Program may be expanded to Koochiching County next year

What started as a question about how to address the problem of local employees without health coverage has resulted in one of the most innovative health coverage programs in the country. Now, as HealthShare celebrates its one-year anniversary, those behind it are reflecting on a successful program that’s up and running, and looking ahead to a major expansion.

HealthShare, which began offering coverage in November 2008, was initiated by a broad base of representatives from local healthcare, governmental and community organizations. Generations Health Care Initiatives, a Duluth-based nonprofit, was the lead agency. The goal was to develop a program that addresses a very real problem: People who work for small businesses and do not have health insurance. Because they’re employed, they generally don’t qualify for state programs. However, the companies they’re working for generally can’t afford to offer insurance — and the individuals can’t afford insurance on their own. In fact, 8.7 percent of the population in Minnesota is uninsured and most uninsured adults are employed full time.

The program is currently available in Duluth, Proctor and Hermantown because of ongoing state funding and through the support of Generations Health Care Initiatives. But now the program is expanding to the rest of St. Louis County, along with Carlton, Cook and Lake counties, thanks to a five-year federal grant. HealthShare will seek legislation in the next session to allow it to expand to Itasca, Aitkin and Koochiching counties as well.

One year into the program, organizers say there is much to celebrate. “Sixty people who are working in our community and did not have health coverage one year ago now have affordable health coverage and the incredible peace of mind that comes along with it,” said HealthShare Executive Director Dan Svendsen.

Svendsen says many of these people thought it was “too good to be true,” that “there has to be a catch,” or “it’s just a bunch of hype and false promises.” But he said once people have learned more, they realized they were wrong.

“It is a truly innovative, community-based health coverage program that is managed by local people who we can trust,” said Dale Kleinschmidt who is co-owner of Lake Superior Brewing Co. and receives coverage through HealthShare. “My wife and I hadn’t been on a regular insurance policy since 1998, so the arrival of this coverage program has been a tremendous benefit for us — and a tremendous relief.”

Kleinschmidt’s sentiments are echoed by the dozens of other people who have enrolled. There are some important criteria for people to understand, according to HealthShare Employer Services Representative Vicki Erickson.

“The program is available to small businesses that employ 50 or fewer people, pay a median hourly wage of $12.50 or less, and have not offered health insurance benefits to employees during the previous 12 months,” explained Erickson, “but if your company doesn’t seem to fit this profile exactly, that doesn’t mean you’re not eligible.”

For example, if a business currently offers health insurance to only full-time employees, HealthShare may be a coverage option they can offer to their part-time employees.

Erickson added that while people can’t receive HealthShare coverage directly — the coverage needs to come through their employer — they can help promote the idea and encourage their employer to look into this option.

“I have at least one enrollee who gets all the credit for her employer offering the coverage. She heard about it, looked into in, and helped show her manager that this was a great idea,” said Erickson.

While there’s still a cost to employers and employees, it’s much more affordable than traditional insurance policies. In most cases, employers pay a monthly fee of $60 per employee and each employee pays a similar amount. Plus, the monthly amount decreases slightly for participants who work toward wellness goals.

The 2010 HealthShare budget is $945,000, with $587,000 (62 percent) coming from the federal government, $180,000 (19 percent) coming from payments for coverage, and $178,000 (19 percent) coming from community sources.

“Because we had this working model in place we were able to receive these funds, and we couldn’t be prouder to help bring similar coverage to so many more people throughout Northeastern Minnesota,” said Svendsen.

Svendsen adds that ultimately this coverage program works because of local health care providers. “They’re a significant partner for us. They don’t have to sign up, but many, many of them do because it makes sense. We’re providing coverage for people who otherwise would have no coverage, plus we’re rewarding people for being healthy. What could be better for our communities?”