Minnesota's uninsured rate held steady in first half of 2020

New research shows Minnesota’s uninsured rate weathered the economic shock of the pandemic in the first half of 2020, staying at a historically low rate of about 5% through July 2020 due in part to government efforts to maintain health care coverage for low-income Minnesotans, support employers and people, and to make insurance available through public programs and MNsure.

Economic downturns often result in higher rates of uninsurance in the U.S. due to the link between health insurance coverage and employment. The state took a proactive approach to prevent as many Minnesotans as possible from losing health care coverage during the pandemic. As a result of those efforts, Minnesota saw only a modest impact on the uninsured rate during the pandemic.

“The investments we made before and during the pandemic to ensure Minnesotans had access to affordable health coverage helped more people stay insured, even in the midst of job losses and economic instability,” said Minnesota Commissioner of Health Jan Malcolm. “However, we also see that there is work to be done to get all Minnesotans covered, especially frontline workers in the hospitality and service industries that have been among the hardest hit by COVID-19. And we remain concerned about rising health care costs.”

Around 264,000 Minnesotans (4.7%) lacked health insurance coverage in 2019, according to the Minnesota Health Access Survey, which is a partnership between the Minnesota Department of Health and the University of Minnesota’s School of Public Health State Health Access Data Assistance Center (SHADAC). The survey had responses from more the 11,500 Minnesotans across the state.

Analysis by the research team of enrollment data supplied by insurance carriers found that by July 2020 the number of uninsured Minnesotans decreased to 258,600 or 4.6%. While there were losses of about 40,000 in employer-based group coverage, they were offset by enrollment gains of 13,000 in the individual market, and a gain of about 46,000 in Minnesota Health Care Programs including Medicaid and MinnesotaCare.

“State and federal stimulus programs and financial supports to employers such as the federal Paycheck Protection Program, flexibility for many to maintain coverage in state public programs, and policies to shore up the availability and affordability of private and state public programs coverage, worked as intended,” said Minnesota State Health Economist Stefan Gildemeister.

Human Services Commissioner Jodi Harpstead credited part of the decrease in uninsured Minnesotans to temporary changes to Medicaid and MinnesotaCare by the department and at the federal level that allowed individuals to maintain continuous coverage in public health programs during the pandemic.

“By keeping people enrolled, our public health programs kept thousands of people each month from falling – even if only temporarily – into the ranks of the uninsured,” Harpstead said. “It’s more important than ever that people have access to care.”

MNsure also played a role in maintaining coverage. “Because Minnesota has MNsure, a state-based health insurance exchange, we had the flexibility to offer uninsured Minnesotans the chance to enroll in comprehensive private health care coverage outside of our open enrollment period,” said Nate Clark, MNsure CEO. “MNsure enrolled over 9,400 uninsured Minnesotans in private coverage during our COVID-19 Special Enrollment Period in March and April of 2020.”

On a less positive note, the survey also found a continuation of troubling trends of Minnesotans forgoing care more frequently and struggling to pay medical bills in 2019. Overall, 1 in 4 Minnesotans reported having to delay or go without needed health care due to cost in 2019, up from 1 in 5 in 2017. The increase was most concentrated in those who get their coverage through their employer.

The Minnesota Department of Health will continue to monitor these trends, particularly in light of the economic hardships associated with the COVID-19 pandemic.

More findings from the Minnesota Health Access Survey are available on the Health Economics Program website.

-MDH-