UCare no longer an option for many of the state’s poor

 

UCare-sponsored performers during this year's Minnesota State Fair
UCare-sponsored performers during this year’s Minnesota State Fair

Starting November 1, 2015 through January 31, 2016, MNsure, Minnesota’s healthcare marketplace that came about as a result of the Affordable Care Act, is open for enrollment for healthcare options for the year of 2016. Due to the decision in September that the Minnesota Department of Human Services (DHS) will be contracting with UCare on a much more limited basis, enrollees will have fewer options to choose from.

Also next year, PMAP, Minnesota’s largest Medicaid program, will no longer be available through UCare except in Olmstead County. The majority of those affected have employers who do not offer insurance and/or are too poor to afford private insurance.

This decision affects more than 360,000 low-income Minnesotans who currently have UCare as their health plan of choice. Although UCare will not be servicing many people in the metro area, Deanne Probst, communications specialist senior for UCare, stated, “Many people think we are not going to serve at all in Minnesota. This is not true. We here at UCare want the public to know that we will continue serving many populations across the state.”

In her interview, Probst added, “A reason partially responsible for the contract loss is competitive contract bidding on the state level as well as technical scores, such as the quality of care, were also deciding factors [on which HMOs got continued contracts]. Probst referenced information from an article written by Christopher Snowbeck of the Star Tribune.

The article quotes State officials saying taxpayers would need to spend an extra $137 million next year if all program enrollees in Hennepin County were covered through UCare rather than by Minnetonka-based Medica, which had the lowest bid in the state’s most populous county. DHS resources state that the new 2016 contracts will save state and federal tax payers about $450 million in 2016. This was a price that Minnesota DHS was not willing to pay.

Those low-income individuals and families will be switched to other health plans unless they are covered by one of the following UCare programs:

  • Minnesota Senior Health Options (MSHO), which integrates Medical Assistance and Medicare services and payments for people age 65 and older.
  • Minnesota Senior Care Plus (MSC+): for people eligible for Medical Assistance age 65 and older.
  • UCare Connect (Special Needs Basic Care, or SNBC): for adults with certified disabilities ages 18-64.
  • UCare Choices and Fairview UCare Choices: commercial products for individual and family coverage available through MNsure.
  • UCare for Seniors (UFS): Medicare Advantage products for people eligible for Medicare.
  • EssentiaCare — a new Medicare Advantage product offered in partnership with Essentia Health for Medicare-eligible people in 10 north-central Minnesota counties.
  • MinnesotaCare and Prepaid Medical Assistance Program (PMAP) for members in Olmsted County, an income-based Minnesota Health Care Programs for individuals and families.

The new contracts will direct many more enrollees to Medica, which expects growth of about 110,000 people, while giving Blue Cross and HealthPartners the potential for growth too in certain parts of the state.

Because of this loss in programming, UCare has announced that it will have to cut some 250 jobs next year. This does not include the already 112 vacant positions and 42 staff taking voluntary buyouts. All in all, those low-income families who have been identified as receiving PMAP and MinnesotaCare insurance, and who live in all counties in Minnesota except for Olmstead, will no longer be receiving these services.

UCare members who are looking for medical insurance to replace those discontinued options are urged to contact MNsure for coverage guidance.

 

Brandi Phillips welcomes all comments at bphillips@spokesman-recorder.com.