COMMUNITY VOICES | What Will You Exchange in the Health Care Exchange, Minnesota?


The online Health Care Exchange approaches. What will change? Will you exchange your health insurance?

 Open enrollment for coverage plans is typically in November, and 14 food co-ops in the Twin Cities, 150 Credit Union Co-ops in Minnesota, and over 300 members of Small Business Minnesota are being targeted by a new campaign to switch to a Consumer-Operated and –Oriented Plan for employee health care.

The Pro’s:

  • No one can be denied health care coverage for being too fat, too skinny, or sick, per recent federal law

  • The Co-Op option being organized in Minneapolis, called A Prairie Health Companion, will be hiring. It’s welcoming new Board members and citizens’ input, as well as new customers and employees

The Con’s:

  • Small businesses that never offered employees insurance before will soon meet with the complications of this requirement, amid other changes

  • $6 million that would’ve funded start-up loans for health care Co-Ops across the country was cut from the Affordable Care Act when Congress cowered before the fiscal cliff in December

  • The new Minneapolis-based Co-Op will be a cheap option, but not so cheap that those receiving state-funded health coverage could switch over to it

 I spoke with someone who’s been educating Minnesotans about co-operative health care pools for years, Joel Albers, Ph.D. of health economics.


He said that Medica, Preferred One, Health Partners and the Blue Cross are using deceptive marketing to make people feel like they have power as individuals, using specific people as an emblem for their product.

One example is the real, down-to-earth smiling face on Medica billboards and bus signage, next to the title “Medica. Changing the Face of Health Care.”

You won’t see CEO David Tilford’s face on these advertisements, because they seem to appeal to Everyman. “That’s not what insurance is about,” Albers told the Daily Planet.

“Choice is a word for ‘We’re going to make this as complicated as possible.’ They don’t want to simplify it.”

 The virtual health care exchange that will open in October 2013 should make enrollment and comparison-shopping simple—for those who are comfortable using the Internet to make that decision. It depends, in part, on the insurance agencies’ communication strategies too. Will Minnesotans see them all at the state fair again, sponsoring tents and booths where everyone lines up for a free flu shot?

What will the established agencies do to fight for your business,  now that at least one start-up co-op or agency  will be competing in the same small virtual arena? Spokespeople for Medica and the Blue Cross of Minnesota declined to comment on their strategies. Preferred One and Health Partners could not be reached for comment.

“90% of the market-share is the Big Four,” explained Albers. He and other concerned citizens in the Universal Health Care Action Network have fought this sort of monopoly over the years, with protests, parades, radical education and advocacy of single-payer health care. Now UH-CAN’s focus is Co-op Care. “We’re building something, that’s our way of fighting. We can depend only on ourselves.”

 It hadn’t worked out to depend on legislative changes at the state level, when, in April 2011, UH-CAN, the Minnesota Nurses’ Association, and the Older Women’s League stood up for state Senator John Marty’s Bill SF 1054. It would’ve compounded the state-funded health programs and replaced $3 Billion in HMO contracts, cutting out the middle-man administrating health care for the poor. A single-payer health care solution had had more momentum between 2008 and 2011 than it had for decades, and a proponent of single-payer health care, Ed Ehlinger, was even instated as the Commissioner of the Department of Health. But Marty’s bill still did not gain traction,  and those receiving state-funded health care stuck with the HMO’s.

 I remember getting big heavy books in the mail detailing different insurance agencies, when I was on Minnesota Care in 2009. The agencies awaited my choice. I went with UCare, glancing through their provider network booklet and HealthPartners’—and not thinking about which would rip off the state more.

Insurance agencies still compete for those customers covered by state funding, though there’s less dental, vision and preventative care covered than before the September 2010 cuts from Minnesota’s money for the poor and sick. The state was trying to balance its budget in 2010 and the General Assistance Medical Care program was cut more than 75%, barely avoiding elimination altogether. GAMC and Minnesota Care used to be good deals for the patient—and the insurance company receiving the state money.

Waste was an issue, and so came the slashes to my pay as a personal care assistant and a reduction of the hours when I could help my clients as a PCA. Instead of consolidating Minnesota Care, Medical Assistance, and the Minnesota Family Planning Program to save money, the state targeted hospitals, nurses and caregivers. Disaster Capitalism as usual steamrolled ahead, and UH-CAN saw single-payer proposals for state programs recede and the ‘public option’ for our country fall away. Let’s not forget these hard lessons.

 Albers points out that 88% of all health care premium revenues in Minnesota flow into the bank accounts of the Big Four insurers. It’s been like this for the last 20 years, as major insurer mergers took place.

 Who benefited? In 2011 Patrick Geraghty, CEO of Blue Cross and Blue Shield Minnesota, was the best-compensated head of any Health Management Organization in Minnesta, taking home $2,647,000, and Medica’s David Tilford took home almost as much. Should the new Co-Op Care mini-agency compensate its board members in the future, how much will they take home?

 The board members I spoke to are not in it for profit. Even business people like Jed Meyer at Affinity Plus Credit Union have stepped up to endorse Co-Op Care, which will likely earn less than the allowed 3% profit from premiums. Albers described credit unions’ approach as similar to his own: “They’re trying to get people out of big banks, we’re trying to get people out of big insurance.” Jed Meyer could not be reached for comment.