Section 5: Public Health Insurance Programs

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Transcript Section 5: Public Health Insurance Programs

Chartbook Section 5
Public Health Insurance
Programs
Section 5: Public Health Insurance
Programs
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Medicare
Medical Assistance (Medicaid)
MinnesotaCare
General Assistance Medical Care (GAMC)
Minnesota Comprehensive Health Association
(MCHA)
A summary of the charts and graphs contained within is provided at Chartbook Summaries - Section 5.
Direct links are listed on each page. Please contact the Health Economics Program at 651 -201-3550 or
[email protected] if additional assistance is needed for accessing this information.
2
MEDICARE
A federal health insurance program for people age 65 or older and
people with certain disabilities and end-stage renal disease.
Data presented on a calendar year basis, unless otherwise specified
Medicare Enrollment and Spending, Minnesota
and the U.S., 2004 to 2014
Enrollment
Expenditures ($ millions)
Spending per Enrollee
Calendar Year
MN
U.S.
MN
U.S.
MN
U.S.
2004
685,842
40,784,276
$4,005
$311,108
$5,839
$7,628
2005
697,522
41,535,879
$4,569
$339,747
$6,551
$8,180
2006
713,242
42,335,590
$5,438
$403,675
$7,624
$9,535
2007
729,147
43,259,280
$5,777
$432,749
$7,923
$10,004
2008
749,065
44,384,954
$6,165
$466,967
$8,230
$10,521
2009
766,806
45,466,997
$6,564
$498,842
$8,560
$10,972
2010
786,154
47,702,632
$6,889
$520,530
$8,764
$10,912
2011
805,146
48,944,303
$7,158
$546,131
$8,891
$11,158
2012
835,756
50,828,094
$7,684
$569,177
$9,194
$11,198
2013
862,991
52,506,598
$7,990
$586,309
$9,258
$11,166
2014
888,371
54,095,565
$8,367
$618,706
$9,418
$11,437
Sources: Enrollment data are from the Medicare and Medicaid Statistical Supplement of the Centers for Medicare and Medicaid Services (CMS) as of July 1st
(2004-2009), and changed to calendar year from CMS Enrollment Dashboard (2010-2014); difference between data sources was marginal. U.S. expenditure
data are from the Personal Health Care estimates of the National Health Expenditure Accounts (NHEA) for 2004 to 2014. Minnesota expenditure estimates
are based on MDH annual spending report data for Medicare – public payer data (updated through 2014). All expenditures exclude out-of-pocket
expenditures (including member deductibles and cost-sharing).
4
Medicare Financing in the U.S., 2015
Transfers from States, 1.4%
Other, 0.8%
Payroll taxes, 37.4%
General revenue, 42.4%
Interest, 1.6%
Premiums, 13.3%
Taxation of benefits, 3.1%
Sources: 2016 Annual Report of The Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds, Table
II.B1, Medicare data for calendar year 2015.
Summary of graph
5
Minnesota Medicare Enrollment and Spending
Growth, 2004-2014
Percent growth over previous year
20%
15%
10%
5%
0%
2004
2005
2006
2007
Enrollment
2008
2009
1
Spending
2010
2011
2012
2013
2014
Spending Per Enrollee
Sources: Enrollment data are from the Medicare and Medicaid Statistical Supplement of the Centers for Medicare and Medicaid Services (CMS) as of July
1st (2004-2009), and changed to calendar year from CMS Enrollment Dashboard (2010-2014); difference between data sources was marginal. Minnesota
spending estimates are based on MDH annual spending report data for Medicare – public payer data and exclude out-of-pocket expenditures (updated
through 2014).
1Spending increase between 2005 and 2006 reflects the addition of the Medicare Prescription Drug Benefit (Part D).
Summary of graph
6
Minnesota Aged and Disabled Medicare
Beneficiaries, 2013
Disabled, 14.1%
Aged, 85.9% 1
Source: CMS, CMS Chronic Conditions Data Warehouse, Medicare Enrollment – MDCR Enroll AB7, calendar year 2013.
