Survey shows more than 400,000 Minnesotans without health insurance in 2013

News Release  

FOR IMMEDIATE RELEASE
February 28, 2014

Survey shows more than 400,000 Minnesotans without health insurance in 2013

About one out of three Minnesotans under the age of 65 experienced financial burdens related to obtaining health care or did not get care because of cost in 2013, according to a health access survey conducted by the Minnesota Department of Health (MDH) and the University of Minnesota. The study also found that an estimated 8.2 percent, or approximately 445,000 Minnesotans including about 80,000 children, were without health insurance last year.

 

The overall rate of uninsured Minnesotans is still above the pre-recession rate of 7.2 percent from 2007.

 

The health access survey is conducted every two years. As part of the 2013 survey, researchers took the opportunity to collect some baseline data in advance of the 2014 implementation of key elements of federal health reform, such as MNsure, the state’s health insurance exchange.

 

The survey of more than 11,000 Minnesota households by MDH and the University of Minnesota, School of Public Health’s State Health Access Data Assistance Center (SHADAC) found that:

• 22.4 percent of Minnesotans under age 65 experienced financial burden from health care costs in the past 12 months.
• 18.9 percent of Minnesotans did not get needed medical care due to cost.
• Nearly three in 10 insured Minnesotans (28 percent) reported problems with paying medical bills or getting needed health care because of health care costs.
• 57.8 percent of uninsured Minnesotans reported having problems with medical bills or getting needed health care due to cost.
• Minnesotans without health insurance were less confident (30.0 percent compared to 79.0 percent) in their ability to receive care, and less likely to have a usual source of care (54.6 percent compared to 89.5 percent) than those with health insurance.
  

While this year’s 8.2 percent rate of uninsured was slightly lower than the 9.1 percent rate of 2011, the difference was not statistically significant.

The rate of employer-based coverage remained statistically unchanged, though slightly lower than 2011, at 55.2 percent. While the decline in employer-based coverage preceded the recession, the lack of rebound in employer-based coverage is particularly disconcerting because the number of jobs nearly returned to pre-recession levels in 2013. And to make matters worse, of those who were eligible, fewer reported taking employer coverage in 2013.

 

“Because employer-based coverage is the bedrock of Minnesota’s comparatively low rate of uninsurance, it is especially concerning that those who do have access to coverage through their jobs are choosing not to take it,” said Dr. Kathleen Call, Professor at the School of Public Health and co-lead of the study.

 

Public coverage, which includes Medicare and Minnesota’s state programs, such as Medical Assistance and MinnesotaCare, increased to 31.1 percent in 2013 from 28.5 percent in 2009. The share of the population that purchased individual coverage in the private market remained steady as well, at about 5 percent.

 

Disparities in health insurance coverage by income, age, and race and ethnicity continued to persist in 2013. Rates of uninsurance for Hispanic/Latino Minnesotans (34.8 percent), African-Americans (14.7 percent), Asians (13.2 percent) and American Indians (18.0 percent) have seen no significant improvement since 2004. In 2013, disparities by race and ethnicity widened since uninsurance among whites fell from 7.8 percent in 2009 to 6.0 percent in 2013.

 

“The lack of access to coverage and care for people of color and American Indians is part of the story of health inequalities that MDH has been documenting” said Dr. Ed Ehlinger, Minnesota Commissioner of Health. “As we have laid out in the recent health equity report, to truly reduce the health gap related to care and insurance, we need to take a fresh look at a broad range of policies, actions, and engagement strategies to ensure that we are working effectively with these communities.”

 

Another challenge is reaching those who are eligible but do not currently obtain health insurance coverage. Nearly 80 percent of the uninsured have potential access to some type of health insurance coverage – in 2013, 62 percent were potentially eligible for public program coverage and 19.6 percent for employer coverage. Beyond the requirement to hold coverage, federal health reform offers some tools to help with this persistent challenge. These tools may include reducing stigma of getting public insurance, employing navigators and other assistors to help people get coverage, and making coverage more affordable – specifically for those with health problems, those in the individual market, and those eligible for federal financial assistance.

 

While Minnesotans have new coverage options starting in 2014 through MNsure, implementation challenges will have to be overcome, such as a lack of awareness of the Affordable Care Act (ACA). The survey found that only 36.4 percent of the state’s uninsured reported knowing enough about the ACA to understand how the law will impact them.

 

“One of the challenges Minnesota faces in implementation of federal health reform is that those most likely to be impacted by the changes are the least likely to know about them,” said Stefan Gildemeister, director of the MDH’s Health Economics Program and a co-lead of the study. “However, what is heartening is that increased media attention, education by a range of stakeholders and marketing efforts, including by MNSure, appears to have made a measurable impact over time.” The greatest increase in familiarity with the 2014 reforms (50 percent), concerned the existence of MNSure as a new marketplace for insurance coverage.

 

Two fact sheets summarizing the initial results of the survey, baseline metrics for monitoring reform implementation and familiarity in the state with provisions of the reform can be found at www.health.state.mn.us/healtheconomics and www.shadac.org. The Minnesota Health Access Survey is a large-scale health insurance survey conducted jointly by the Minnesota Department of Health and the University of Minnesota every two years.

 

-MDH- 

Media inquiries:

Scott Smith
MDH Communications
651-201-5806

Matt DePoint
University of Minnesota School of Public Health
612-625-4110