Like all states, Minnesota will be faced with making changes in its insurance regulations to comply with the provisions of the 2010 Patient Protection and Affordable Care Act. Already laws regarding pre-existing conditions have changed for children, who may not be excluded from coverage for this reason. Additionally, children may remain on their parents’ health policies through age 26, even if they are not students or have married.
The states have been working with the federal government over the past two years to establish high risk pools and to design the health care exchanges required by the Affordable Care Act.
General Insurance Regulations
Minnesota insurance regulations do not allow permanent riders on individual health insurance policies. Currently, conditions diagnosed or treated six months before a health policy is written may be excluded from coverage for a year if there has been no period during which the individual was without health insurance. There are few regulations regarding which applicants must be accepted and the level of premiums charged. Minnesota health insurance regulations do provide guaranteed renewability, however, and no current policy can be canceled due to health issues.
For Minnesota health insurance group policies, a company must meet minimum participation requirements. If these terms are not met, the policy may be canceled. Companies must pay a portion of employee premiums, and rates may be raised according to the overall risk profile of the group.
Health Care Exchanges
Minnesota is studying its options for the implementation of its health care exchange, with plans to see it fully implemented by December 31, 2012, although the 2012 presidential election and the Supreme Court’s decision regarding the Affordable Care Act after its March review may affect that projected timeline.
Pre-Existing Condition Insurance
The Minnesota Pre-Existing Condition Insurance Plan is run by the U.S. Department of Health and Human Services and provides benefits for primary care, specialty care, hospitalization, and prescriptions. According to the age of the beneficiary and the option chosen, monthly premiums range from $96 to $414 with deductibles for $1000 to $3000 (and potentially a separate drug deductible.)
Medicaid benefits are income dependent and calculated according to a percentage of the federal poverty level, the same formula used for Children’s CHIP-funded Medicaid Expansions. All children from infancy to age 19 in Minnesota qualify at 275% FPL, with infants under one year of age qualifying for CHIP aid at 280% FPL.
Pregnant woman may receive Medicaid at 275 FPL, parents at 275, childless adults (state funds only) at 200, and the elderly and disabled at 100%.
Approximately 14 percent of the state’s population draws Medicare benefits, with more than 753,000 drawing on prescription drug coverage.
The MinnesotaCare program helps low-income Medicare recipients who qualify to pay medical expenses that are incurred out-of-pocket. Minnesota’s Senior Health Insurance Program is called Senior LinkAge Line and offers counseling services to individuals who qualify for Medicare. This program helps consumers with choosing a Medicare program that is right for them and helps consumers understand laws regarding Medicare.
Minnesota has several health insurance programs that are available to low-income residents. They offer Medicaid, MinnesotaCare and Sage Screening program that are designed to assist people who would otherwise be without medical insurance. The Medicaid program is an eligibility based program that is contingent on household income. The MinnesotaCare program provides those who have been without insurance for at least four months and do not have access to a group plan the opportunity for coverage.