1Aged beneficiaries are people 65 and older. Disabled beneficiaries includes enrollees with disabilities that are under age 65 and those with End-Stage Renal
Disease-only. Categorization and data source changed since 2012 and is not directly comparable.
Summary of chart
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Minnesota Medicare Beneficiaries with Dual
Coverage, 2014
1
Dually Enrolled, 13.7%
Not Dually Enrolled, 86.3%
Sources: Enrollment data is from the CMS Enrollment Dashboard; dually enrolled is based on Minnesota Health Care Programs reporting from the
Minnesota Department of Human Services, data for calendar year 2014.
1Dually enrolled Medicare beneficiaries are individuals that qualify for Medicare and Medical Assistance (Medicaid).
Summary of chart
8
Minnesota’s Medicare Enrollment as Percent of
Population, by Region, 2014
25%
22.2%
20.2%
21.1%
20.9%
20%
19.7%
17.9%
17.3%
16.3%
15%
13.9%
10%
5%
0%
Northwest Northeast
West
Central
Central
Southwest
South
Central
Southeast Twin Cities Minnesota
Metro
Total
For the regional boundaries, see slide 47 at the end of this chartbook.
Sources: CMS, CMS Enrollment Dashboard 2014, calendar year; U.S. Census Bureau, Population Estimates for Minnesota Counties for July 1, 2014.
Summary of graph
9
Statewide Distribution of Medicare Enrollees, by
Region, 2014
Northwest, 4.5%
Northeast, 6.6%
West Central, 3.5%
Central, 13.5%
Metro, 54.1%
Southwest, 4.5%
South Central, 4.7%
Southeast, 8.5%
For the regional boundaries, see slide 47 at the end of this chartbook.
Sources: CMS, CMS Enrollment Dashboard 2014, calendar year; U.S. Census Bureau, Population Estimates for Minnesota Counties for July 1, 2014.
Summary of chart
10
Medicare Enrollment,
as of December 2014
Original Medicare, 47.3%
Medicare Cost and
Medicare Advantage, 52.7%
Source: CMS, Medicare Advantage Monthly Enrollment by State/County/Contract as of December 2014.
Medicare Advantage and Medicare Cost Plans cover Medicare hospital and provider benefits (Part A and Part B), and may cover Part D (drug). Original
Medicare is the traditional fee-for-service Medicare health care system. These do not include stand-alone Medicare Part D (drug) plans, or other Medicare
supplement plans. As this is a point in time estimate, results may differ from data reported on a calendar year basis.
Summary of graph
11
Medicare Private Plan Enrollment Trends,
as of December 2004 to 2014
60%
50%
40%
30%
20%
10%
0%
2004
2005
2006
2007
2008
2009
Minnesota
2010
2011
2012
2013
2014
U.S.
Source: CMS, Medicare and Medicaid Statistical Supplement (2002-2005); CMS, Medicare Advantage Monthly Enrollment by State/County/Contract as of
December (2006-2014). Private plans include Medicare Advantage and Medicare Cost Plans that cover Medicare hospital and provider benefits (Part A and
Part B), and may cover Part D (drug). It does not include stand-alone Medicare Part D (drug) plans, or other Medicare supplement plans.
Summary of graph
12
Minnesota Medicare Private Plan Enrollment in
Urban and Rural Counties, as of December 2014
60%
53.7%
52.7%
Urban
Statewide
50.5%
40%
20%
0%
Rural
Source: CMS, Medicare Advantage Monthly Enrollment by State/County/Contract Report as of December 2014. Private plans include Medicare Advantage
and Medicare Cost Plans that cover Medicare hospital and provider benefits (Part A and Part B), and may cover Part D (drug). It does not include standalone Medicare Part D (drug) plans, or other Medicare supplement plans.
