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Blewett, Lynn A.
Principal Investigator

p 612-624-4802
e blewe001@umn.edu

Lynn Blewett on Health Affairs Blog: Capping Enrollment in Minnesota’s Individual Market

April 18, 2017:

In a new piece on the Health Affairs Blog, SHADAC Principal Investigator Lynn Blewett discusses the recently announced plan, brokered by the Minnesota Department of Commerce, to cap enrollment in Minnesota’s individual market in an effort to prevent the market from collapsing.

The Caps

The enrollment caps, along with significant rate increases, are aimed at preventing a market collapse following the announcement that Blue Cross Blue Shield (BCBS) would leave the individual market—an announcement that sparked concerns about other insurers doing the same—and are meant offer some insulation against an influx of the enrollees from BCBS, which had a higher risk profile than other insurers in the state. The caps include each plan’s current enrollment (from 2016) plus a small number of openings for new enrollees and apply to all but one narrow-network HMO plan, called Blue Plus, that is owned by BCBS.

The Implications

Dr. Blewett points out a key problem with the new policy: There will be no plan option for the five counties in which Blue Plus is not offered (Benton, Morrison, Crow Wing, Mille Lacs, and Stearns counties) once the state-wide caps in the other plans are met. As Dr. Blewett explains, the enrollment caps create conditions in which the ACA core principle, guaranteed issue, will not apply to everyone, and the rate increases for remaining plans “are likely to make coverage unaffordable for many.” Potentially exacerbating this problem is that there are 18,000 remaining uninsured in the counties where Blue Plus is not available. These and other remaining uninsured throughout the state (234,000 people total) will also be looking for affordable coverage, and “accommodations will need to be made to ensure access to plan coverage once…caps have been met.”

Dr. Blewett points to additional areas of concern surrounding Blue Plus, including potential problems accessing major providers in certain areas of the state and the incentive for Blue Plus to recruit the healthiest of its current enrollees (for whom BCBS has health status information). She notes that it will be critical to inform people of their choices (or lack of choices) during this transition.

Possible Solutions

Among other policy options and solutions for these issues, Dr. Blewett identifies the following:

Hold a special legislative session to address large premium increases through a rebate program.
Establish a state-based reinsurance system for its entire individual market.
Provide access to a public option such as the Minnesota Care Program for those living in counties with no plan options after enrollment caps are met.

Read the piece here.

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SHADAC Staff

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e shadac@umn.edu

Now Available: 2015 State and County Uninsured Estimates (ACS)

October 11, 2016:

SHADAC has produced tables of state and county uninsured estimates for 2015. These estimates come from the 2015 American Community Survey and were generated using the U.S. Census Bureau’s American FactFinder (AFF) tool.

SHADAC’s tables provide uninsured rates by characteristics (e.g., age, race/ethnicity, and poverty level) for both 2015 and comparison year 2014 for each state (and the District of Columbia and Puerto Rico) and for all counties within the each state that have a population greater than 65,000. Tables are available via clickable map here.

Additional Tables: Private, Public, & Uninsured Change from 2014 to 2015

SHADAC has created the following 50-state comparison tables (with maps) in addition to the state and county uninsured tables:

Publication

Physician Participation in Medi-Cal: Is Supply Meeting Demand? (Webcast)

This webinar was broadcast on September 27, 2016.

Download the presentation slides.

Download the event transcript.

Event Description

Dr. Janet Coffman, a health services researcher at the University of California, San Francisco, presented results from the 2015 survey on California physician participation in the state's Medicaid program, Medi-Cal. Dr. Coffman examined physician acceptance of new patients overall and by specialty type, practice type, and region. She also considered how these results compare to different benchmarks for assessing adequacy of physician supply and how current Medi-Cal physician supply compares to the supply in previous years.

Alan Mckay, CEO of Central California Alliance for Health (CCAH), a Medi-Cal managed care plan serving members in three Central California counties, provided several examples of strategies employed by CCAH to address physician access challenges. These efforts fall into four areas: (1) increasing physician supply, (2) supporting physician retention, (3) promoting the best use of the available healthcare workforce, and (4) reducing the need for physician services.

This event was co-sponsored by the Robert Wood Johnson Foundation through its SHARE grant program and by the California Health Care Foundation.

Event Materials

California Legislation Mandating Physician Survey

The California law that requires the state's Medical Board to administer a mandatory physician survey is set forth in Section 2425.3 of California's Business and Professions Code. Access the full text of the law.

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SHADAC Staff

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e shadac@umn.edu

Census Bureau Experts Examine Newest ACS & CPS Data during Annual Data Release Webinar on 9/21

September 19, 2016:

Update: Webinar slides, recording, and resources are now posted here.

SHADAC will host our annual webinar discussion of the newest health insurance coverage estimates from the American Community Survey (ACS) and the Current Population Survey (CPS) on September 21st. Data released last week from these annual surveys provide a picture of coverage at the national and state level under two years of ACA implementation while also providing historical trend information for context.

Join us for this free, public event during which we will examine the new estimates with technical insight from experts at the U.S. Census Bureau, which administers both the ACS and CPS, and from SHADAC researchers.

EVENT DETAILS

Date: September 21, 2016
Time: 12:00 p.m. Central / 1:00 p.m. Eastern

Attendees will learn about:

The new 2015 national and state coverage estimates
When to use which estimates from which survey
How to access the estimates via Census reports and American FactFinder
How to access state-level estimates from the ACS using SHADAC tables

Attendees will also have the opportunity to hear more about CPS estimates of employer coverage offer and take-up rates, for which three full years of data are now available.

SHADAC researchers and Census experts will answer questions from attendees after the presentation.

Related Content

2015 ACS: Variation in Public and Private Coverage at the State Level
-SHADAC Blog, September 16, 2016

2015 ACS: Widespread State-Level Declines in Uninsurance, with Inter-State Variation Persisting (Infographic)
-SHADAC Blog, September 13, 2016

Publication

New Data from the ACS & CPS: Conversation with Census Bureau Experts (2016 Webcast)

The webcast below was recorded on September 21, 2016.

Download the presentation slides.
View the event transcript.

Event Summary

This webinar provided an overview of the 2015 health insurance coverage estimates from two key, large-scale federal data sources: The American Community Survey (ACS) and the Current Population Survey (CPS).

Data from these annual surveys paint a picture of coverage at the national and state level under two years of ACA implementation while also providing historical trend information for context.

This webinar examined the new estimates with technical insight from experts at the U.S. Census Bureau, which administers both the ACS and CPS, and from SHADAC researchers.

Webcast viewers will learn about: