As Minnesotans prepare to embrace the Affordable Care Act, commonly called Obamacare, Koochiching County officials Tuesday expressed concern and frustration about health care coverage.
Nearly all U.S. residents will be required to have health insurance when coverage begins Jan. 1. MNsure, the state’s version of President Barack Obama’s health care law, opens for enrollment Tuesday.
Qualifying residents who are currently enrolled in or will apply for medical assistance through the county will no longer have three providers from which to choose for a health insurance plan. Instead, they will be required to be serviced by UCare, a company that until July, was not used by the county because of access issues.
“UCare is not going to work in our county,” said Terry Murray, director of the county’s Community Services Department.
County commissioners agreed to send a letter to Lucinda Jesson, commissioner of the Minnesota Department of Human Services, Gov. Mark Dayton and local lawmakers in an effort to establish another provider to service the county’s medical assistance clients.
Murray was unsure whether the letter would do any good after he was told it was too late to reverse the decision.
“I don’t want to get client’s hopes up,” he said of the letter. “But if there is even a 1 percent chance it will help, I think it is worth a try.”
In August, Murray informed the board that the Minnesota Department of Human Services would not be asking Medica and Blue Plus, the county’s current health care providers, to supply coverage for Koochiching County clients. Murray explained UCare is the least used plan by the county’s medical assistance clients because of transportation issues. During the August meeting, Murray said he would wait for more information from the state on the issue.
“I’ve got some bad news,” Murray said at the beginning of his update Tuesday.
The director said Koochiching, along with other counties impacted by the state’s decision, submitted an appeal to get at least two plans to provide service to their areas. However, Murray learned it was the department’s plan to only have one provider service smaller counties.
“A philosophy (of the department) before made pretty clear to us we were supposed try to give the clients as much choice as possible,” Murray said.
In July, the board agreed to allow UCare, a nonprofit health plan providing health coverage and services to more than 300,000 members in Minnesota and western Wisconsin, to provide health care services to recipients of medical assistance in Koochiching County.
However, Murray said Tuesday had he known UCare would end up being the only provider serving the county, he “wouldn’t have even picked UCare.”
“Medica does a good job up here, Blue Plus does a pretty good job, UCare fails in a lot of the areas,” Murray said. “You’d think Medica (would have been selected).”
During a conference call in response to the appeal, Murray asked Human Service Department officials if surveys had been distributed to county medical assistance consumers. He said after being told the department doesn’t do that, he explained to officials that had surveys been given, it would have been discovered that there are only 50 clients in the county who use UCare because of the access issue.
“If you have to travel over 30 miles to see a specialist, (UCare) won’t pay for it,” Murray said. “We have to call and ask for special authorization to do it every time.”
In addition, Murray said there are medical facilities in the area that don’t accept UCare.
“Trying to get UCare to reimburse us (is difficult),” he said. “That is why their rates are so low because it is almost impossible to get paid from them.”
County Commissioner Wade Pavleck echoed Murray’s concerns.
“This county board over the years has traditionally felt that we need to give clients choice,” he said, adding that having one provider eliminates competition.
“Here we are in the far regions of Minnesota with these huge distances to travel and we’re being discriminated against...at least that is my belief,” he said. “I don’t think we say this is over and we just take this...This should not stand.”
Murray said during the conference call he told officials “they failed miserably” and is already anticipating a flood of complaints.
“I’m not the middle man anymore,” Murray said. “I don’t like telling people there’s nothing I can do. Dealing with this is going to be a nightmare.”
Pavleck said the letter drafted by the county will invite health department officials and local lawmakers to the area to “express extreme displeasure over what they’ve done.”
“We don’t need to buy that it’s too late,” he said. “What they’ve done here is so wrong. This is a big issue for northern Minnesota.”