Summary of graph
13
Distribution of Minnesota Medicare Private Plan
Enrollees by Region and Type of Plan, as of
December 2014
80%
32.0%
0.2%
0.1%
0.3%
100%
39.9%
37.6%
60.0%
62.2%
Urban
Statewide
60%
40%
67.7%
20%
0%
Rural
Medicare Cost
Local Medicare Advantage
PFFS
Source: CMS, Medicare Advantage Monthly Enrollment by State/County/Contract Report as of December 2014.
These plans cover Medicare hospital and provider benefits (Part A and Part B), and may cover Part D benefits (prescription drugs). These do not include
stand-alone Medicare Part D (drug) plans, or other Medicare supplement plans. Medicare Cost plans represented are 1876 Cost Plans, the local Medicare
Advantage plans represented are local Coordinated Care Plans (CCPs); PFFS refers to Private Fee For Service Plans. In 2014 there were no Regional
Medicare Advantage CCPs.
Summary of graph
14
Share of Medicare Private Plan Enrollment
Medicare Private Plan Types in Minnesota,
as of December 2010 and 2014
100%
0.2% (PFFS)
4.9%
14.4%
37.6%
80%
36.0%
60%
40%
62.2%
44.8%
20%
0%
2010
Medicare Cost
Local Medicare Advantage
2014
PFFS
Regional Medicare Advantage
Source: CMS, Medicare Advantage Monthly Enrollment by State/County/Contract, data as of December 2010 and 2014.
These plans cover Medicare hospital and provider benefits (Part A and Part B), and may cover Part D benefits (prescription drugs). These do not include
stand-alone Medicare Part D (drug) plans, or other Medicare supplement plans. Medicare Cost plans represented are 1876 Cost Plans, the local Medicare
Advantage plans represented are local Coordinated Care Plans (CCPs); PFFS refers to Private Fee For Service Plans. In 2014 there were no Regional Medicare
Advantage CCPs.
Summary of graph
15
Types of Prescription Drug Coverage for
Medicare Enrollees, 2014
50%
43.0% 44.2%
40%
30.8%
30%
26.0%
20%
11.6% 11.1%
10%
10.9%
13.7%
3.7% 5.0%
0%
Stand-Alone
Medicare Advantage
Prescription Drug
Plan
Employer Plan
Minnesota
Other Coverage
No Identified Source
of Creditable
Coverage
U.S.
Source: CMS, CMS Program Statistics 2014, calendar year. “Employer Plan” is defined as Medicare participants enrolled in a Retiree Drug Subsidy (RDS).
“Other Coverage” is defined as Medicare participants without a Part D plan or RDS. “No Identified Source of Creditable Coverage” is defined as Medicare
participants without a Part D plan, RDS, or creditable coverage (defined as coverage that meets or exceeds the actuarial value of the standard Medicare Part
D benefit).
Summary of graph
16
MEDICAL ASSISTANCE (MA)
Minnesota’s Medicaid program – jointly financed by the state and the
federal government – provides health insurance to people with lowincomes and people with disabilities. In 2014, under the Affordable Care
Act (ACA), Medical Assistance eligibility was increased to all childless
adults, parents and caretakers, and children (aged 19 to 20) with incomes
at or below 133 percent of Federal Poverty Guidelines (FPG), and children
(aged 2 to 18) with incomes at or below 275 percent of FPG.
Data presented on a state fiscal year (SFY) basis, unless otherwise specified
Medical Assistance Enrollment and Spending,
2006 to 2016
State
Fiscal Year
Avg.
Monthly
Enrollment
Spending
($ millions)
Avg.
