Elizabeth Stawicki, Minnesota Public Radio News, Author at �鶹Ů�� Health News

Taking A New Tack To Persuade ‘Young Invincibles’ To Buy Health Insurance

Elizabeth Stawicki, Minnesota Public Radio News — Mon, 19 Aug 2013 11:30:00 +0000

MINNEAPOLIS, Minn. — Robert Bauer is young, lean and healthy – just the kind of person the government wants to buy into its new online health insurance marketplaces.

Bauer doesn’t see the need. The 24 year old, a 2011 graduate of the University of Minnesota, works in organic farm fields three days a week, and prides himself on eating well. He’s uninsured – health covereage just hasn’t been part of his lifestyle.

Robert Bauer, 24, shows off the small garden he tends in front of his house in Minneapolis (Photo by Elizabeth Stawicki/MPR)

“I just don’t think it’s worth the money for me to get health insurance at this point,” he said.

He hopes that if he got seriously ill or had an accident his family would have the resources to help or “maybe I’d just lose my life,and that would be OK, just so other people wouldn’t have to live the rest of their lives in poverty or bankruptcy.”

While Bauer generally doesn’t fear a health crisis, the people building insurance exchanges worry about Bauer and the millions of other healthy Americans whom they fear may simply opt out. The marketplaces are a key part of federal Affordable Care Act, also known as Obamacare. Younger, low-risk people are needed to offset the costs of covering older, sicker Americans.

“It’s important for everybody to participate all of the time and to pay an average amount in premiums so that when something happens to one of us — we have a baby, we get cancer… that will require thousands of dollars of care, the money is there in the pool,” said Karen Pollitz of the nonpartisan Kaiser Family Foundation and a former Obama administration official. (Kaiser Health News is an editorially independent program of the foundation.)

The law requires Americans obtain health insurance or pay a penalty beginning in 2014. But some young people might just pay the penalty, which in the first year isn’t much, the greater of $95 or 1 percent of income. rises to $695 or 2.5 percent in 2016. While the ACA allows children to stay on their parents’ policy until age 26, that doesn’t help young people such as Bauer, because his mother is uninsured and his father is on disability. And, Pollitz notes, younger people are “systematically uninsured.”

“We boot them off,” Pollitz said. “We kick them out of Medicaid, (or) their parents’ health insurance coverage just when they’re starting off, just when they’re not earning much and the odds are pretty low that they’re going to get that first great new job with new benefits.”

Young people aren’t against being insured. A found that about three quarters of 18-30 year olds believe having insurance is something they need and is important to have. The top reason younger people didn’t have it: too expensive. But the law does provide subsidies for people earning up to 400 percent of the federal poverty line, $46,000 for a single person or $94,000 for a family of four. And, officials and advocacy groups are searching for ways to lure younger people in.

“What really appeals to that younger age group is both affordability — they feel they just can’t afford it — and also communicating the value of insurance and how valuable it is to have that insurance and why you need,” according to April Todd-Malmlov, the executive director of MNsure, Minnesota’s online insurance marketplace. Minnesota is one of the that’s building its own exchange.

Todd-Malmlov said Minnesota will target young adults in two ways — in the social media they use, such as Twitter and Facebook, and the messages themselves.

Massachusetts found that out the value of targeted messages. The Bay State’s 2007 law requires residents to obtain health care coverage or pay a fine, just like the federal law.

Looking to reach a wider audience, the state partnered with the Boston Red Sox and its New England Sports Network to encourage residents who lacked insurance to sign up through its online insurance marketplace, the Connector, Massachusetts’ version of MNsure, which will launch Oct 1.

Fans at Fenway Park were a captive audience for ads touting the Connector on the Jumbotron or articles tucked inside game day programs. The public relations pitch stumbled at first as the public reacted poorly to TV ads featuring baseball players.

Uninsured people “didn’t want anyone who had insurance and was making a good salary to sort of lecture them. It came off as ‘you better do this,'” said Tara Murphy of the public relations firm Weber Shandwick, which devised the Massachusetts campaign.

