Minnesota

2018 MIDTERM ELECTION

Time: D H M S

One more very small update today. This isn't an official data release, but this press release from yesterday mentions the total enrollment in Minnesota as being "nearly 95,000". This presumably includes enrollments through 2/17.

Assuming the same 32% / 68% ratio between existing private QHPs and Medicaid enrollments in Minnesota, this should break out to roughly 30,200 Private / 64,700 Medicaid, an increase of around 700 and 1,700 respectively.

Today, MNsure announced new TV and radio ads that tell the stories of Minnesotans who have used MNsure to find better, more affordable health care coverage. The ads highlight the affordability of MNsure plans and underscore the fact that MNsure offers the lowest premium rates in the country – with additional financial help available through tax credits. The ads are aimed at encouraging more Minnesotans to enroll in affordable, quality health coverage before the March 31 deadline. Nearly 95,000 Minnesotans have already selected health insurance through MNsure.

Minnesota's Private QHP enrollments went up a smidge from 28,611 to 29,493 the first week of February, while Medicaid enrollments increased from 61,784 to 63,005 (Medical Assistance + MinnesotaCare combined). Pretty weak tea, I have to admit.

Minnesota's Private QHP enrollments went up about 3% between January 18 and February 1st, from 27,775 to 28,611, while Medicaid/CHIP enrollments went up a more dramatic 18%, from 52,225 to 61,784 (when combining Medicaid & CHIP along with MinnesotaCare, which still counts).

Insurance sign-ups through Minnesota's health care marketplace continued to grow into February to more than 90,000 people, but enrollment continues to be weighted more toward public plans over private insurance.

MNsure released its latest enrollment measures on Wednesday, which covered mid-January through Feb. 1. By that date, more than 28,000 people had enrolled in commercial plans — an increase of about 3 percent from two weeks earlier.

In addition, Minnesota's SHOP (Small Business) exchange tally has gone up a bit as well, to 541 employees covered; multiplying this by a conservative average of 1.8 per employee household brings it up to around 974 people covered by MN SHOP plans.

Some minor updates buried in the MNsure Board of Directors report; thanks to an anonymous tipster for calling my attention to it. Nothing major, but some small updates to both the Private QHP and Medicaid/CHIP enrollment figures (27,775 and 52,225 respectively). The most noteworthy addition is the 475 SHOP (Small Business marketplace) enrollments noted on page 27 of the report.

A friend who wishes to remain anonymous provides a bit more info on the MinnesotaCare program discussed earlier.

The program seems similar to California's Low Income Health Program. The LIHP wasn't part of Medicaid, but it was set up with federal funds in preparation for Medicaid Expansion. However, Minnesota Care predates the ACA. It began in 1992. Part of its funding comes from federal Medicaid funds:

"MinnesotaCare is a publicly subsidized health care program for residents who do not have access to affordable health care coverage. It is funded by a state tax on Minnesota hospitals and health care providers, federal Medicaid funds and enrollee premiums.

Most enrollees pay a monthly premium based on family size and income. Children under 21, some military families, and families with an enrolled American Indian do not pay a monthly premium.

A regular site visitor has sent me some in-depth information about the public healthcare program situation in Minnesota, which is evidently quite a bit more complicated than most other states. I've put together this information into what I hope is a cohesive whole, with my response below. Anyone who's more familiar with the Minnesota situation can feel free to correct or clarify any of this if you'd like.

Regarding your blog post entitled Minnesota Update: Nominal private increase; Medicaid up 10% In it, you quote the Minnesota StarTribune, which states, in part, that:

"Of those nearly 72,000 enrollees, slightly more than 26,000 signed up for private insurance while the rest are on public plans."

Several thousand more than 26,000 should be counted as exchange sign-ups rather than Medicaid signups. Minnesota has a sort of in-between basic health plan called MinnesotaCare. It covers people between 133% and 200% (I think?) of poverty. It is not Medicaid (which is called Medical Assistance in Minnesota) and therefore not part of the ACA Medicaid expansion, but it is a public plan. So, when the StarTribune refers to "public plans," they are lumping Medicaid and MinnesotaCare together. The state has cleared this up before in reporting on Minnesota's enrollment numbers in the New York Times. MinnPost reported on this correction back in November.