Monthly
Spending
per Enrollee
2006
498,406
$5,452
2007
510,155
2008
Growth in:
Enrollment
Total
Spending
Spending
per Enrollee
$911
3.2%
4.9%
1.6%
$5,858
$957
2.4%
7.5%
5.0%
527,001
$6,277
$993
3.3%
7.2%
3.7%
2009
557,337
$6,779
$1,014
5.8%
8.0%
2.1%
2010
608,651
$7,236
$991
9.2%
6.7%
-2.3%
2011
665,483
$7,530
$943
9.3%
4.1%
-4.8%
2012
727,390
$8,241
$944
9.3%
9.4%
0.1%
2013
739,158
$8,046
$907
1.6%
-2.4%
-3.9%
2014
838,256
$9,265
$921
13.4%
15.2%
1.5%
2015
1,049,819
$10,461
$830
25.2%
12.9%
-9.8%
2016
1,079,407
$11,192
$864
2.8%
7.0%
4.1%
Source: Minnesota Department of Human Services, November 2016 Expenditure Forecast, data for state fiscal years.
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Medical Assistance Enrollment and Spending
Growth, 2006 to 2016
Percent growth over previous year
30%
25%
20%
15%
10%
5%
0%
-5%
-10%
2006
2007
2008
Enrollment
2009
2010
2011
2012
State Fiscal Year
Total Spending
2013
2014
2015
2016
Spending per Enrollee
Source: Minnesota Department of Human Services, November 2016 Expenditure Forecast, data for state fiscal years.
Summary of graph
19
Medical Assistance Enrollees as Percent of
Population, by Region, Calendar Year 2015
30%
23.5%
22.3%
21.6%
19.6%
20%
19.4%
17.5%
18.2%
19.3%
19.5%
10%
0%
Northwest Northeast
West
Central
Central
Southwest
South
Central
Southeast Twin Cities Statewide
Metro
For the regional boundaries, see slide 47 at the end of this chartbook.
Source: Minnesota Department of Human Services, enrollment data for calendar year 2015; U.S. Census Bureau, population estimates of Minnesota
counties for July 1, 2015. Enrollment excludes “other” with no known category.
Summary of graph
20
Statewide Distribution of Medical Assistance
Enrollees, by Region, Calendar Year 2015
Northwest, 4.5%
Northeast, 6.6%
West Central, 3.5%
Central, 13.5%
Twin Cities Metro, 54.1%
Southwest, 4.5%
South Central, 4.7%
Southeast, 8.5%
For the regional boundaries, see slide 47 at the end of this chartbook. Source: Minnesota Department of Human Services, enrollment data for calendar year
2015. Enrollment excludes “other” with no known category.
Summary of chart
21
22
Medical Assistance Enrollment by Eligibility
Category, 2006, 2011, and 2016
1,200,000
1,000,000
209,000
800,000
180,000
28,000
600,000
174,000
400,000
150,000
200,000
348,000
690,000
463,000
2006
Families with Children
2011
State Fiscal Year
Aged/Disabled
2016
1
Childless Adults
Source: Minnesota Department of Human Services, November 2016 Expenditure Forecast, data for state fiscal years based on similar eligibility categories as
of 2016.
1Prior to 2011, childless adults who did not have a disability were not eligible for Medical Assistance. In 2011, Medical Assistance was expanded to include
childless adults with incomes at or below 75 percent of the Federal Poverty Guidelines (FPG); in 2014, Medical Assistance was expanded to include childless
adults, parents and caretakers, and children (aged 19 to 20) with incomes up to 133 percent of the FPG, and children (aged 2 to 18) up to 275 percent of the
FPG.
Summary of graph
22
23
Medical Assistance Spending by Eligibility
Category, Calendar Year 2015
100%
17.0%
19.2%
80%
5.4%
16.7%
11.1%
60%
39.7%
40%
64.3%
20%
26.6%
0%
Eligibility
Families with Children
Spending
Disabled
Source: Minnesota Department of Human Services, data for calendar year 2015.
Summary of graph
Elderly
Childless Adults
23
24
Actual and Projected Cumulative Changes in
Medical Assistance Spending and Eligibility,
2010 - 2021
120%
104.2%
Projected
Actual
100%
80%
88.9%
81.5%
79.3%
72.5%
78.8%
60%
54.6%
40%
21.4%
20%
44.6%
9.3%
Eligibility
11.2%
0%
2010
4.1%
2011
2012
2013
2014 2015 2016 2017
State Fiscal Year
2018
2019
Spending
2020
2021
Sources: Minnesota Department of Human Services, November 2016 Expenditure Forecast, data for state fiscal years. Actual spending for fiscal years 2010
through 2016. Projected spending for 2017 through 2021.