The campaign switched gears. The Red Sox still provided the platform but the messages came instead from young people who’d suffered serious illnesses or crashes and others who were able to find affordable coverage on the state’s new marketplace. TV ads featured a young woman sitting in a green stadium seat at Fenway talking about her life following a breast cancer diagnosis.

Minnesota officials have been talking with its pro teams, including the Twins, Timberwolves, Vikings and the Lynx to encourage residents to sign up for coverage, borrowing a page from the Massachusetts playbook.

And, just yesterday, that Paul Bunyan and Babe the Blue Ox will be the faces of the exchange.

The state is contracting with BBDO Proximity Minneapolis for roughly $9 million marketing campaign. At the campaign’s launch Sunday, BBDO creative director Brian Kroening said he wanted the advertising to be easy to understand, local, and upbeat.

“Because this is in fact great news for those that are uninsured. We liked Paul and Babe because everybody seems to recognize them. They were easy to work with. We were looking for what was unique to Minnesota,” Kroening said.

Billboards with Bunyan and Babe’s images are going up, along with MNsure advertising on buses and in skyways and newspapers. The campaign’s motto will be “The Land of 10,000 Reasons to get Health Insurance.”

Meanwhile, Robert Bauer may get health coverage after all. Starting next week, he’ll be attending graduate school at Virginia Tech to study plant and soil science where, he says, insurance will cost him $200 a year in out of pocket costs. That’s only about $100 more than the penalty he would have to pay if he chose not to get insurance.

MPR reporter contributed to this story, which is part of a collaboration that includes Kaiser Health News, , and .

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Minnesota Facing Bigger Bill For State’s Health Insurance Exchange

Elizabeth Stawicki, Minnesota Public Radio News — Sun, 25 Nov 2012 19:15:38 +0000

This story is part of a reporting partnership that includes ,�� and Kaiser Health News.

ST. PAUL, Minn. — Minnesota’s state health insurance exchange will cost $54 million in 2015 to operate, according to the Gov. Mark Dayton administration.

The cost comes in at greater than earlier estimates of $30 to $40 million. The state would not have to find the money until 2015, when the state exchanges are required to be financially self-sustaining. But the cost rises to a projected $64 million in 2016. State officials are still weighing how the exchange will pay for itself. Options include user fees, a sin tax, and selling ads.

The exchange, a cornerstone of the federal health care overhaul, will create an insurance marketplace where consumers and small businesses can comparison shop for health insurance policies starting in October of next year. Coverage would take effect in 2014.

The Dayton administration also announced it will seek an additional $39 million to fund development of the state’s exchange. If the federal government approve the additional grant, Minnesota will have received a total of about $110 million from the feds.

The new financial details emerged earlier this month when the state submitted to the federal government.

Many states are behind in their plans for exchanges, and the Obama administration has already agreed to a request by Republican governors for more time to decide whether they’ll build their own state exchange or use the federal alternative. The federal government extended that deadline to Dec. 14.

This story is part of a reporting partnership that includes ,�� and Kaiser Health News.

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Hospital Debt Collector Settles Minnesota Case For $2.5 Million

Elizabeth Stawicki, Minnesota Public Radio News — Tue, 31 Jul 2012 09:13:00 +0000

This story is part of a reporting partnership that includes ,�� and Kaiser Health News.

Accretive Health, the former bill collector for Fairview Health Service in Minnesota, has agreed to pay a $2.5 million fine and leave the state as part of a settlement of a federal lawsuit brought by state Attorney General Lori Swanson.

Minn. Attorney General Lori Swanson speaks about the state’s lawsuit against Accretive Health (Photo by Elizabeth Stawicki/MPR).

A federal judge approved the settlement late Monday. The case against Chicago-based Accretive attracted national attention with allegations of repeated privacy breaches and abusive collection tactics, such as approaching patients in emergency rooms for payment.

Swanson, who filed the lawsuit in January, says justice was served.

“A hospital emergency rooms is a high stress place — of trauma, of suffering,” Swanson said in a press conference. “It should be a solemn place, not a place to shake down patients for money. It’s good to close the door for Minnesota on this really disturbing chapter in our health care history.”

