Many of the details of Minnesota's new healthcare exchange, called MNsure, have yet to be determined: what specific plans will be available, what the rules will be for the state-run program, and who will be there to help people navigate the computer-based system.
Governor Mark Dayton signed the bill into law Wednesday, and his office expects 1.3 million Minnesotans to sign up for state insurance plans by 2016. Individuals and small businesses will be able to apply for plans by October 2013, with insurance coverage to begin in 2014. Insurance providers are expected to submit plans to the state for inclusion in the program in the coming weeks, and current data can be found at www.mn.gov/hix.
Winona County leaders are waiting to find out the details, too, as county employees will likely be the troops on the ground helping residents find the right plan and sign up.
The MNsure system will allow citizens to apply for insurance online. Because not everyone has access to computers and the internet, counties will be responsible for adding computer terminals at health and human services offices for people to use to apply. The federal government is expected to cover only about 50 percent of the cost of the computers.
While the plan assumes a "no-touch" system, meaning people will not need assistance to apply, Winona County Board members discussed the fact that it is likely that many people who use the county computer terminals will need help figuring out insurance plan details and the application itself. Additionally, because of the federal mandate that everyone have insurance next year, hundreds of people in Winona County who are eligible for Medical Assistance, but do not have it, are expected to sign up for the assistance program, and those people will need county case workers. The board was told that between 300 and 400 county residents would likely sign up for Medical Assistance through the county—which would require a new county employee to act as a case worker. Additionally, it is unclear how many county employees might be needed to help people with the MNsure program.
The bill signed by Dayton includes language that would provide for "navigators" to help people with the program, although the details for navigator training and reimbursement for counties has not been determined. Additionally, a call center and state office will be charged with administering the program at a cost of $110 million, with a $50 million annual operating cost anticipated.
Winona County Commissioner Marcia Ward attended an Association of Minnesota Counties meeting in the Twin Cities on Thursday, where commissioners from across the state learned more about the MNsure program. "It's still very unclear," she said about the insurance exchange. She said the "fast track" being taken on the program was unsettling. In particular, Ward wondered how the navigators would be funded, and what sort of training they would have. "The question was: are those people going to be licensed insurance sales people? Are they going to have the experience to know what the right questions are to ask these people to get them the right insurance?" she asked. "Do they know what it's going to require for staff? No. We've got a whole population that's going to scratch their heads on this. We're trying to paint a very optimistic picture but I'll tell you, it just scares the crap out of me, the road we're going on."
Minnesota Health and Human Services Commissioner Lucinda Jesson will visit Winona on Monday, March 25, to speak about MNsure. The event will begin at 10 a.m. at the Ben and Adith Miller Auditorium on the third floor of Winona Health.