Opinion editor’s note: Editorials represent the views of the Star Tribune Editorial Board, which operates independently of the editorial board.
Tim Jopp is used to consumer skepticism about what’s offered through MNSure, the state’s online marketplace for those buying private health insurance.
Jopp operates Legacy Health Insurance in Waconia, which offers free assistance to those looking for a health plan that meets their needs and fits comfortably within the family budget. What he says to shoppers who may not have found great deals at MNsure in the past:
“Let’s just see.”
There is often good news after Jopp analyzes their information. Many who were ineligible for financial assistance in the past because their incomes were too high are now eligible for assistance that acts as a discount on monthly insurance premiums immediately. That reality should be top of mind for consumers as they compare plans and prices during open enrollment, which began Tuesday.
A recent example at Jopp’s brokerage: a couple who realized they were already eligible for significant savings.
“We saved them $350 a month, and he said, ‘Are you kidding me?’ and I was like, ‘No!'” Jopp said, recounting the conversation with his excited customers after crunching the numbers.
Open enrollment is the annual window at the end of the year to purchase coverage for the following year. It runs through Jan. 15 for those who buy health insurance on their own instead of through an employer or a public program like Medicare. Approximately 169,000 Minnesotans buy coverage in the individual market, about 3% of the state’s population.
Historically, coverage has been expensive for this group, which often includes early retirees, farmers and the self-employed. That’s why the Affordable Care Act (ACA), the landmark health care law of 2010, provides subsidies to offset these costs.
While this provision helped many consumers, the income limits, set at 400% of the federal poverty level ($54,360 for an individual or $73,240 for a couple), unfortunately prevented others from qualifying for this assistance. They faced a difficult decision: stretch themselves financially to purchase a quality health plan or go without coverage.
But Congress’ response to the pandemic temporarily removed the 400% cap, allowing more people to qualify for ACA financial assistance. The change was supposed to expire this year, but then Congress passed the Inflation Relief Act in August. The legislation included a measure to leave extended eligibility in place for another three years.
Users should not avoid taking advantage of the extension. There are serious savings. “Eligible Minnesota families will save an average of $6,700 a year next year because of tax credits,” according to the state Department of Commerce.
Prices of individual plans from many large insurers also remained relatively stable or even fell. The final average rate change for 2022-2023 was 0.8% for UCare, 2.1% for HealthPartners and 2.6% for Medica. Blue Plus registered a decline of 2.3%.
Choosing a health plan and determining eligibility for help can be complicated, but help is available in Minnesota for free. “MNsure Certified Brokers and Navigators (Assistants) provide free enrollment assistance via virtual appointments, phone appointments or in-person appointments,” according to the marketplace. To find one near you, go to tinyurl.com/FindMNsureHelp.
Going through MNsure is essential. In Minnesota, this is the only place consumers can get financial help from the ACA.
Brokers and assistants can also help Minnesotans who could benefit from another recent and beneficial change in the ACA: the “family issue fix.” A previous editorial explaining the fix is available at tinyurl.com/FamilyGlitchFix.
Jopp also emphasized that expert assistance can help consumers navigate other issues to ensure the plan is working well — for example, checking to see if a consumer’s doctor is in the plan’s network of medical providers. It’s also critical to find a plan that can easily accommodate a life change, such as having a baby.
Assistance is free. “Get someone to help you with this,” Yopp said. “You want to make sure you’re choosing the right plan.”