Data: More Have Healthcare Coverage in State, But More Go Without Care Due to Cost

April 4, 2024

New data released on April 3 by the Minnesota Department of Health (MDH) provides both good and bad news regarding health insurance coverage in Minnesota. 

The good news: The percentage of Minnesotans without healthcare coverage fell to 3.8% in 2023, an all-time low for the 22-year survey.  

The not-so-good-news: Minnesotans who went without care due to costs and those who expressed concerns about the financial protection of health insurance both increased. 

The data comes from the Minnesota Health Access Survey, a biennial state-based population survey that collects information on Minnesotans’ health insurance coverage and healthcare access. The survey measures how many Minnesotans have health insurance and how easy it is for them to get healthcare. 

“We are encouraged by Minnesota’s overall uninsurance rate,” said Minnesota Commissioner of Health Brooke Cunningham, MD, PhD. “However, we must keep in mind these rates are dynamic. The state must remain committed to ensuring that Minnesotans eligible for public coverage have it available to them and that those who are no longer eligible for public coverage have affordable private options.” 

Researchers concluded that the commitment made by the state to prevent eligible Minnesotans with Medical Assistance (MA) from losing coverage and becoming uninsured after the end of COVID-19 protections has thus far paid dividends in helping to keep the overall uninsurance rate low. They also acknowledge that these efforts should continue to prevent future coverage interruptions. 

Another area where the state's uninsured rate showed improvement is in racial disparities among Hispanic Minnesotans, which fell from 21.4% in 2021 to 11.4% in 2023. However, the data shows there is still work needed in this area to close the sizable gap in uninsurance rates between Minnesotans of color and American Indians (6.9% in 2023) and non-Hispanic white Minnesotans, which remained steady at 2.4%. 

Most uninsured Minnesotans experience long-term uninsurance, lacking insurance coverage for a year or longer. In 2023, however, they accounted for a smaller number of the uninsured and a smaller share, falling from 82.7% the year before to 74.5%. In contrast, the number of people with shorter gaps of insurance coverage increased in 2023, impacting approximately 16,000 more Minnesotans. The short-term uninsured accounted for 25.5% of all uninsured in 2023, up from 17.3% in 2021. 

Half of the people experiencing short-term uninsurance in 2023 previously had group coverage, while 27.5% previously had public coverage. This is a stark contrast to 2021 when MA redeterminations were paused and 81.3% of those experiencing short-term uninsurance were previously enrolled in group coverage. 

Concerns over the financial protections provided by health insurance also edged higher in 2023. Minnesotans expressed increased anxiety about their ability to both cope with high deductibles and be protected from large medical bills by their insurance coverage. These cost concerns saw the rates of forgone care due to costs climb from 20.2% in 2021 to 24.5% in 2024, returning to pre-COVID-19 levels.  

Lower income Minnesotans, Minnesotans of color and people with group coverage experienced the largest increases of forgone care according to the data, while uninsured Minnesotans had the highest rates. 

The Minnesota Health Access Survey (MNHA) is conducted as a partnership between MDH and the State Health Access Data Assistance Center (SHADAC), which is part of the Health Policy and Management Division of the School of Public Health at the University of Minnesota, Twin Cities. The survey had responses from more the 15,000 Minnesotans across the state and was conducted between September and December 2023. More findings from the survey are available on the MDH Health Economics Program website.