Minnesota's new online health insurance exchange is hiring people to help residents sign up for its health plans. But advocates say the system is unfair because consumer assistants will be paid less for helping poor applicants who are reliant on Medicaid.
States are required to help applicants navigate through the new health insurance exchanges, an essential part of President Barack Obama's federal health care law. Starting in 2014, about 1.3 million Minnesota residents are expected to get coverage through the state's exchange, MNsure, including 300,000 who currently don't have health insurance.
MNsure will pay consumer assistants $70 for each person enrolled in a commercial health plan. But assistants will get only $25 if the enrollee can only afford federally funded Medicaid.
"We're seeing really a caste system of compensation where folks who are doing outreach and enrolling people in our public programs are getting less than half of the compensation that organizations will get for enrolling people in private coverage," said Sarah Greenfield, Health Care program manager of TakeAction MN, a coalition of unions and other advocacy organizations.
Portico Healthnet's President Deb Holmgren told Minnesota Public Radio (http://bit.ly/1bN7n0N) for a Monday report that poor applicants are usually the hardest to reach because they work several jobs, move frequently and may not speak English well. She also said it usually costs between $250 and $300 to enroll qualified people in Medicaid.
"It's easy to say we'll put millions of dollars into systems that will make us efficient," Holmgren said. "But when we say, 'OK, in addition, we need millions of dollars to put into outreach and enrollment assistance in order to get these really difficult to reach populations,' that's seen as a luxury."
MNsure officials said the compensation difference is due to the state lacking adequate financial resources: The program didn't get any state funding during the two years that the GOP controlled the Legislature, nor was it given any federal aid.
State Human Services Commissioner Lucinda Jesson said they were scrambling last fall to tell federal officials how Minnesota would provide the assistance service.
"We were in a bind," Jesson told the MNsure board last week. "So it was, 'What can we use to provide this service in order to get an exchange up and running that's already being funded?'"
Currently, Minnesota is relying on an existing enrollment program to pay the assistants. Jesson said the state is also seeking up to $7 million in federal funding to do so.
"There is absolutely no question that we need to move to one streamlined approach, and we're really working on it," she said.