Survey: Minnesota’s Jump in Uninsured Led by Drop in Private Coverage

February 22, 2018 by

The number of Minnesota residents without health insurance jumped by 116,000 in the past two years, the state Department of Health said.

A biennial survey by the department and the University of Minnesota School of Public Health found that the uninsured rate rose to 6.3 percent last year, up from 4.3 percent in 2015. Around 349,000 Minnesotans lacked coverage in 2017, it found.

The report said the rise in uninsured Minnesotans corresponded with two private market trends — a decline in residents with coverage offered by employers and shrinking enrollment in the individual market. The share of residents getting insurance through their jobs fell 3 percentage points, to 52.9 percent, while enrollment in the individual market declined 2 percentage points, to 4.4 percent.

Democratic Gov. Mark Dayton said in a statement that the report shows that efforts by the Republican-controlled Congress and President Donald Trump to undermine the Obama administration’s health care overhaul and its goal of universal coverage are having “destructive effects.”

The top reasons cited by people who lost coverage included losing jobs that included coverage, losing eligibility for coverage or an inability to afford the premiums. Just over half of the people surveyed who no longer had coverage last year said they couldn’t afford to keep it or couldn’t afford new coverage.

Enrollment in public plans — Medicare, Medical Assistance and MinnesotaCare — increased by 3 percentage points, to 36.5 percent, but that wasn’t enough to offset the declines in private coverage.

“2017 was a disappointing year in which higher costs, undercutting of the Affordable Care Act at the federal level and declining coverage by employers moved us away from our public health goal of achieving universal access to health care,” Health Commissioner Jan Malcom said in a statement.

Minnesota’s state health economist, Stefan Gildermeister, said the magnitude of the rise in uninsured residents was “particularly concerning,” given that it came at a time of economic growth and low unemployment.

Minnesota’s individual insurance market has been rocked by double-digit premium increases in recent years. Every carrier offering plans in that market threatened to exit it last year until legislators came up with an expensive solution, a $549 million reinsurance program meant to help insurers cover their claim costs and stabilize premiums.

The number of uninsured Minnesotans is, coincidentally, about the same number of residents that Minnesota’s health insurance exchange, MNsure, enrolled in private plans during the open enrollment season that ended in January, which narrowly beat MNsure’s previous high of nearly 115,000. Lower income Minnesotans also use MNsure to enroll in Medical Assistance, which is the state’s version of Medicaid, and MinnesotaCare, a state program for the working poor.

Heidi Mathson, executive director of the Minnesota Association of Health Underwriters, agreed that the decline was disappointing and concerning, but disputed the Dayton administration’s diagnosis of the causes. Soaring premiums, not Trump administration or congressional Republican actions, are why coverage has become unaffordable to many employers and individuals, she said.

“The uninsured rate is not a surprise to those of us in the industry,” Mathson said. “All we have done is shifted who the uninsured are in the country, and it is now a middle-class problem. … We spent millions on MNsure, billions on the expansion of Medicaid and MinnesotaCare, and what we have succeeded in doing is driving up the cost of individual and group insurance so more people can’t buy it.”