Why I love MinnesotaCare

What it would cost me to stay alive for one month without MinnesotaCare = $1,682.76

What it costs me to stay alive for one month with MinnesotaCare = $3

I owe my life to MinnesotaCare.

I have type 1 diabetes, which means my pancreas stopped making insulin when I was about 8. I have to take a synthetic version of the essential hormone and constantly monitor my food intake and blood sugars to prevent complications like kidney disease, blindness and amputations.

All this is annoying, for sure, but it’s also quite expensive — even when I have private health insurance through an employer.

But at the end of November, after my COBRA subsidy had run out, I could no longer afford to keep even that.

Faced with no other options, MinnesotaCare stepped in to help. The state-run program has kept me from going bankrupt, blind or comatose during a time when full-time work in my field has been difficult hard to find.

MinnesotaCare by the numbers In fiscal year 2009, an average of 117,704 people were on MinnesotaCare each month. In 2010, that monthly average jumped to 131,806 participants. Given the economy and former Gov. Tim Pawlenty’s cuts to General Assistance Medical Care, this figure is expected to rise even more, to 151,884 monthly MinnesotaCare enrollees in 2011.  In 2010, the MinnesotaCare program cost $665,508,204. About 5 percent was paid for by enrollee premiums. Another 28 percent was paid for by the federal government, while the majority of the cost – 67 percent, or $445,844,072 – came from state appropriations. Source: State reports provided by and email conversations with Karen Smigielski, Communications Manager, Minnesota Department of Human Services Update: Medicaid Opt-In relieves pressure on MinnesotaCare and Health Access Fund One of Governor Mark Dayton’s first acts on taking office was to sign on for an expansion of the federal Medicaid program in Minnesota. Today, January 20, Dayton and his new Human Services Commissioner Lucinda Jesson announced that the Medicaid Opt-In will be implemented in March. That’s seven months earlier than the previous DHS officials had said was possible.   This program will enroll 95,000 low-income adults without children: 51,00 adults currently enrolled in Medicare, 32,000 people currently on General Assistance Medical Care, and 12,000 people not enrolled in a state health care program. Those eligible have incomes below $677/month or $8,124/year for one person. According to Dayton’s press release, “In addition to bringing thousands onto the rolls of the insured, early Medicaid enrollment will bring in approximately $1.1 billion in federal resources in the next biennium for our current investment in health care for this population.  The move reduces the projected shortfall in the Health Care Access Fund.” Source: January 20 press release, Office of the Governor

Unlike Medical Assistance or General Assistance Medical Care, which serve extremely low-income folks, MinnesotaCare caters more toward the working poor. To be eligible as a single adult, your income has to be at or below 250 percent of the federal poverty guidelines. That means you can’t make more than $2,257 a month (a limit that hasn’t been a problem on my income as a freelance journalist and part-time co-op cashier).

You can’t have more than $10,000 in assets to get on MinnesotaCare, though the state’s website says cars and homes often don’t count toward this limit. You also can’t be working for an employer who offers insurance and will pay half the cost. For most people, you have to have lived without any health insurance for four months — though thankfully, I qualified for an exception from this scary prospect.

These negatives are very minor, though, when compared to the program’s best points.

Reason why I love MinnesotaCare #1: affordable premiums

MinnesotaCare makes most enrollees pay a monthly premium, but it’s determined according to a very humane sliding scale. Living on the middle to upper reaches of the income limits, I’ve been paying just $46 a month.

Reason why I love MinnesotaCare #2: comprehensive coverage

When I’ve had insurance through private employers, I’ve often opted out of the dental or vision plans because they’re too damn expensive. Now I’m on the most basic MinnesotaCare plan — it’s called Basic Plus One — and I have access to complete medical, dental and vision care.

Reason why I love MinnesotaCare #3: doctor choice

Before I was on MinnesotaCare, I was able to see excellent diabetes specialists at Park Nicollet Clinic in St. Louis Park. Since I’ve been on MinnesotaCare, I’ve been able to keep seeing these doctors, as well as the wonderful family doctors from the Sheridan Clinic in Northeast Minneapolis.

And should I want to change doctors, or need a new specialist, there’s no shortage of options in the 648-page Member Handbook and Provider Directory sent to me by Medica.

Reason why I love MinnesotaCare #4: amazingly affordable co-pays

I couldn’t believe it only costs $3 to see a doctor under my plan, and $6 to make a visit to an urgent care facility at a hospital.

But the prescription co-pays are what completely blew me away.

• Without insurance, one month’s worth of Novolog insulin would have cost me $579.89 from my local Walgreens. With MinnesotaCare, I paid $3.

• Without insurance, one month’s worth of Accu-Chek blood testing strips would have cost me $389.97 from my local Walgreens. With MinnesotaCare, I paid nothing.

• Without insurance, three months’ worth of Medtronic insulin pump supplies would have cost me $2,138.70 from Edgepark Medical Supplies (making the monthly cost $712.90). With MinnesotaCare, I paid nothing, as you can see from my invoice below.

I’m not the only one who loves MinnesotaCare. Ken Johnson, a fine artist who lives in Minneapolis’ Longfellow neighborhood, lost his full-time wood finishing job, and the health insurance that came with it, about two years ago.

“I couldn’t get by without (MinnesotaCare),” said Johnson, who’s now looking for any full-time work he can get.

Johnson, 54, deals with depression and ADHD. He’s able to keep seeing his old specialists under his new plan, and he can afford his medications.

“I just can’t even believe it,” he said. “I just hope it continues.”

I’ll go a bit further and say I hope MinnesotaCare not only continues, but that it expands to help many more Minnesotans stay alive and well.

If this is what government-run health care looks like — affordable, comprehensive and high quality — then why were attempts to include a public option in the federal health care reform bill demonized? If our state can take care of the folks on MinnesotaCare so well, why not try to do the same for the rest of our country’s citizens?

I’m afraid I don’t have an answer.

But I do know this: Tomorrow I’ll wake up with enough insulin to balance my blood sugars, plenty of testing strips to check my levels and the ability to immediately go to the doctor if infection or illness hits.

Thank you, MinnesotaCare, for giving me another day of good health in our great state.

Interested in health care policy? Check out Session Daily’s article on the Republican proposal in the Minnesota legislature to move people off MinnesotaCare and onto private insurance.