22 December 2020. This is one week more than open recording will run in states that use HealthCare.gov.

In response to the Covid-19 pandemic, MNSure created a special emergency enrollment period that ran from March 23 to April 21. During that time, anyone who was not insured could register without certifying the type of "change of life", such as the loss of work-based insurance, normally necessary for enrollment outside the annual open enrollment period. In part as a result of SEP, nearly 100,000 Minnesotans enrolled in private or public health insurance plans from March 1 to June 21.

Registration is still possible for people who encounter a qualifying event, including the loss of other coverage, but applying you will require proof of the qualifying event.

Five insurers - Blue Plus, Group Health, Medica, UCare and PreferredOne - offer individual market coverage in Minnesota. PreferredOne only offers out-of-stock coverage, while the other four make their plans all available through MNsure. For 2021, they proposed average premium changes ranging from a decrease of more than 1% to an increase of about 7%. Insurers have different service areas, so there are more plans available in some areas than in others.

Minnesota enrollment first declined in 2019, when 113,552 people enrolled in individual market plans through MNsure. But it rose again, to 117,520, during the open enrollment period for 2020 coverage.

Medicaid expansion and basic health program in Minnesota

In February 2013, Governor Mark Dayton signed HF9, a bill that expanded access to Minnesota's Medicaid program under the ACA. From late 2013 to May 2020, enrollment in the Minnesota Medicaid (Medical Care) and CHIP plans increased by 23 percent. During the Covid-19 pandemic, enrollment in Minnesota-managed Medicaid plans increased by 14% from February to August 2020.

Minnesota has also established a Basic Health Program (BHP) under the ACA, and is one of only two states to do so (New York is the other). Basic health programs provide robust, low-premium coverage to people with incomes between the Medicaid eligibility threshold and 200 percent of the poverty level. as well as to legally present non-citizens with incomes below 138% FPL who have been prevented from enrolling in Medicaid. In Minnesota, the Basic Health Program is known as Minnesota Care, a program that precedes the ACA but has been revamped to serve as BHP as of January 2015.

[New York has also created a BHP since 2016; to date, New York and Minnesota are the only states that have BHP, even though DC's Medicaid eligibility extends to 210% of the poverty level.]

Premiums and out-of-pocket costs in Minnesota Care are lower than plans offered at low income in other ACA markets. Minnesota lawmakers have considered extending access to Minnesota Care to higher income levels or even all income levels, but those plans have not been enacted.

Short-term health insurance in Minnesota

Short-term health insurance plans in Minnesota cannot last more than 185 days unless the policyholder is in the hospital on the day the plan would end and the insurer extends coverage until the end of the hospital degamus.

Short-term plans are not revived in Minnesota, but a person can purchase additional plans as long as their total time with short-term coverage does not exceed 365 days over a 555-day period , plus all days when a plan is extended to an insured person who is in the hospital on the day the plan would end. Buying a new plan involves starting over with a new deductible.

The Affordable Care Act in the State of the Northern Star

In passing the Affordable Care Act in 2010, Minnesota's two Democratic senators - Amy Klobuchar and Al Franken - both voted in favor of health care reform. Franken is credited with including a medical loss report (MLR) requirement in the reform bill, which led market insurers to send discounts - often substantial - to enrollees when the percentage of premiums collected spent on enrollees' medical expenses is below the minimum allowed.

One of the ACA's first popular provisions, mlr requires insurance companies to issue refunds if they spend more than 20% of premiums on administrative items (15% on large-group plans). The MLR rule led to $1.1 billion in refunds in 2012, and by the end of 2019, total cumulative repayments had reached over $5 billion.

Franken resigned in 2017 and Minnesota's lieutenant governor, Tina Smith, was appointed to fill his Senate seat. Smith then won the special election for the seat in 2018. Klobuchar also won his re-election candidacy in 2018, so both Minnesota senators continue to be Democrats.