Ironically, even though the article itself is primarily about Medicaid expansion in Nevada (from a newspaper in Georgia), I can't actually use the Medicaid numbers provided since they're fuzzy. It does, however, give slightly higher numbers for private enrollments in NV.

It also mentions 23,000 dental plans, which I'm not even covering. In other news, the spreadsheet includes minor corrections to both Colorado (private enrollment typo had it off by 10) and Minnesota (I had MN down as 26,001 based on "just over 26,000", this article specifies it as being exactly 26,011...or an increase of 10, although that also means decreasing  the MN Medicaid number by 10 as well).

Another report presented later Thursday to the board overseeing Nevada's insurance exchange shows 17,946 people who shopped for private insurance through the online portal have confirmed plan selections. Of those, 10,776 have paid the premiums. About 23,000 have chosen stand-alone dental coverage.

Pretty slim pickings here on the private enrollment front (up just 141 assuming "slightly more than 26K" = 26,001), but the Medicaid number is up 9.6% to 45,981.

Despite MNsure's problems, so far 71,982 people have signed up for insurance coverage through the exchange. According to newly released demographic details, 53 percent are women and the median age is 48. The largest number signed up for mid-level "silver" plans — about 35 percent of total enrollees. Of those nearly 72,000 enrollees, slightly more than 26,000 signed up for private insurance while the rest are on public plans.

After last week's confusing numbers, Minnesota is back on track with private exchange enrollments increasing by 6,440 over a week earlier, or 33%. Enrollment in MinnesotaCare and Medical Assistance went up to 15,997 and 25,948 respectively.

MNsure got through the first round of customer sign-ups, which had a Dec. 31 deadline. On Friday the agency reported that 67,805 Minnesotans had used the site to enroll in a health plan by year’s end. Some 25,860 consumers bought an individual plan on the commercial market, with the rest eligible for one of the publicly subsidized programs.MNsure said that 14,600 people signed up in the last four days of December, a last-minute burst that Leitz described as “an encouraging sign.”

Last night I teased that I'd be providing some context and insight into the Iowa and Nebraska updates posted on the spreadsheet, and I still plan on doing so later today. However, there's been an interesting development over at Minnesota which I need to address first.

Yesterday, Jackie Crosby of the Minnesota StarTribune posted "MNsure grids for late crush of enrollees", which among other things gave an update on the MNsure enrollment numbers, stating:

More than 53,000 Minnesotans have bought coverage as of last Friday, with the biggest gains coming from those buying private health plans on the individual market. By Friday, 19,420 had signed up for individual or family plans; 12,051 had been enrolled in Medical Assistance; and 12,708 were getting coverage through MinnesotaCare.

So far, fair enough. However, in the original version of the article posted yesterday, there were two more paragraphs immediately following this. The first paragraph specified that these enrollments actually represented about 125,000 actual people (i.e., additional family members, etc). It also specified that about 20,000 of those were being held up due to paperwork issues and so forth. The next paragraph stated that around 3,900 people had completed enrollment but hadn't actually paid their first premiums yet.

Yesterday morning's big news, of course, was that the Federal ACA exchange (covering 36 states) is now up to over 1.1 million private healthcare plan enrollees. Today brings 4 new state-level updates...and a teaser for two others you probably weren't expecting to see.

New York:
Today's big news is in New York, which announced that they're up to a total of 241,522 enrollees in either private plans or Medicaid/SCHIP expansion. They haven't broken out the number yet, but based on the split in the previous update (156K private, 58K Medicaid/SCHIP) I'm going with a 73% private / 27% Medicaid split until more specific info is released. This increases NY's private enrollments to 176K, up 20K from last week. h/t to Buenaventura for being the first to notify me.

Connecticut:
Connecticut issued a formal press release which includes their final 12/23 deadline enrollment tally for 1/1/14 plan coverage. The total is only slightly higher than what I had (34,295 instead of 34,000 even); the noteworthy part of the announcement is that they've confirmed ACASignups.net's declaration of CT as the first state to surpass their original CBO enrollment projection. CBO had them achieving 33,000 private enrollments by 3/31/14; instead they've managed to break through that number in less than half the 6-month enrollment period. Given the poor October performance of the ACA exchanges as a whole, this is an amazing development.

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