Health Law Wrinkle Could Penalize Minn. Insurers
|By Christopher Snowbeck, Pioneer Press, St. Paul, Minn.|
|McClatchy-Tribune Information Services|
The issue involves a long-standing program called the
One of the key changes coming in 2014 with the federal Affordable Care Act is that insurers no longer will be able to deny people coverage based on pre-existing conditions. To make sure that the expense of covering these patients is evenly spread among insurers, the federal law will give health plans a chance to receive "reinsurance" payments if they happen to attract many patients with costly conditions.
The money will come from a fund that insurers across the country will pay into, but health plans in
regulations wouldn't allow it.
"The money that's going to be deposited by insurers in
Health plans in
Federal officials are reviewing concerns from
"What are the chances the feds will do the right thing and be fair to
MCHA is what's known as a "high-risk pool," and
The program is one of the reasons that
"If high-risk pools are not allowed to participate in the transitional reinsurance program and they continue to exist for some period of time, carriers would pay both the federal reinsurance assessments as well as assessments for the MCHA program," state officials wrote in the
"An analysis by MCHA of their members whose annual claims exceed
The problem could go away if
Health plans in
Some people like their MCHA coverage, Erickson said, and might prefer to stay out of the health exchange for a year or two until they are familiar with the new marketplace. Health insurers, meanwhile, say that if all 26,000 members of MCHA immediately moved into the health exchange in 2014, it could cause premiums to skyrocket. That, in turn, could prompt some people to drop coverage altogether -- including some people currently covered by MCHA who have serious health problems.
"Our concern is that you don't want people losing coverage," said
Still, some think there could be problems if high-risk pools continue to operate.
A December letter to federal officials from the
Buying coverage on the exchange could be a good deal for some covered through MCHA if they fall within certain income limits for federal subsidies.
"Individuals in high-risk pools will have the greatest financial incentives to participate in an exchange," wrote the
It's unclear whether individuals who don't qualify for subsidies and are covered by MCHA would be better off buying on the exchange.
Lourey, who is chief author of the bill in the
But if the federal government doesn't let the MCHA program collect reinsurance payments, the state might need to close the program sooner, Lourey said.
"If that phased, gradual approach costs us
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