"MNsure is one part of Minnesota's long-standing commitment to affordable, quality health care reform. "

Health Care Reform


The Affordable Care Act (ACA) was passed by Congress and signed into law by the President in March 2010. On June 28, 2012, the Supreme Court rendered a final decision to uphold the health care law.

One key feature of the law was that affordable health insurance exchanges or markeplaces (like MNsure) would be set up in every state. They will allow residents to compare health plans, get their questions answered, find out if they qualify for tax credits or health programs, and enroll in a health plan.

More info on the ACA

Essential Health Benefits

One of the provisions of health reform requires that, beginning in 2014, new health insurance plans must include a minimum set of health care services and products. The minimum set is commonly called Essential Health Benefits and it applies to plans within exchanges and also outside of exchanges.

Plans in effect prior to March 23, 2010 are not required to add Essential Health Benefits. However, if the plan does cover an essential health benefit, it must eliminate annual and lifetime coverage limits on the essential health benefit.

The Minnesota Department of Commerce is responsible for setting the standard “benchmark plan” for the state. 

More info on establishing Essential Health Benefits. 

Health Care Coverage Requirement

The ACA requires that all individuals have health insurance beginning January 1, 2014. In addition, insurers are required to cover everyone, regardless of health status or history. 

The purpose of the requirement is to make sure people don’t wait until they have a health issue to purchase insurance. By bringing healthy people into the covered group, there is a better balance of sick and healthy individuals, and average costs are kept down.

Through the MNsure exchange/marketplace, individuals and families can find out if they qualify for health programs, or for tax credits that will lower the cost of coverage. Small employers with fewer than 25 employees who provide health insurance may qualify for a federal tax credit of up to 50%.

Although employers are not required to offer health insurance to employees, most who employ more than 50 employees will pay an assessment if they don’t offer affordable coverage that covers minimum essential health benefits.

Additional Background Information

FAQs

  • Does everyone have to purchase health insurance?

    Yes. Beginning January 1, 2014, all U.S. citizens and legal residents will be required to obtain health insurance coverage. Many will be covered by an employer plan, some will qualify for health programs, and others will purchase it themselves.


  • What happens if I don’t buy coverage?
    Starting in 2014, you will pay a tax penalty. The penalty will increase over time:
    • In 2014, it will be the greater of $95 per adult or 1 percent of taxable income.
    • In 2015, it will be the greater of $325 per adult or 2 percent of taxable income.
    • In 2016, it will be the greater of $695 per adult or 2.5 percent of taxable income.
    • After 2016, the tax penalty increases annually based on a cost-of-living adjustment.
    • A person will only pay one-twelfth of the total annual penalty for each month without coverage.
    • The penalty for a child is half that of an adult.
    • A maximum penalty would be calculated based on premiums for plans offered through the Exchange.
  • Are there exceptions?
    Yes. The law provides exceptions for: 
    1. Individuals and families below a certain income 
    2. People who cannot afford the coverage that is available 
    3. Individuals who have been uninsured for less than three months 
    4. Members of American Indian tribes 
    5. People who do not obtain coverage because of religious objection.