Minnesotans shopping for health insurance in 'uncharted territory' this year

[MUSIC PLAYING] NINA MOINI: Our top story, the MNsure Health Insurance Marketplace is now open for Minnesotans to shop for a variety of plans for 2026. The cost, they'll see, may be discouraging. Premiums on the individual marketplace are 22% higher on average. And that does not account for the expiring federal tax credits that are at the center of the federal government shutdown. If they do expire, premiums will be even higher.

About 190,000 Minnesotans get their health insurance through the marketplace. They can't sign up for a plan until open enrollment starts November 1. As a health insurance navigator, our guest is beginning to walk people through this process. Jonathan Marchand is community services manager for United Community Action Partnership. It's based in Wilmer. Thanks so much for your time today, Jonathan.

JONATHAN MARCHAND: You're so welcome. Thanks for having me.

NINA MOINI: Would you start by just briefly explaining, for people who may not be familiar, what your role entails as a health insurance navigator? What do you do to help?

JONATHAN MARCHAND: Sure. So MNsure navigators are able to assist consumers to apply for and enroll in and maintain their coverage through MNsure, through the MNsure portal. And now, that is for public program health insurance, like medical assistance, sometimes referred to as Medicaid, also Minnesota Care or qualified health plans. Sometimes you'll hear QHP thrown around in our alphabet soup, sometimes. And the QHP plans, those health plans are for folks who are eligible to also receive premium tax credits that can sometimes help to reduce the amount of their premium every month.

And so navigators assist with that process. They can help to help provide any documentation that the consumer needs to submit to the respective agency or responsibility, say, for medical assistance. That would be counties. Minnesota Care would be Department of Human Services, through the state. And if they're on a QHP plan, then they would have to go back and forth between MNsure. So the navigator can work as an intermediary between those different entities and the consumer to help them to gain, maintain their coverage.

NINA MOINI: I'm sure it can be an overwhelming process for folks, as it is, and also something of great concern, because people's health is so important to them. And like I was mentioning off the top there, this concern around increase in premiums for 2026, I wonder how that is impacting your role this year.

JONATHAN MARCHAND: We're kind of wandering into uncharted territory, just considering the amount of increases that some people might potentially face. The anonymous shopping tool just went live this week on the MNsure site. And that tool, it's kind of like a sandbox. It allows people to go on and enter information, like their age and how many household members they have, spouse, children, what their income is, to get a picture of what they might be able to qualify for in terms of a premium tax credit and what the different plan options that they have to choose from would be.

And so to just kind of play around with what folks who are potentially facing the most substantial change would be, we sandboxed some scenarios. The one that we looked at was, let's say there are two adults, age 63. They would make $87,000 per year, about $43,500 each.

And sometimes we see quite a few of these folks, who maybe their employer-offered insurance is ending, or maybe they're self-employed, or whatever the case would be, that there's just no access to employer coverage. And they're in that gap period of their life before Medicare would start. So they're looking for that coverage to just to get them over onto the Medicare side.

So with that scenario, looking at a plan in 2025, the lowest cost plan available, in our region, anyway, on the marketplace, would be $280.10 a month after their premium tax credit. Now, that would be for the both of them together. Now, we look into 2026 with the expiration of the extended premium tax credits. Same scenario, same age, same income, but now the lowest cost plan available to them on the exchange is $1,988.

NINA MOINI: Yeah, wow. Wow, yeah. And the federal government shutdown that's now in its third week is hinging largely on the idea of these tax credits and just the expense of health care to a lot of people who, like you mentioned, are in different situations. Some people are at an age where it's difficult to find anything that's affordable. I wonder how much time people should take to wait and see what happens at the federal level. Or what are you encouraging people to do at this point?

JONATHAN MARCHAND: I would encourage folks to, if they are looking at MNsure coverage, to really reach out and talk to their navigators or brokers. There is a search tool on the MNsure site and the sister directory. Folks can enter their zip code, city, or county that they live in, and it will pull up a list of navigators or brokers in their area.

And they can give them a call, make an appointment, come in to talk, let them know what their needs are, what they're worried about, and just look at what their options may be. MNsure is still the only option where folks can take advantage of those premium tax credits if they would be eligible to receive them, or if something changes and that expansion continues into 2026.

But at this time, just getting ahead of the curve a little bit and letting those-- consumers should let their sisters know, this is what our current coverage is. Maybe we have a planned medical event. Or maybe we just need something in place in case the wheels fall off. Just really being able to drill down on what the needs are and seeing what their options may be. I worry that there's going to be a lot of sticker shock. And there may be very fewer options for a lot of folks going forward that are going to be very-- that are going to be cost-saving.

NINA MOINI: So you're saying, at least start looking at what the options are immediately under the situation as it is likely to unfold. I know--

JONATHAN MARCHAND: Exactly.

NINA MOINI: Before I let you go, Jonathan, I know premiums are going up, too, for employer-based health plans. There are other factors going on, rising demand. Do you have concerns right now? Or what are your concerns about the long-term future of health care costs right now?

JONATHAN MARCHAND: Well, when you mentioned the employer plans change, the affordability standard has increased for 2026. Right now, I believe it's about 9.2% a person. An employee's coverage cannot exceed that amount of their pay. And that's raising up to-- it's getting very close to almost 10%. So that means that employers are going to be able to charge their employees more for their employee plans, shifting those costs onto them. Not saying that's something that they're going to do, that they're one monolithic thing. But it's a concern that's out there.

I think our biggest concern with this environment that we're in right now is that people may, in fact, choose to go uninsured and take that risk. And that can really be a worst case scenario for families if something tragic happens.

NINA MOINI: Yeah. So you're hoping that people will still move forward and make a plan because it sounds like no matter what, people need to plan for an increase in what they're going to be paying for health insurance next year.

JONATHAN MARCHAND: Yes. We only know what we know right now. And if things change in a week or a day or on December 31, we go with it. But we can only work with our consumers with the information that we know right now.

NINA MOINI: Sure. Jonathan, thank you so much for your time and sharing about your work. Really appreciate it.

JONATHAN MARCHAND: You're very welcome.

NINA MOINI: Jonathan Marchand is Community Services Manager for United Community Action Partnership, based in Wilmer.