Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.
Health insurance bargains abound again
Open enrollment kicks off Nov. 1 for those who buy health insurance on their own. Expanded financial assistance remains in place for those buying on MNsure, potentially delivering significant savings.
October 21, 2023 at 11:00PM
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Being healthy is no guarantee against needing serious medical care. Accidents happen. Appendixes burst. COVID-19, influenza and other pathogens continue to circulate. Heart attacks and cancer can strike with little warning.
If that happens, those without insurance can face daunting bills. The average cost of a three-day hospital stay: about $30,000, according to federal health data. Costs can soar even higher when surgery is needed or ongoing cancer care is required, for example.
No one should run the risk of crushing debt from a medical crisis. Especially now when expanded financial aid, which can instantly discount monthly insurance premiums, remains in place for those who buy coverage on their own instead of getting it through an employer or a public program.
There are some good deals out there for those eligible for this assistance. That's important to know as open enrollment — the annual window of time to buy coverage for the coming year — kicks off Nov. 1 and runs through Jan. 15 for those who purchase individual policies.
Because most people get coverage through a job, and the Medicare program covers seniors, individual buyers are a relatively small group. In Minnesota, it's just 3% of the state's population, or about 167,000 people.
Included in this group are the self-employed, farm families and early retirees who fall short Medicare's eligibility age of 65. One of the Affordable Care Act's core components is financial assistance — in the form of advance tax credits — for these buyers to prevent them from being priced out of coverage. The aid is available only to those who buy insurance through MNsure.
As part of the nation's pandemic response, Congress lifted the income eligibility ceiling for these subsidies and then in 2022 passed a three-year extension of this. A key message from MNsure CEO Libby Caulum: If you weren't eligible in the past for these subsidies, come back and check again.
"It's always worth giving it another look. Some people are pleasantly surprised," she said in an interview, noting that the subsidies can make "a huge difference" in keeping monthly premiums affordable.
From an overall standpoint, MNsure estimates that "Minnesotans who are eligible for tax credits will save $6,750 in 2024 and spend 5% less on private health plan premiums than they did this year, on average."
Cost-saving scenarios from MNsure further illustrate the savings potential. Note: Gold plans "generally have higher monthly premiums but pay more of your costs when you need care," according to MNsure. Silver or bronze plans "cost you less per month, but pay less of your costs when you need care."
- A household of two in Duluth with an annual income of $72,000 that chooses a gold plan could qualify for $1,180 a month in subsidies, reducing premiums from $1,903 a month to more manageable $723 a month.
- A family of three in Mankato making $97,000 a year choosing a silver plan could see their monthly premium drop from $1,180 to $634, thanks to the expanded subsidies.
- A family of four in Thief River Falls earning $98,000 annually that chooses a gold plan could qualify for subsidies of $779 a month, dropping monthly premiums from $1,450 to $671.
Awareness of this expanded assistance is also important to note with the recent end of a pandemic relief measure — a policy called "continuous enrollment." It suspended eligibility checks of people on medical assistance throughout the public health emergency. The intent: to keep as many people covered as possible in case they became ill with COVID.
Redetermination resumed this year. Those who no longer qualify for medical assistance or MinnesotaCare may still qualify for financial help buying private coverage through MNsure.
Caulum noted that help is available across the state from insurance brokers, assisters and navigators for those wanting expert assistance sorting through their coverage options. To find help near you, go to MNsure.org and click on "Assister Directory" under "Find Free Help." Those who don't want to do an in-person visit can also use this tool to find assistance via phone or video conferencing.
While open enrollment doesn't begin until next month, consumers can window shop ahead of time to research 2024 plans and learn more about financial help that may be available. Choosing the right plan for your family is vital, and getting a running start is smart.
Editorial Board members are David Banks, Jill Burcum, Scott Gillespie, Denise Johnson, Patricia Lopez, John Rash and D.J. Tice. Star Tribune Opinion staff members Maggie Kelly and Elena Neuzil also contribute, and Star Tribune CEO and Publisher Steve Grove serves as an adviser to the board.
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