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Serving Northern St. Louis County, Minnesota

Many more will qualify for health insurance subsidies


There’s good news and bad on the healthcare front in Minnesota. First, the bad news— the number of Minnesotans without health insurance increased this year, by about 18,000. For most of these folks, access to healthcare is now largely limited to the use of badly overrun emergency rooms, where the focus is solely on patching folks up and sending them on their way.

The increase is not unexpected. In their efforts to gut the Affordable Care Act, or ACA, the Trump administration and Republicans in Congress, last year, did everything in their power to undermine the ACA, and all but halted outreach efforts to encourage the uninsured to sign up for coverage under the act. As it is, plenty of people still don’t understand the ways that the ACA does make healthcare access more affordable.

The ACA accomplishes this in a couple ways. The most significant has been through the expansion of the Medicaid program to allow families with middle-class incomes to qualify in many cases for free, high-quality healthcare coverage, with minimal or no co-pays or deductibles. The income limits have increased in recent years, which means many folks who might think they don’t qualify actually do. That’s the good news.

In fact, according to the Minnesota Department of Commerce, about 75 percent of the estimated 250,000 Minnesotans currently going without health coverage in the state, including thousands right here in St. Louis County, would qualify for either a low- or no-cost public program, like Medical Assistance or MinnesotaCare, or an advanced tax credit to assist in the purchase of private insurance. And from my own experience, I know that a significant number of people who do qualify, at a minimum, for the advanced tax credits, are not taking advantage of them.

More than once, I’ve worked through the MNsure website, plugging in family sizes and income for friends who’ve groused about the high cost of health insurance premiums, blaming it mostly on the ACA. In almost every case, when I’ve crunched the numbers for them, it turns out they’ve qualified for substantial tax credits that would save them thousands of dollars a year.

And the new income guidelines mean even more people qualify than before. Even a single person with an adjusted gross income of $49,960 a year or less should qualify for private health insurance tax credits beginning in 2020. For a family of two, you can earn up to $67,640 and still qualify for the advanced tax credits. A family of four can still qualify up to a household income of $103,000. Keep in mind, these are adjusted gross income figures, which means they are based on the numbers you report on your tax return after accounting for certain expenses such as child support payments or contributions to a retirement plan.

And, remember, once you apply and are approved for the advanced tax credit, the credit is applied each month to your premium and will often cut the cost of your monthly premium in half, or more, depending on your total income and the type of insurance plan you select.

Many families in our area with children under 18 may also qualify for Medical Assistance, or Medicaid, which is far more inclusive than most private plans, with minimal if any co-pays or deductibles. As of next year, a family of four can earn up to $70,812 and their two children, under age 18, could both still qualify for Medical Assistance.

The fact is, about the only people in our area who don’t qualify for some kind of free or subsidized health insurance through the MNsure system are those who already have coverage through their place of employment, or self-employed individuals with incomes well above the median in most of our area communities. We’ve published the income guidelines here, so take a look to see if you or your family might qualify. If you want more information on income guidelines for healthcare coverage assistance through MNsure, visit:

So, for folks who don’t currently have health insurance but are interested, either for themselves or members of their family, now is the time to start thinking about signing up for next year. The new rates will be issued on Oct. 15 and open enrollment for next year begins on Nov. 1.

You’ll want to sign up as soon as possible so any questions or issues can be addressed well ahead of the start of your coverage on Jan. 1.

Can signing up be a bit complicated? Potentially, which is one reason I still firmly believe that a universal, single-payer system is the best way to go. Until that happens, however, utilizing MNsure and signing up for the public coverage or private tax credits offered, makes sense if you don’t have coverage through your employer. There’s no reason to go without insurance if affordable coverage is out there.


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Scott Atwater

We've all heard the empty promises of the ACA before.

My personal favorite by Obama: The ACA will "reduce insurance premiums by $2,500 for the typical family", was he ever full of it.. LoL.

Saturday, October 12, 2019
Marshall Helmberger

The ACA was not intended to impact people who already have insurance through work. But for those who are purchasing insurance on the private market, the ACA has had a significant and beneficial impact. I know for my wife and I, the ACA is saving us about $12,000 a year on the cost of insurance. And for those who qualify for programs like Medical Assistance, otherwise known as Medicaid, based on income, the ACA has meant the difference between no insurance and having quality insurance. Many of those on the private market who are not currently benefiting from the ACA simply choose not to utilize the program because of their political opposition to the former president or other political reasons. That is certainly their right, but they can't blame the consequences (costly insurance or no insurance) for their decision on the ACA.

And don't get me wrong... I'm not really defending the ACA. My view is that it fell far short of what was necessary because it propped up a dysfunctional and inefficient private health insurance system that serves the interests of the industry, not the public. A universal, single-payer system would be far more efficient.

Saturday, October 12, 2019
Scott Atwater

The problem is, Marshall, that the ACA did impact people who already had insurance through work in a negative way. Worse yet, those that didn't have insurance through work often ended up paying for healthcare out of their own pocket plus that absurd penalty for not having insurance.

Sunday, October 13, 2019