U of M study shows a high level of unfamiliarity around health reform in Minnesota

Tuesday, September 10, 2013

A new University of Minnesota study shows that more than 60 percent of enrollees in Minnesota’s high-risk insurance pool define themselves as “somewhat” or “very unfamiliar” with health reform and the pending changes to their current health coverage stemming from the implementation of the Affordable Care Act.

To increase enrollee understanding, the latest study suggests immediate implementation of targeted education and outreach efforts to address concerns and ensure a smooth transition of coverage in January 2014.

The new study, titled “Survey Of High-Risk Pool Enrollees Suggests That Targeted Transition Education and Outreach Should Begin Soon,” was led by Lynn Blewett, Ph.D., professor in the University of Minnesota’s School of Public Health, Division of Health Policy & Management, and director of the State Health Access Data Assistance Center (SHADAC). The study will appear in the September issue of the journal Health Affairs

“Our surveys found that enrollees are worried about the effects of health reform on the cost and affordability of their health care coverage,” said Blewett. “That said, states will need to do a good job of explaining the many new options and potential financial effects of these options in an understandable and straightforward way.”

Other study results:

  1. Enrollees in the Minnesota Comprehensive Health Association (MCHA)  were an average of 52 years old, and more than half had incomes greater than 400 percent of the federal poverty level and will likely not have access to federal financial support (their current income exceeds eligibility for Medicaid or subsidies through health insurance marketplaces).
  2. Two-thirds of MCHA enrollees have carried their high-risk pool coverage for more than three years, more than a third were enrolled in high deductible plans ($5,000 or $10,000 deductibles), and 80 percent were either somewhat or very satisfied with their current coverage. 
  3. Enrollees particularly value prescription drug access, the ability to see specific providers, and having access to coverage despite their health condition.
  4. Despite having coverage through MCHA, a sizable portion of enrollees still reported unmet health needs due to cost (this is particularly prevalent among those with lower incomes and higher deductibles). 

The study suggests that those selling the new health care coverage options to high-risk pool enrollees should focus on the benefits of the new coverage which include no exclusions based on preexisting conditions, no copays or deductibles for preventive services such as annual exams, no lifetime limits on medical claims, and federal subsidies in the form of tax credits for those who qualify.

States with high-risk pool enrollees should also consider providing specially trained brokers to help with the transition process so that high-risk pool enrollees understand their coverage options and choose the most appropriate plan for their health care needs and preferences. 

The University researchers are comparing the health conditions and utilization of MCHA enrollees with the rest of Minnesota’s insured population to provide additional information on how these MCHA enrollees will affect the insurance markets when they shift in 2014 to Minnesota’s health care marketplace--MNsure.

More than 2,600 people participated in the mail survey which was made up of adult-aged MCHA enrollees that have been continuously enrolled for at least twelve months.

In addition to Blewett, University of Minnesota co-authors included Elizabeth Lukanen, M.P.H., senior research fellow at SHADAC, Kathleen T. Call, Ph.D., professor in the School of Public Health’s Division of Health Policy & Management and investigator at SHADAC, and Heather Dahlen, a doctoral candidate in applied economics and research assistant at SHADAC.