January 31, 2023

Healthy About Liver

Masters of Health

Health plan bargains abound again in 2023

Opinion editor’s note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.

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Tim Jopp is accustomed to consumer skepticism about what’s available through MNSure, the state’s online marketplace for those who buy private health insurance.

Jopp runs Legacy Health Insurance in Waconia, which offers no-charge assistance to those searching for a health plan that meets their needs and fits comfortably into a household budget. What he tells shoppers who might not have found bargains on MNsure in the past:

“Let’s just see.”

There’s often good news after Jopp analyzes their information. Many who weren’t eligible for financial assistance in the past because their income was too high now qualify for aid that acts to discount monthly insurance premiums instantly. That reality should be top-of-mind for consumers as they compare plans and prices during open enrollment, which kicked off on Tuesday.

A recent example at Jopp’s brokerage: a couple who found out they’re now eligible for substantial savings.

“We saved them $350 a month, and he was like, ‘Are you kidding me?’ and I was like, ‘No!'” Jopp said, recounting the conversation with his excited clients after he crunched the numbers.

Open enrollment is the annual end-of-the-year window to buy coverage for the coming year. It runs through Jan. 15 for those who buy health insurance on their own instead of through an employer or a public program such as Medicare. An estimated 169,000 Minnesotans purchase coverage on the individual market, about 3% of the state’s population.

Coverage historically 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 2010 health care law, provides subsidies to offset this cost.

While this provision helped many consumers, income limits set at 400% of the federal poverty level ($54,360 for an individual or $73,240 for a couple) unfortunately kept others from qualifying for this assistance. They faced a tough decision: stretching financially to buy a quality health plan or going without coverage.

But the congressional pandemic response temporarily removed the 400% cap, allowing more people to tap into the ACA’s financial assistance. The change was set to expire this year, but then Congress passed the Inflation Reduction Act in August. The legislation included a measure to leave the expanded eligibility in place for another three years.

Consumers shouldn’t shy away from taking advantage of the extension. There are serious savings to be had. “Minnesota families that qualify will save an average of $6,700 annually next year because of tax credits,” according to the state Department of Commerce.

Prices on individual plans from many big insurers also held relatively steady or even declined. The final average rate change for 2022-2023 was 0.8% for UCare, 2.1% for HealthPartners and 2.6% for Medica. Blue Plus posted a 2.3% decline.

Choosing a health plan and navigating eligibility for assistance can be complicated, but help is available across Minnesota at no charge. “MNsure-certified brokers and navigators (assisters) provide free enrollment help through virtual meetings, phone appointments or in-person meetings,” according to the marketplace. To find one close to you, go to tinyurl.com/FindMNsureHelp.

Going through MNsure is essential. In Minnesota, it’s the only place where consumers can tap into ACA financial assistance.

Brokers and assisters can also help Minnesotans who might benefit from another recent and beneficial change to the ACA: the “family glitch 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 works well — for example, checking that a consumer’s doctor is in a plan’s medical provider network. It’s also critical to find a plan that can easily accommodate a life change, such as the birth of a baby.

The assistance is free. “Use somebody to help you with this,” Jopp said. “You want to make sure that you’re picking the right plan.”