MNsure early adopter rides a rocky roadThe Affordable Care Act is opening up a new world for Lynn Newberg.
By: John Lundy, Duluth News Tribune
The Affordable Care Act is opening up a new world for Lynn Newberg.
“I’ve never had the luxury of picking out a health insurance plan in my life,” the 50-year-old Endion resident said.
Newberg was 10 or 11, she said, when she was diagnosed with Type 1 diabetes. With a chronic disease, Newberg was one of those who fell into the health-insurance abyss.
“I called one insurance agent, and he said, ‘Oh, you can’t get insurance,’” Newberg said of striking out on her own after she was divorced and lost her husband’s work coverage. “And (the agent) laughed at me. Literally laughed at me.”
So Newberg is one of about 26,000 Minnesotans covered through Minnesota Comprehensive Health Association, or MCHA, which the state Legislature created in 1976 for those denied coverage in the commercial market because of pre-existing conditions.
It’s no free ride. Newberg, who said she makes $4.37 an hour as owner-operator of the Lakeview Montessori preschool, pays a premium of nearly $600 per month.
The Minnesota Department of Commerce, which oversees MCHA, notes that enrollees have been paying premiums between 101 and 125 percent of comparable market rates. That covers about 43 percent of the health-care claims they file. The remainder is assessed on the insurance industry, which passes the cost on to its customers.
But MCHA is being phased out. It’s no longer needed, said Kirby Erickson, the agency’s executive director, because starting Jan. 1 insurance companies will be required to cover people who have pre-existing conditions.
MCHA won’t accept new enrollees beginning Jan. 1, Erickson said, but will continue to cover those who already are enrolled through 2014, if they don’t choose to go elsewhere.
But until she received a clarifying letter from MCHA on Monday, Newberg thought she had to make the transition by
Jan. 1. With a new array of choices facing her, she wanted help to make the best decision. She called MNsure, the agency created to manage Minnesota’s online insurance marketplace, and discovered the woman who answered the phone was as frustrated as she was.
“First she was grumping about, ‘I can’t believe how they have this set up. I can’t find anything,’” Newberg related. “That didn’t instill a lot of confidence.”
Newberg was looking for a navigator — the term used for the people trained to help guide people through their health insurance choices. She was told there was a navigator at the Center for Alcohol and Drug Treatment and another at the Lake Superior Community Health Center. But their hours ended at 5 p.m., the MNsure representative said. Newberg works from 7 a.m. to 5:30 p.m. five days a week and schedules her days off far in advance.
“When they first proposed this … they talked about having navigators come to your house and helping you pick out a plan,” Newberg related. “And she said, ‘Oh, not in your area. That’s not happening.’ “
Jenny Peterson, executive director of Duluth-based Generations Health Care Initiatives, said there are plans to give navigators extended hours. However, because of delays in the process of certifying
navigators, there may not be any available in the area on Tuesday, when MNsure enrollment opens, she said. All should be certified within a few weeks, she added. The enrollment period runs through March 31.
Even with more time than she expected, Newberg said she’s eager to make the transition to the marketplace. With her premium plus out-of-pocket expenses, she’s paying close to $1,000 per month for health care, she said, and thinks she can get a better deal than that. But she needs to know what to expect.
“I’m not passive,” Newberg said. “I’m trying to seek out answers. If I have to pay more, I have to plan for it. When you have a chronic, degenerative, incurable disease you don’t just wait. You take action.”
Newberg doesn’t come off as a complainer. She laughs easily. She bought the preschool in 1988 and says she finds the work fulfilling. That comes across as she interacts with her young charges in the kid-friendly main floor of a traditional-style yellow house.
She’s happy about the Affordable Care Act, Newberg said. It’s just the transition that concerns her.
“I just want to be clear: It’s about time,” she said. “It’s about time that people weren’t penalized for managing their diseases. And I didn’t expect it to be smooth. But I was kind of hoping that the information would be more free-flowing.”