Paul Fleissner: Olmsted County prepares to implement health care reform

Health-care reform is streamlining health insurance access and improving coverage for many Americans. Olmsted County will continue to serve as a gateway for residents to access publicly subsidized health insurance programs through Medicaid funding.

To improve customer service and maximize efficient use of resources, the county is working to automate and streamline these services, scheduled to open on Oct. 1.

What are the ACA and MnSure?

The Affordable Care Act contains a variety of health-care reform policies, including a mandate for all Americans to carry health insurance. ACA also includes expansion of eligibility for Medicaid-funded programs such as Minnesota's Medical Assistance, as well as a new subsidy program — Advanced Premium Tax Credits — for people and families between 200 percent and 400 percent of the federal poverty level. Additionally, ACA includes a mandate that all states designate an online health insurance marketplace.

Who is affected by ACA and MnSure?


Many people already have been affected by changes stemming from ACA. For example, starting in 2011, laws were changed to require insurance products to allow some dependent children up to age 24 to remain on family insurance coverage. One of the biggest changes resulting from ACA is mandated health insurance coverage for all Americans, with very few exceptions, as of Jan. 1.

To help Minnesotans find and select health insurance that best meets each individual's or family's needs, Minnesota has developed its own health insurance marketplace, called MnSure. MnSure is a web-based tool that allows consumers to learn about their insurance options, and it also provides real-time enrollment processing.

MnSure will be a resource for several different groups of consumers, including: people seeking to receive a health insurance subsidy such as Medical Assistance or Advanced Premium Tax Credits; people without access to employer sponsored health insurance who want to compare plans; and small businesses seeking a health insurance plan for their employees.

How does MnSure affect Olmsted County residents?

Olmsted County residents who are uninsured may use MnSure to help select a health insurance plan that is right for them, starting in October. Similarly, small businesses in Olmsted County may choose to use MnSure to find plans that might work for covering their employees. Olmsted County residents who are eligibility for public subsidy programs (Medical Assistance, Minnesota Care or Advance Premium Tax Credits) will use MnSure for eligibility and administration of services.

What is the role of Olmsted County government?

Counties will use MnSure to determine eligibility for Medical Assistance beginning Oct. 1. (Medical Assistance is Minnesota's suite of health care programs funded primarily by federal Medicaid dollars for Minnesotans living near the poverty line.) Because of the federal mandate for health insurance, many thousands of Minnesotans are projected to use MnSure starting this fall.

Olmsted County expects to serve about 23,000 residents with Medical Assistance through MnSure. This number includes 18,000 residents who are currently enrolled and an additional 5,000 residents projected to enroll with the ACA mandate and eligibility expansion policies.


In order to meet the needs of the increased caseload and the new system, Olmsted County has invested in new technologies — such as Electronic Document Management Systems — that create more efficient processes and allow us to hire fewer staff to implement ACA and MnSure than other counties. The federal government has increased reimbursement to counties for work to determine a person or family's eligibility for Medical Assistance, so additional property taxes are not needed at this time.

Starting Oct. 1, residents will be able to use MnSure ( to enroll in health care programs. Insurance coverage for plans available through MnSure will begin Jan. 1, 2014.

The website provides information on the plans, costs, benefit sets and more.

If you are a recipient of Medical Assistance through the county, you do not need to do anything to be part of MnSure. Medical Assistance cases will be automatically moved into MnSure. If you have a question about a current Medical Assistance case in Olmsted County, please call the Olmsted County Family Support and Assistance staff at 507-328-6500.

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