Background on MCHA
Minnesota Comprehensive Health Association (MCHA) is the state’s high risk pool that provides health insurance coverage to individuals as a plan of last resort when they cannot get coverage in private markets. MCHA is considered a model high risk pool in the nation.
Who is covered by MCHA?
MCHA covers Minnesotans that cannot obtain insurance through other means such as:
In addition, MCHA insures those individuals that lose group coverage and are eligible under either the:
How is MCHA funded?
MCHA receives its funding from two main sources:
2014 and MCHA Transition
MCHA was developed to be the plan of last resort for individuals not able to obtain insurance in the private market. Under the federal Patient Protection and Affordable Care Act (ACA), beginning in 2014, MCHA will not be needed to perform this function in the market due to:
There are special eligibility categories in MCHA that will need to be addressed as part of this transition:
Common questions and answers about Minnesota Comprehensive Health Association (MCHA). Click on the question to view the answer.
The Minnesota Insurance Marketplace Act, signed into law by Governor Mark Dayton on March 20, 2013, directs, “the commissioner of commerce in consultation with the board of directors of the Minnesota Comprehensive Health Association, has the authority to determine the need for and to implement the eventual appropriate termination of coverage provided by the Minnesota Comprehensive Health Association under Minnesota Statutes, chapter 62E. The phase-out of coverage shall begin no sooner than January 1, 2014.”
As authorized by the Minnesota Insurance Marketplace Act, the Commerce Department, in consultation with MCHA, has begun the process to determine the need for and to implement the eventual appropriate termination of coverage provided by MCHA. The transition of coverage (including phase-out) from MCHA to the health insurance markets shall not begin sooner than January 1, 2014. The transition process will include an opportunity for public notice and comment on a draft transition plan.
The initial goal of a transition plan, as required under the Minnesota Insurance Marketplace Act, will be to determine the need for and to implement the eventual appropriate termination of coverage provided by MCHA, with any phase-out of coverage not to begin sooner than January 1, 2014. The Commerce Department goals in developing a transition plan will include the following:
The Commerce Department will continue to consult with MCHA and will provide opportunities for the public to receive notice of, and comment on, a draft transition plan.
MCHA has approximately 26,000 members, many of whom have serious ongoing health conditions.
The Department, in consultation with MCHA, is working with stakeholders to determine the most effective and responsible manner to transition members from MCHA to the private markets while they are in the midst of a course of treatment without causing hardship, including developing education and outreach efforts to inform consumers of upcoming changes.
With the advent of the ACA’s requirements of guaranteed issue in the entire market, which means that insurance companies can no longer deny coverage to individuals with pre-existing conditions, the reason for MCHA's existence as the insurer of “last resort” to provide coverage for individuals who cannot purchase products in the private market is going away. Additionally, a significant portion of MCHA enrollees who do not have large ongoing claims may look to leave MCHA as new opportunities and subsidies are available in the new insurance market beginning in 2014.
In accordance with the Minnesota Insurance Marketplace Act, the Commerce Department has begun a process to develop a plan to transition and phase-out MCHA. Initially, Commerce has consulted with MCHA to gather important financial, operational, and other data. The Department then will publicly announce a timeline for the process to develop a transition plan, which will include opportunities for public notice and comment in its development.