Minnesota's eight representatives split their votes on the ACA in 2009/2010, with Democrat Collin Peterson joining three Republicans in voting no. Peterson did not support 2017 House Republicans in their efforts to pass the American Health Care Act, a partial ACA repeal bill, but his votes on health care reform have been mixed over the years and he continues to represent the 7th rural district, fairly conservative, winning his 15th term in 2018.

The Minnesota House delegation consists of three Republicans and five Democrats in 2020. Four districts (1st, 2nd, 3rd and 8th) flipped in the 2018 election, but two flipped over to Democrats and two flipped over to Republicans.

Former Minnesota Governor Mark Dayton had long been a supporter of Obamacare. Dayton chose not to run for a third term in 2018, but Tim Walz, the DFL (Democrat-Farmer-Labor) candidate, won the election, so the governor's seat continues to be occupied by a Democrat.

After Democrats gained control of the Minnesota House and Senate in the 2012 election, a bill was passed to implement a state-run health insurance exchange. Minnesota has also expanded Medicaid, which it calls Medical Care, to residents with family incomes up to 138% of the federal poverty level. Medicaid expansion has been a key strategy of the ACA to reduce the uns insured rate. And as noted above, Minnesota has also created a basic health program under the Affordable Care Act, further protecting residents with an income a little above the Medicaid eligibility cut.

Did Obamacare help Minnesotans?

Minnesota has enjoyed a low uninsured rate for years due to generous Medicaid eligibility standards and Minnesota Care, a health insurance program for uninsured and working residents. Under the Affordable Care Act, Minnesota not only expanded Medicaid, but also created a state-based health insurance exchange called MNsure.

As of 2020, there were more than 105,000 people with individual private market coverage through MNsure. All have coverage for the ACA's essential health benefits without annual or lifetime ceilings on benefits. And nearly 59,000 of them receive subsidies for premiums that make health insurance more affordable.

According to U.S. Census data, Minnesota's uninsured rate fell from 8.2% in 2013 to 4.1% in 2016. But it rose slightly, to 4.4% in December 2018. That slight rise in the unssecured rate was common across the country after the Trump administration's institute. This is due in part to new federal policies that have undercut the ACA, but also to rising health insurance premiums - in turn due in part to the Trump administration and GOP congressional actions - that have made coverage less affordable for people who are not eligible for premium subsidies.

Does Minnesota have a high-risk pool?

Before the ACA reformed the individual health insurance market, coverage was underwritten in nearly every state, including Minnesota. As a result, people with pre-existing conditions were often unable to purchase coverage in the private market, or if coverage was available it came with a higher premium or with cyclists excluding pre-existing conditions.

The Minnesota Comprehensive Health Association (MCHA) was created in 1976 to offer people an alternative if they were not eligible to purchase individual health insurance because of their medical history. (Only Connecticut has a risky pool as old as Minnesota.)

Under the ACA, all new health insurance policies have become a guaranteed issue as of January 1, 2014. This change largely eliminated the need for high-risk pools and MCHA stopped enrolling new members as of December 31, 2013. It remained operational for existing members until the end of 2014.

Medicare coverage and enrollment in Minnesota

As of August 2020, there were 1,046,846 people enrolled in Medicare in Minnesota.

Minnesotans can choose Medicare Advantage plans instead of Original Medicare if they want to gain additional benefits and don't care about the restrictions (including network restrictions) that go against having a private plan. Nearly half of all Medicare beneficiaries in Minnesota are enrolled in private plans -- primarily Medicare Advantage, but also Medicare Cost plans, a form of commercial Medicare coverage that pre-data Medicare Advantage. Minnesota has long had the nation's highest enrollment in Medicare Cost plans, but about 300,000 enrollees had to switch to different coverage (Original Medicare or Medicare Advantage) when their cost plans were phased out in 2019.

Minnesota Health Insurance Resources

● MNsure - the state's health insurance market and the only place Minnesota residents can get financial assistance with the cost of their individual health insurance premiums.

● Greater Minnesota Healthcare Coalition

● Minnesota Department of Human Services, Health Coverage — Medicare Care (Medicaid)

● Minnesota State Health Insurance Assistance Program — Information and resources for Minnesota Medicare beneficiaries