In 2014, Medical Assistance was expanded to include childless adults, parents and caretakers, and children (aged 19 to 20) with incomes up to 133 percent
of the Federal Poverty Guidelines (FPG), and children (aged 2 to 18) up to 275 percent of the FPG, in accordance with the Medicaid Expansion in the
Affordable Care Act.
Summary of graph
24
25
Medical Assistance Funding
by Source of Funds
100%
80%
1.4%
1.6%
1.7%
1.5%
2.0%
48.6%
48.2%
45.4%
41.7%
40.5%
50.0%
50.2%
52.9%
56.8%
57.6%
2012
2013
2014
State Fiscal Year
2015
2016
60%
40%
20%
0%
Federal1
State
County
Sources: Minnesota Department of Human Services, November 2016 Expenditure Forecast, data for state fiscal years. Includes state Chemical Dependency
(CD) fund share, state medical education share, state chemical dependency fund, state medical education share, and CHIP enhanced.
1Under the Affordable Care Act, the Federal Government will cover 100 percent of the costs of newly eligible enrollees from the Medicaid Expansion for
calendar years 2014-2016, and 90 percent after 2016.
Summary of graph
25
MINNESOTACARE
A sliding-fee-scale Minnesota health insurance program - financed
by state funds, federal funds, and enrollee premiums - for low
income Minnesotans who are not offered insurance through their
employer which meets certain criteria. In 2015, MinnesotaCare was
converted to a Basic Health Plan (BHP) under the ACA, which
expanded benefits and reduced the maximum income requirements
to 200 percent of Federal Poverty Guidelines (FPG).
Data presented on a state fiscal year (SFY) basis, unless otherwise specified
27
MinnesotaCare Enrollment and Spending History,
2006 to 2016
State
Fiscal Year
Avg.
Monthly
Enrollment
Spending
($ millions)
Avg.
Monthly
Spending
per Enrollee
2006
128,727
$438
2007
117,893
2008
Growth in:
Enrollment
Total
Spending
Spending
per Enrollee
$283
-9.2%
7.1%
18.0%
$434
$307
-8.4%
-0.8%
8.3%
114,350
$463
$337
-3.0%
6.6%
9.9%
2009
117,704
$527
$373
2.9%
13.8%
10.5%
2010
131,784
$665
$421
12.0%
26.4%
12.9%
2011
148,152
$738
$415
12.4%
10.9%
-1.4%
2012
128,729
$551
$357
-13.1%
-25.3%
-14.1%
2013
124,681
$570
$381
-3.1%
3.4%
6.8%
2014
101,646
$520
$426
-18.5%
-8.8%
11.9%
2015
91,105
$510
$466
-10.4%
-2.0%
9.4%
2016
115,197
$480
$347
26.4%
-5.8%
-25.5%
Source: Minnesota Department of Human Services, November 2016 Expenditure Forecast, data for state fiscal years.
27
28
MinnesotaCare Enrollment and Spending
Growth, 2006 to 2016
Percent growth over previous year
30%
20%
10%
0%
-10%
-20%
-30%
2006
2007
2008
Enrollment
2009
1
2010
2011
2012
State Fiscal Year
Total Spending
2013
2014
2015
2016
Spending per Enrollee
Source: Minnesota Department of Human Services, November 2016 Expenditure Forecast, data for state fiscal years.
1Enrollment and spending declines after 2010 reflect that some MinnesotaCare enrollees qualified for Medical Assistance (MA) following the March 2011
MA eligibility expansion to include childless adults with incomes at or below 75 percent of the Federal Poverty Guidelines (FPG).
