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As HealthShare closes, Generations refocuses on MNsure enrollment
Photo: As the Affordable Care Act rolls out, Generations Executives Dan Svendsen, left, and Jenny Peterson will review the program to determine if there are any coverage gaps the non-profi t can address.
A program that empowered small regional employers to offer their workers affordable health coverage will close on Dec. 31, when key provisions of the Affordable Care Act (ACA) take effect.
HealthShare, a demonstration project authorized in 2007 by Minnesota legislators, doesn’t meet the ACA’s criteria for a qualified health plan , its member companies were told Sept. 3. Between now and Dec. 31, employees covered by HealthShare must find alternative coverage or face a financial penalty as mandated by the act, which frequently is called “Obamacare.”
“Change is difficult, and sometimes painful, but after it shakes out, people get used to a new normal,” said Jenny Peterson, executive director of Generations Health Care Initiatives, which designed the HealthShare model and launched it as an independent non-profit company in 2008 to assist firms that employ 50 or fewer people.
Generations, a private foundation that works to improve healthcare access, will continue to operate in that capacity, largely unaffected by HealthShare’s closure.
Statistics show HealthShare has proven effective in expanding health access. Although patient care is available only in Minnesota’s Arrowhead, the program has enrolled 288 companies in five years, providing coverage to 849 employees. Since 2012 alone, participating companies have grown by 31 percent and participating employees by 34 percent. It’s pending closure has raised concerns among member companies.
“HealthShare was created for a very valid purpose, and so far it has worked remarkably well,” said Bob Boone, owner of the Duluth-based Reader weekly newspaper. A HealthShare customer since its inception, he fears similar coverage won’t be available once the Affordable Care Act fully takes effect.
Companies enrolled in HealthShare pay a minimum of $68 per worker. The employee portion of the premium is no more than $99 per month. Boone anticipates policies offered through MNsure, Minnesota’s health insurance exchange, might cost many multiples of that rate and, unlike HealthShare, require high deductibles. That could prompt some small companies to stop offering coverage or force them to provide much more expensive plans. Either alternative would make it much more difficult for small firms to attract good employees, he said.
Several executives at regional hospitals are voicing similar concerns. In recent interviews, they have told BusinessNorth that both premiums and deductibles are likely to climb, leaving many people with insurance that only covers catastrophic health problems.
Such concerns are not lost on executives at Generations. Despite the upcoming demise of HealthShare, Peterson said Generations will continue its mission of enhancing healthcare access. The first step will be to promote enrollment in a health insurance plan.
Generations received a grant from MNsure to help people enroll. Further, Wyn Mathews, HealthShare's business services representative, will meet with HealthShare’s member companies to assist them with the transition to alternate coverage. Employers also are being encouraged to seek advice from brokers with whom they already buy other types of insurance. When it becomes available, HealthShare will provide its customers a list of “navigators” who will help guide people through Minnesota's insurance exchange.
Generations’ task could be more difficult in Wisconsin, which has opted to use the federal insurance exchange rather than develop its own state-run process, said Dan Svendsen, Generations' chief financial officer. When interviewed in mid-September, little was known about the federal exchange even though it was scheduled to launch Oct. 1. Nonetheless, he was hopeful of a positive outcome.
The next step for Generations will be to identify any coverage gaps that emerge in the Affordable Care Act, then attempt to offer solutions that help people obtain health coverage.
“There will be bumps in the road. Generations will try to determine who won’t be covered,” Peterson said, which could take a year or two of analysis.
Initially, it’s anticipated that some people – particularly young adults who are in good health – will decline to buy insurance. They will face a penalty, but it's relatively small when compared with premiums – $95 or 1 percent of their income, whichever is greater, during 2014, then $325 or 2 percent of their income in 2015 and $695 or 2.5 percent of their income in 2016.
“I think this first year in particular, we’ll see a lot of people willing to pay the penalty and go without health insurance, which is unfortunate,” Peterson said. “As gaps arise, we’ll do our best to make sure everyone is enrolled.”
Svendsen, a 43-year veteran of the healthcare field, believes people will adjust to America's new healthcare model.
“When something is new, there's always gloom and doom, but then everybody survives and moves on. You learn to adapt,” he said.
Three persons will be laid off when HealthShare ceases operations, but Generations will continue to operate or assist several other programs it has previously established.
Key among them is the Healthcare Access Office located at the Lake Superior Community Health Centers in both Duluth and Superior. Its staff helps low-income persons enroll in government healthcare programs, prescription drug programs offered by pharmaceutical companies and patient assistance programs offered by healthcare facilities. The Health Care Access Office staff and other local navigators will also help individuals apply for qualified health plans on MNsure and the federal health exchange in Wisconsin. Low and middle income individuals and families will be eligible for subsidies to reduce the cost of a health plan if they enroll on a health exchange.
“They really do a wonderful job of finding any available program that people are eligible for,” Peterson said.
The ShareCare program also will continue. It qualifies lower-income persons who aren’t eligible for public healthcare assistance to obtain reduced-price care from about 40 providers in Duluth and Superior. Applications for ShareCare are accepted through the Health Care Access Office.
A dental clinic at Lake Superior Community Health Center’s Duluth and Superior locations also will continue to provide treatment for individuals who qualify.
“We know the Affordable Care Act won’t address everything. The role for Generations is to examine the fallout – determine who won’t be covered,” Peterson said, then examine options to help them obtain the health care they need.Previous BusinessNorth Exclusives Articles:
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