EDITORIAL | Health insurance deals abound again

Opinion Editor’s Note: Editorials represent the views of the Star Tribune editorial board, which operates independently of the newsroom.

Being in good health does not guarantee that you will not need serious medical attention. Accidents happen. The appendices burst. COVID-19, influenza and other pathogens continue to circulate. Heart attacks and cancer can happen without warning.

If that happens, those without insurance could face huge bills. The average cost of a three-day hospital stay: About $30,000, according to federal health data. Costs can rise even higher when surgery is necessary or ongoing cancer care is required, for example.

No one should risk running out of debt because of a medical crisis. Especially now that expanded financial assistance, which can instantly lower monthly insurance premiums, remains in place for those who purchase coverage themselves instead of getting it through an employer or public program.

There are good deals available for people eligible for this assistance. It’s important to know that under open enrollment, the annual window to purchase coverage for the upcoming year begins on November 1 and ends on January 15 for those purchasing individual policies.

Since most people have coverage through employment and the Medicare program covers seniors, individual buyers are a relatively small group. In Minnesota, that’s only 3 percent of the state’s population, or about 167,000 people.

This group includes self-employed workers, farm families and early retirees who have not reached the Medicare eligibility age of 65. A key part of the Affordable Care Act is financial assistance in the form of advance tax credits for these buyers to keep them from being priced out of coverage. Help is only available to those who purchase insurance through MNsure.

As part of the national response to the pandemic, Congress lifted the income eligibility cap for these grants, then in 2022 passed a three-year extension. A key message from Libby Caulum, CEO of MNsure: If you weren’t eligible for these grants in the past, come back and check again.

“It’s always worth taking another look. Some people are pleasantly surprised,” she said in an interview, noting that subsidies can make “a huge difference” in maintaining monthly premiums at an affordable level.

From an overall perspective, MNsure estimates that “Minnesotans eligible for tax credits will save $6,750 in 2024 and spend 5% less on private health plan premiums than this year, on average.”

MNsure’s savings scenarios further illustrate the savings potential. Note: Gold plans “generally have higher monthly premiums, but pay a larger share of your costs when you need care,” according to MNsure. Silver or Bronze plans “cost you less per month, but pay less of your out-of-pocket costs when you need care.”

• A two-person household in Duluth with an annual income of $72,000 that chooses a Gold plan could qualify for $1,180 per month in subsidies, reducing premiums from $1,903 per month to a more manageable $723 per month .
• A family of three in Mankato earning $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 Thief River Falls family of four earning $98,000 a year who 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, noting that with the recent end of a pandemic relief measure, a policy called “continuous enrollment.” It suspended eligibility checks for people receiving medical assistance for the duration of the public health emergency. The intention: to cover as many people as possible in case they get sick with COVID.

Redetermination resumed this year. Those who no longer qualify for Medicare or MinnesotaCare can still receive financial assistance to purchase private coverage through MNsure.

Caulum noted that help is available statewide from insurance brokers, assistants and navigators for those who want expert help sorting out their coverage options. To find help near you, go to MNsure.org and click on “Assist Directory” under “Find Free Help.” Those who do not wish to visit in person can also use this tool to get assistance by phone or video conference.

Although open enrollment doesn’t begin until next month, consumers can window shop in advance to research 2024 projects and learn more about financial aid that might be available. Choosing the right plan for your family is essential, and getting off to a good start is a good idea.

Editorial board members include David Banks, Jill Burcum, Scott Gillespie, Denise Johnson, Patricia Lopez, John Rash and DJ Tice. Star Tribune Opinion staffers Maggie Kelly and Elena Neuzil also contribute, and Star Tribune CEO and Publisher Steve Grove serves as an advisor to the board.