Summary of graph
28
29
MinnesotaCare Enrollees as Percent of
Population, by Region, Calendar Year 2015
3%
2.3%
2.1%
2.0%
2.2%
2.1%
2.0%
2%
1.8%
2.1%
1.7%
1%
0%
Northwest Northeast
West
Central
Central
Southwest
South
Central
Southeast Twin Cities Statewide
Metro
For the regional boundaries, see slide 47 at the end of this chartbook.
Source: Minnesota Department of Human Services, enrollment data for calendar year 2015; U.S. Census Bureau, population estimates of Minnesota
counties for July 1, 2015. Enrollment excludes “other” with no known category.
Summary of graph
29
30
Statewide Distribution of MinnesotaCare
Enrollees, by Region, Calendar Year 2015
Northwest, 3.8%
Northeast, 6.6%
West Central, 3.5%
Central, 14.2%
Twin Cities Metro, 55.6%
Southwest, 4.0%
South Central, 4.7%
Southeast, 7.8%
For the regional boundaries, see slide 47 at the end of this chartbook.
Sources: Minnesota Department of Human Services, enrollment data for calendar year 2015. Enrollment excludes “other” with no known category.
Summary of chart
30
31
MinnesotaCare Enrollment by Eligibility Category,
2006 to 2016
State
Fiscal Year
Average Monthly
Enrollment
Parents
and Children
Childless Adults
2006
128,727
98,858
29,869
2007
117,893
83,876
34,017
2008
114,350
73,211
41,139
2009
117,704
70,051
47,654
2010
131,784
71,165
60,619
2011
148,152
85,486
62,667
2012
128,729
86,106
42,623
2013
124,681
86,604
38,077
2014
101,646
62,398
39,249
2015
91,105
39,135
51,970
2016
115,197
53,456
61,742
Source: Minnesota Department of Human Services, November 2016 Expenditure Forecast, data for state fiscal years. Data for legal non-citizens not
available prior to 2012 and are included within childless adults.
31
32
MinnesotaCare Enrollment by Eligibility Category,
2006 to 2016
100%
80%
60%
40%
20%
0%
2006
2007
2008
2009
2010
2011
2012
State Fiscal Year
Parents and Children
2013
2014
2015
2016
Childless Adults
Source: Minnesota Department of Human Services, November 2016 Expenditure Forecast, data for state fiscal years. Data for legal non-citizens not
available prior to 2012 and are included within childless adults.
Summary of graph
32
33
MinnesotaCare Funding by Source
100%
8.2%
5.7%
6.2%
26.3%
80%
34.4%
60%
69.8%
40%
68.0%
57.5%
20%
23.9%
0%
2006
State Appropriations
2011
State Fiscal Year
Federal Appropriations
2016
Premiums
Source: Minnesota Department of Human Services, November 2016 Expenditure Forecast, data for state fiscal years. SFY 2016 Federal Appropriations
includes Federal Basic Health Program (BHP) Funding.
Summary of graph
33
GENERAL ASSISTANCE
MEDICAL CARE (GAMC)
A state health insurance program that was for low-income adults,
ages 21 to 64, who did not have dependent children under 18 and
who did not qualify for other federal health care programs. It was
replaced by demonstration projects, a temporary uncompensated
care pool, and fully replaced by Medicaid expansion under the ACA
in March 2011.
Data presented on a state fiscal year (SFY) basis, unless otherwise specified
35
General Assistance Medical Care Enrollment and
Spending History, 2002 to 2012
State
Fiscal Year1
Avg.
Monthly
Enrollment
Spending
($ millions)
Avg.
