Health plan enrollment decline eases in Minnesota

April 26--A year ago, the trade group for Minnesota's nonprofit health insurers sounded the alarm over a 30 percent decline in the number of people buying health insurance policies for themselves.

This year, the tally is down once again, but not by nearly such a large margin, according to new figures from the Minnesota Council of Health Plans. What's more, the number of people buying individual health plans at the end of March was up compared with the previous December -- the first increase between the fourth and first quarters in three years.

There are still troubles in the individual market, insurers said, but the enrollment figures contribute to an emerging picture of relative stability that builds on recent financial results.

"There are some signs of improvement," said Jim Schowalter, chief executive of the Minnesota Council of Health Plans, in an interview. "But the signals are mixed."

The improvement comes in a small market that primarily serves people under age 65 who are self-employed or don't get coverage from their employer. The market has seen big premium jumps under the federal Affordable Care Act, which brought sweeping changes beginning in 2014.

Whereas about 270,000 people were buying coverage in the market in March 2016, it fell by 80,000 people, or roughly 30 percent, to 190,000 at this time last year, according to the Minnesota Council of Health Plans.

As of March 2018, the tally was down about 28,000, or about 15 percent from the previous year, to 161,798, the trade group said. The Minnesota Council of Health Plans said there were 151,364 people buying individual policies in December 2017.

The federal health law prevents health plans from denying coverage to people based on pre-existing health problems. Insurers in Minnesota amassed so much red ink under the law that regulators feared the market might collapse going into 2017, with health plans threatening to pull out.

Ultimately, insurers stayed with the market and wound up posting a large profit on the business last year -- so large that one insurer expects to pay $30 million in consumer rebates.

The state's individual market still isn't out of the woods, said Eileen Smith, a spokeswoman for the Minnesota Council of Health Plans.

The market is smaller than it was at this time last year, Smith noted, adding that survey data suggest the share of Minnesotans lacking health insurance increased in 2017. Changes being considered at the federal level to promote alternate forms of coverage for individuals could pull healthy consumers who typically use less care from the individual market, Smith added.

Finally, many consumers in Minnesota's individual market are struggling with the high cost of coverage.

"The medical bills for people who buy insurance on their own are similar to those who get employer coverage," Schowalter said. "The big difference is that they see the entire premium and don't have an employer covering the majority of those costs."

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