Even though Accretive signed on to the settlement, the company shot back in what has been a fiery war of words.

“The attorney general rebuffed us and bushwacked us; told us she would meet with us,” Accretive attorney Joe Anthony said. “We turned over 100,000 documents to her in the spirit of cooperation. And then what she did was she made them publicly available. That’s just not the kind of straightforward behavior that Minnesotans expect from their attorney general. And that’s what happened to us. In this environment, who wants to do business here?”

The settlement requires Accretive to do several things:

create a patient restitution fund of nearly $2.5 million, with any funds remaining going to the state treasury;
hand over all data about Minnesota patients treated at Twin Cities hospitals that contracted with Accretive;
wind down operations in Minnesota by November and stay away for six years unless the attorney general approves.

Accretive has maintained that Swanson’s actions cost more than 100 Minnesota jobs. But Swanson called that “an absurd comment” saying that Accretive tells investors it makes money by outsourcing jobs to India.

Swanson alleged Accretive was lax about securing sensitive patient information. She said a laptop containing more than 23,000 Fairview and North Memorial patient information records was stolen out of an Accretive employee’s rental car.

The settlement comes at a time when Congress and the Obama administration have beefed up medical privacy laws and enforcement of those provisions.

In 2009, Congress gave state attorneys general such as Swanson the power to sue over violations of federal privacy protections. The federal Department of Health and Human Services has even the state prosecutors.

Accretive ran afoul of another provision of federal privacy laws. Lawmakers expanded responsibility for medical privacy from hospitals and health plans to their subcontractors like Accretive. University of Minnesota law professor Bill McGeveran says that’s a huge change.

“It makes those kinds of subcontractors directly responsible to follow the rules themselves,” McGeveran says. “Now they’re needing to answer not just to their clients, like the hospitals that hire them, but to the government about privacy and security arrangements.”

Swanson alleged that Accretive and North Memorial Hospital shared patient data for six months without a legally required agreement on securing data and then created a backdated one to cover the omission.

The Obama Administration has also stepped up enforcement of medical privacy laws, according to Washington D.C. attorney Arianne Callender.

Callender was a senior lawyer in the Office of Inspector General to the U.S. Department of Health and Human Services. She says about a year ago, the agency’s internal watchdog issued a on the department’s lax enforcement of patient privacy laws.

“They’re under a microscope right now,” Callender said. “So I think that’s why we’re seeing more privacy breach settlements and cases coming down the pike.”

Last month,�� to pay a $1.7 million fine and to establish a three-year corrective action plan when a USB hard drive “potentially containing electronic protected health information” was stolen out of an employee’s car.

In that case, the office of civil rights found Alaska lacked adequate policies and procedures to safeguard patient information. But Alaska’s Health and Social Services commissioner and said the state admitted no liability but that the settlement and cap was a way to “avoid costly and protracted litigation.”

Three other medical centers or insurers have recently paid fines approaching or exceeding $1 million, as well. In March, BlueCross BlueShield of Tennessee the U.S. Department of Health and Human Services $1.5 million to settle violations, after 57 unencrypted computer hard drives were stolen from a leased facility in Tennessee. The drives contained the protected health information of more than 1 million individuals.

Other government settlements for violating patient privacy laws include:

, which agreed to pay $865,000 in 2011, after unauthorized employees viewed electronic medical records of celebrities;
for $1 million, after an employee left 192 patient medical files on a subway train. Those files were never recovered.

Efthimios Parasidis, a health law professor at St. Louis University says the privacy regulations are far from detailed and many are waiting for official guidance from HHS. But he says Minnesota’s case against Accretive was not premature.

“We’ve learned from other areas of government regulation and other agencies, guidance can take decades to come down,” Parasidis said. “And if we wait for guidance. We’re going to be living in a world where patients aren’t having the protection that the law actually provides them.”

This story is part of a reporting partnership that includes Minnesota Public Radio News, NPR and Kaiser Health News.

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