Monthly
Spending
per Enrollee
2002
29,886
$182
2003
37,340
2004
Growth in:
Enrollment
Total
Spending
Spending
per Enrollee
$508
21.5%
35.3%
11.3%
$248
$553
24.9%
36.1%
8.9%
34,957
$246
$586
-6.4%
-1.0%
5.8%
2005
36,797
$237
$536
5.3%
-3.7%
-8.5%
2006
39,199
$289
$614
6.5%
22.1%
14.6%
2007
33,824
$281
$692
-13.7%
-2.7%
12.8%
2008
28,853
$263
$759
-14.7%
-6.5%
9.6%
2009
31,964
$288
$751
10.8%
9.6%
-1.0%
2010
27,386
$296
$901
-14.3%
2.8%
20.0%
2011
19,540
$76
$325
-28.6%
-74.2%
-63.9%
2012
0
$2
--
--
-97.2%
--
Source: Minnesota Department of Human Services, enrollment, 2002-2009 from February 2010 Expenditure Forecast and 2010-2011 from February 2012
Expenditure Forecast, data for state fiscal years.
12010 and 2011 spending includes old GAMC program payments, Coordinated Care Delivery System (CCDS) block grants, uncompensated care pool
payments, and pharmacy benefit payments. GAMC enrollees eligible for Medical Assistance expansion were converted March 2011. 2012 includes only old
GAMC program payments.
35
36
General Assistance Medical Care Enrollment and
Spending Growth, 2002 to 2011
Percent growth over previous year
60%
40%
20%
0%
-20%
-40%
-60%
-80%
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
State Fiscal Year
Enrollment
Spending
Spending Per Enrollee
Source: Minnesota Department of Human Services, enrollment, 2002-2009 from February 2010 Expenditure Forecast and 2010-2011 from February 2012
Expenditure Forecast, data for state fiscal years.
Summary of graph
36
37
General Assistance Medical Care Enrollees as
Percent of Population, by Region,
1.0%
Calendar Year 2010
0.8%
0.7%
0.6%
0.6%
0.6%
0.5%
0.4%
0.3%
0.3%
0.3%
0.3%
West
Central
Central
Southwest
South
Central
0.3%
0.2%
0.0%
Northwest Northeast
Southeast Twin Cities Statewide
Metro
For the regional boundaries, see slide 47 at the end of this chartbook.
Sources: Minnesota Department of Human Services, enrollment data for calendar year 2010; U.S. Census Bureau, population estimates of Minnesota
counties for July 1, 2010.
Summary of graph
37
38
Statewide Distribution of General Assistance
Medical Care Enrollees, by Region,
Calendar Year 2010
Northwest, 4.5%
Northeast, 6.9%
West Central, 1.8%
Central, 6.7%
Southwest, 2.1%
South Central, 2.5%
Twin Cities Metro, 70.8%
For the regional boundaries, see slide 47 at the end of this chartbook.
Sources: Minnesota Department of Human Services, enrollment data for calendar year 2010.
Summary of chart
Southeast, 4.7%
38
MINNESOTA COMPREHENSIVE
HEALTH ASSOCIATION (MCHA)
High-risk pool that offers health insurance to Minnesotans who are
turned down in the private market due to pre-existing conditions.
In March 2013, the Minnesota Legislature adopted legislation to
phase out MCHA and create a state-based health insurance
exchange, MNsure. MCHA stopped accepting new enrollees in
January 2014. Former MCHA enrollees that do not qualify for
Medical Assistance or MinnesotaCare may purchase private
insurance on MNsure.
Data presented on a calendar year basis, unless otherwise specified
40
MCHA Enrollment and Spending History,
2004 to 2014
Estimated
Monthly
Enrollment
Avg.
Monthly
Premiums
Avg.
Monthly
Claims per
Enrollee
2004
32,959
$264
2005
31,049
2006
Calendar Year
Growth in:
Enrollment
Premium
per Enrollee
Claims per
Enrollee
$448
4.6%
9.9%
-0.5%
$291
$557
-5.7%
10.1%
24.2%
29,089
$322
$610
-7.4%
10.9%
9.5%
2007
28,859
$326
$653
-1.1%
1.2%
7.1%
2008
27,386
$347
$735
-4.0%
6.5%
12.6%
2009
27,187
$370
$753
-2.5%
6.4%
2.4%
2010
27,073
$397
$807
-1.1%
7.3%
7.2%
2011
26,859
$408
$878
0.0%
2.7%
8.7%
2012
25,815
$411
$923
-3.1%
0.8%
5.2%
2013
24,155
$403
$978
-3.3%
-2.0%
5.9%
2014
8,454
$371
$1,383
-66.7%
-7.9%
41.5%
Source: Minnesota Comprehensive Health Association. Monthly enrollment estimated by MDH average of end of year enrollment figures for 2004-2013.
