After gathering feedback from some of Minnesota's sickest patients, the state is moving ahead with a plan to close a safety-net program that helped people with prior health problems get insurance.
The federal health care law prevents insurance companies from denying people with pre-existing conditions, so high-risk pools like the Minnesota Comprehensive Health Association are no longer necessary -- at least in theory.
Many of the MCHA's patients have serious, expensive conditions, such as AIDS, autism, cancer or multiple sclerosis, and insurers have refused to sell them coverage. But others in the program have less serious conditions, like allergies or high blood pressure.
Under the plan unveiled Tuesday the MCHA won't accept new patients starting with the new year. By the end of next year, the program will close for current enrollees. But there will be an appeal process for people who have difficulty finding adequate coverage outside MCHA.
"We believe the final draft transition plan will allow for a safe, orderly transition with the least amount of disruption to your healthcare and the insurance marketplace in general," said Commerce Department Secretary Mike Rothman in a letter to program participants.
Starting this month, participants will be encouraged to find coverage either through MNsure, the state's online insurance market, or on the individual market through a broker.
The Commerce Department, which regulates the program, will reach out to particularly vulnerable patients individually and help them find assistance through organizations the state has contracted to help people with MNsure.
MCHA participants can also get information from MNsure, said exchange executive director April Todd-Malmlov.
The transition from the MCHA to the individual market has caused anxiety for some high-risk patient groups because they're unsure if the new plans available will cover the care they need, be it expensive drugs, specific treatments or being able to see their current doctors.
Later this week, the state will release details about the MNsure plans, including cost and coverage.
Nevertheless, groups representing people enrolled in the safety-net program say they like that the state is going to put a lot of effort into making sure patients don't experience any hiccups in their care.
"Continuity of care when it comes to people who are under MCHA is truly important," said Sue Abderholden is executive director of the National Alliance on Mental Illness of Minnesota.
For people with mental health problems, that means being able to see their regular doctor and being able to get medication without trouble.
Abderholden is particularly impressed with that the state will keep track of any problems patients have finding adequate on the individual market and how those issues are resolved.
Matt Toburen, public policy director for the Minnesota AIDS Project, said he likes that the plan is flexible. He pointed in particular to the appeal process for patients who have a hard time finding adequate coverage outside MCHA after 2014.