Minnesota Health Access Survey Shows Mixed Results on Health Care Coverage

New findings from the Minnesota Health Access Survey (MNHA) show mixed results regarding health insurance coverage within the state during 2023.

The Minnesota Department of Health’s Health Economics Program (HEP) recently shared a new brief saying the percentage of Minnesotans without insurance in 2023 fell to just 3.8%; about 11,000 fewer Minnesotans were uninsured compared to 2021. Stefan Gildemeister, the Program Director for HEP, believes there are a number of factors that affect Minnesota’s historic high coverage rates.

“I think we have a fairly strong employer based insurance system,” said Gildemeister. “It has been eroding over time somewhat, but it’s still sort of the foundation for insurance coverage in the state. Free or subsidized insurance coverage is sort of the second factor. The third might be that we’re just in a fairly strong economy and labor market where employers are looking to attract staff through wage benefits and non-wage benefits such as health insurance coverage.”

Because of the COVID-19 pandemic, some COVID-related care was free, and certain financial and coverage protections were in place for individuals. With a new normal emerging and many protections allowed to lapse, you would imagine health care coverage would drop, but in the state of Minnesota that wasn’t the case. Gildemeister believes protections to prevent eligible Minnesotans from losing coverage was the main reason why.

“Maintaining the roles of eligibility for Medicaid was the single biggest contributing factor,” he explained. “I think what we’re looking at right now, at the end of 2023, there hasn’t been much of a change to that picture in that redetermination of eligibility has begun, but the process has really succeeded in making sure that most people who remain eligible can stay on the program.”

There may be a decrease to the number of Minnesotans without health care coverage, but the percentage of Minnesotans who went without some type of health care in 2023 due to costs increased quite a bit, from just over 20% in 2021, to 24.5% in 2023. And about a quarter of Minnesotans are not feeling satisfied with the protection the insurance provided.

“This is not new information.” added Gildemeister. “Health care for Minnesotans is costly, both at the individual level but also at the system level. So we have high health care costs and we have a rising health care cost, and that affects individuals access to insurance coverage and health care services. Now, there are multiple reasons for that. It could be because the system is difficult to understand the cost to hard to predict or the actual cost that individuals pay at the point of service where they are maybe accountable for deductible or other forms of cost sharing are prohibitive in people’s individual circumstances.”

Conclusions from the 2023 Minnesota Health Access Survey show promising signs, but also some points of caution for the Minnesota Department of Health.

“Medicaid coverage is pretty strong, but we’re beginning to see cases where people cycle off the program and maybe are not quite ready to find or afford full time employer coverage or individual market coverage,” said Gildemeister. “People experience real disruption in insurance coverage. And then there’s also the component of access to care, as well as the disparities that we continue to see in the state.”

The MNHA is conducted as a partnership between the Minnesota Department of Health and the University of Minnesota School of Public Health’s State Health Access Data Assistance Center. The survey can be read here.