Enrollment for 2014 is based off of average calendar year member months; claims per enrollee in 2014 may include costs incurred in 2013. 2015 run-out
and reversals are not included.
40
41
MCHA Enrollment and Spending Growth,
Calendar Year 2004 to 2014
60%
Percent growth over previous year
40%
20%
0%
-20%
-40%
-60%
-80%
2004
2005
2006
Enrollment
2007
2008
2009
Premiums per Enrollee
2010
2011
2012
2013
2014
Claims per Enrollee
Source: Minnesota Comprehensive Health Association. Enrollment for 2014 is based off of average calendar year member months; claims per enrollee in
2014 may include costs incurred in 2013.
Summary of graph
41
42
MCHA Claims, Premiums, and Losses from
Operations, Calendar Year 2004 to 2014
Calendar Year
Claims
($ millions)
Premiums
($ millions)
Losses from
Operations
($ millions)
Premiums as
% of Claims
2004
$182
$107
$104
58.9%
2005
$214
$111
$110
52.2%
2006
$217
$114
$109
52.9%
2007
$229
$115
$122
50.0%
2008
$248
$117
$139
47.2%
2009
$248
$122
$133
49.1%
2010
$262
$129
$139
49.1%
2011
$285
$133
$159
46.4%
2012
$291
$129
$167
44.5%
2013
$298
$122
$181
41.1%
2014
$140
$38
$104
26.8%
Source: Minnesota Comprehensive Health Association (MCHA). Administration fees, pharmacy rebates, and 2015 run-out and reversals are not
included.
42
43
MCHA Enrollees as Percent of Population by
Region, as of December 2014
0.4%
0.19%
0.20%
0.2%
0.15%
0.14%
0.14%
0.11%
0.11%
0.09%
0.09%
0.0%
Northwest Northeast
West
Central
Central Southwest
South
Central
Southeast Twin Cities Statewide
Metro
For regional boundaries, please see slide 47 at the end of this chartbook.
Source: Minnesota Comprehensive Health Association (MCHA), enrollment by county as of December 1, 2014; U.S. Census Bureau, population estimates
for Minnesota counties as of July 1, 2014.
Summary of graph
43
44
Statewide Distribution of MCHA Enrollees, by
Region, as of December 2014
Northwest, 4.8%
Northeast, 4.7%
West Central, 4.4%
Central, 12.6%
Twin Cities Metro, 44.9%
Southwest, 6.9%
South Central, 6.5%
Southeast, 15.1%
For regional boundaries, please see slide 47 at the end of this chartbook.
Source: Minnesota Comprehensive Health Association (MCHA), enrollment by county as of December 1, 2014.
Summary of chart
44
45
Age Distribution of MCHA Enrollees, as of
December 2014
Ages 0-19, 10.3%
Ages 60+, 24.3%
Ages 20-39, 17.8%
Ages 40-59, 47.6%
Source: Minnesota Comprehensive Health Association (MCHA), age distribution as of December 1, 2014.
Summary of chart
45
Additional Information from the Health
Economics Program Available Online

Health Economics Program Home Page


Publications


Health Economics Program Home Page
Health Economics Program Publications
Health Care Market Statistics (Presentation Slide Decks)

Health Economics Program Chartbook Homepage
A summary of the charts and graphs contained within is provided at Chartbook
Summaries – Section 5. Direct links are listed on each page. Please contact the Health
Economics Program at 651-201-3550 or [email protected] if additional assistance
is needed for accessing this information.
Appendix: Minnesota Counties and Regions Used
in the Geographic Analysis
47
Summary of image