MNsure: Who is it for? Not everyone

As health insurance marketplaces go online in every state today as part of the Affordable Care Act, surveys indicate that confusion abounds over how the so-called exchanges will work and who should use them. The president's health care overhaul relies heavily on the exchanges, like MNsure in Minnesota, to expand access to insurance. But MNsure isn't for everyone.

"MNsure will be very helpful for people who don't have health insurance today," said Minnesota Human Services Commissioner Lucinda Jesson. "It will also be a real option for people who are buying insurance on the individual market, especially for people who have pre-existing conditions and may not have access to affordable insurance before."

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MNsure is expected to enroll about 1.3 million Minnesotans in commercial or government health plans by 2016. About eight out of every 10 Minnesotans projected to enroll in public health programs such as Medicaid, called Medical Assistance in Minnesota, or MinnesotaCare. Jesson said many of those people are eligible to enroll in those plans now but haven't done so.

"We make it difficult currently for people to sign up and enroll because of all of the paperwork. MNsure is really going to change that for people on public programs. I think it's one of the main ways that we're going to get health insurance to more people in our state," she said.

While those eligible for Medicaid and MinnesotaCare recipients will enroll through MNsure, those eligible for or already enrolled in Medicare will not. Medicare serves people aged 65 and older or those who have disabilities.

"If you are on the Medicare program, MNsure is not for you," said AARP Minnesota Executive Director Michele Kimball. There has been confusion among seniors because the MNsure and Medicare open enrollment periods overlap. Both have October start dates, although Medicare's open enrollment period doesn't begin until Oct. 15. Seniors should enroll in Medicare as they always do. If they have questions, they should call the the Minnesota Board on Aging's senior linkage line.

For people who have access to coverage through an employer, but find the coverage is too expensive, MNsure may offer an alternative. Consumers can buy coverage on MNsure if they can find a better deal. But there is a catch: It's much harder to qualify for federal subsidies that help shoulder the cost. Only if your employer's coverage costs you more than 9.5 percent of your income can you qualify for a federal insurance subsidy. For a household with the state's median income, that's $463 a month.

Employers are required to notify employees of their coverage options by Oct. 1 -- including coverage on state-run insurance marketplaces such as MNsure. But there is no penalty or fine if they don't.

Carolyn Pare, CEO of the Minnesota Health Action Group, an employer coalition, said she expects employee questions will ramp up in the coming weeks as the insurance marketplaces get up and running. She recommends workers talk to their human resources departments if they have any questions about coverage.

"Employers have been spending a lot of time on trying to figure out how in fact they're going to communicate this to the employees," she said. "They're just stepping into their open enrollment information now so now is the time you'd really want to talk to your human resource department about what you should be considering."

Experts also say that no one needs to decide whether to use MNsure on Day 1 of the program -- today. Open enrollment on MNsure will run through the end of March and there's no penalty for lacking insurance until then. Also, if you decide on one MNsure plan and then change your mind, you can switch to another plan as long as you do so during open enrollment.