Minnesota Agencies

Govern the activities of the Minnesota association that provides basic health insurance coverage to persons in Minnesota unable to obtain coverage through the open market.

The Minnesota Comprehensive Health Association (MCHA) was created in 1976 to serve individuals with pre-existing medical conditions who had been denied coverage in the commercial insurance market. MCHA was regulated by the Minnesota Department of Commerce and an eleven-member board of directors provided direction to MCHA. The executive staff managed the administration of the plan though MCHA's contract with Medica, for the day-to-day operations.

The Patient Protection and Affordable Care Act (ACA) required health insurance carriers to offer coverage to all individuals regardless of any pre-existing medical condition. With that population covered by the ACA, the Minnesota Legislature provided the Commissioner of the Minnesota Department of Commerce with the authority to develop and implement the phase-out and eventual termination of coverage provided by the MCHA (Laws of Minnesota 2013, chapter 9, section 15).

Today, according to their website, the MCHA "is a nonprofit organization that administers the Premium Security Plan. This role entails selecting and managing the vendors that calculate reinsurance payments to health insurers, legal counsel, accounting and other administrative support to the PSP and the Board and timely management of the PSP. Prior to the Affordable Care Act (ACA), MCHA played a different role in the individual health insurance market: managing the state’s high-risk pool that provided coverage to individuals with preexisting conditions or other high-cost healthcare needs. The ACA eliminated states’ high-risk pools as part of its broader elimination of coverage limits and open enrollment for those with preexisting conditions. However, people previously served by the high-risk pools still make up about 17 percent of Minnesota’s individual insurance market."

As of 2022, the MCHA is governed by a board of directors comprised of 13 individuals. Six members are selected by the health insurance industry, subject to approval by the Minnesota Department of Commerce and one must be a health actuary. Five public directors are selected by the Commerce Commissioner. At least two of these public directors must be individual plan enrollees, one must be a licensed insurance agent, and at least two must reside outside the seven-county Metro Area. Two public directors are selected by the Commissioner of Human Services; one must represent hospitals and one must represent healthcare providers.