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Study: Minnesota's uninsured rate remains high

The percentage of Minnesotans without health insurance did not show improvements nearly two years after the official end of the economic recession.

Minnesota's uninsured rate in 2011 was 9.1 percent, which is unchanged compared to 2009, according to a new study by the Minnesota Department of Health (MDH) and the University of Minnesota School of Public Health.

During the last decade, Minnesota's uninsured rate has trended upward from 6.1 percent in 2001. Minnesota saw its uninsured rate jump from 7.2 percent in 2007 to 9 percent in 2009, largely because of the impact of an economic downturn. An estimated 490,000 Minnesotans were uninsured in 2011, compared to 480,000 Minnesotans in 2009, and 374,000 in 2007. Researchers estimate that approximately 70,000 children were without health coverage in 2011.

"This report indicates that we have not recovered from the losses in health insurance coverage that we sustained subsequent to the Great Recession," said Dr. Ed Ehlinger, Minnesota Commissioner of Health. "It is also clear that the cost of insurance is a barrier to coverage. We absolutely must redouble our efforts focused on disease prevention, public health, and payment reform so that health coverage becomes more affordable for Minnesotans."

Minnesota's insurance rate did not improve in part because employer coverage did not recover from the erosion documented in 2009. It appears that at least through 2011, the economic upturn has either not produced the jobs that would offer employer-based insurance, or that coverage gains from new jobs are offset by coverage losses in existing firms. Flat or slowly rising incomes for employees in the face of rising health care costs likely contributed to the stagnant picture.

"If there is one bit of good news in the research findings, it is that young adults ages 18 to 25 saw a decline in their uninsured rate in 2011," said Stefan Gildemeister, Director of the Health Economics Program at MDH "For the first time in years, young adults saw an increase in coverage through an employer." This is likely due to provisions in the Affordable Care Act (ACA) that allow young adults to remain on their parents insurance through age 26 years. The ACA broadened provisions in place in Minnesota that had already expanded dependent coverage to some young adults.

Coverage in public insurance programs, including Medicare and Minnesota's state programs, such as Medical Assistance and MinnesotaCare, remained constant at 29.2 percent. It was 28.7 percent in 2009, compared to 25.2 percent in 2007. The share of the population that purchased individual coverage in the private market remained steady as well, at about 5 percent.

The study shows continuing disparities in health insurance coverage by race and ethnicity, with Hispanic/Latino Minnesotans having the highest uninsured rate at 26 percent compared to blacks (17.9 percent), American Indian (14.3 percent), Asians (11.8 percent), and whites at (7.6 percent). American Indians saw significant improvement in their rate, which fell to its lowest point in ten years after peaking at 20.7 percent in 2009.

"These consistently high uninsured rates within our Hispanic/Latino community, one of the fastest growing populations in Minnesota, are alarming. While their access to group coverage rebounded a bit since 2009, this has not translated into lower uninsured rates. Policies aimed at making private coverage more affordable are long overdue, yet making public program coverage work better for this population may also be necessary" said Dr. Kathleen Call, Professor at the School of Public Health and co-lead of the study.

A continuing concern is that nearly three-fourths of the uninsured have some potential access to coverage but don't take advantage of it. About 60 percent of the uninsured were eligible for public coverage and about 17 percent were eligible for coverage through their employer. Similar to 2009, the uninsured were more likely than the population as a whole to be self-employed, work for very small firms with fewer than 10 employees, and have part-time jobs, multiple jobs, or temporary or seasonal jobs.

The study results are based on a telephone survey of more than 11,000 Minnesota households. The survey was conducted in English and Spanish. The survey results are statistically weighted so that they are representative of the state population. Cell phones were included in the survey for the first time in 2009 and again in 2011.

A fact sheet summarizing the initial results of the survey can be found at 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.