MN Uninsurance Rate Drops, But Racial Disparities Persist

The uninsurance rate among Minnesota residents hit an all-time low in 2021 due to increased federal and state funding, but more people of color were uninsured, highlighting racial disparities in coverage, the Minnesota Health Access Survey found.

The Minnesota Department of Health (MDH) and the University of Minnesota School of Public Health’s State Health Access Data Assistance Center conduct the survey every other year to gather data on healthcare coverage rates across the state.

The most recent survey collected responses from more than 18,000 Minnesotans between October 2021 and January 2022.

The data revealed that the state’s uninsurance rate dropped from 4.7 percent in 2019 to 4.0 percent in 2021—the lowest rate the state has ever recorded. Compared to 2019, the study found that 34,000 fewer Minnesota residents went without health insurance in 2021. Individuals were also less likely to go without needed healthcare services due to cost.

While a declining economy typically leads to higher uninsurance rates because of the connection between employment and health insurance coverage, federal and state funding introduced during the COVID-19 pandemic helped produce the opposite effect.

Government efforts helped maintain coverage for low-income individuals and offered premium subsidies in the individual market. Federal and state funding increased the availability of affordable healthcare coverage, helping Minnesota reduce its uninsurance rate during the pandemic.

More than 40 percent of insured Minnesotans received coverage through public programs in 2021, including Medicare, Medical Assistance, and MinnesotaCare. The number of individuals with public grew by 238,000. On the other hand, the number of people with private coverage fell from 57.8 percent in 2019 to 54.8 percent in 2021.

However, the study noted that the growth in public coverage made up for this private coverage decline.

Despite the overall decrease in uninsurance, racial disparities in coverage worsened. The uninsurance rate among people of color and American Indians increased from 7.6 percent in 2019 to 10.2 percent in 2021. Meanwhile, the uninsurance rate among non-Hispanic White Minnesotans dropped from 3.7 percent in 2019 to 2.4 percent in 2021.

“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,” Jan Malcolm, Minnesota Commissioner of Health, said in the press release.

“Sadly, we saw that people of color and American Indians did not benefit as much from these efforts. We must learn about what worked and what didn’t so we can adapt our approach to reach the goal of ongoing and equitable access to affordable healthcare for all Minnesotans.”

Although the state saw high healthcare coverage rates during the pandemic, the study authors expressed concern about the future. Most federal and state programs that offered additional financial support, increased subsidies, and expanded Medicaid eligibility have expired or are set to expire in 2022.

“Historically, Minnesota has enjoyed a strong labor market and a strong employer-sponsored insurance market,” Kathleen Call, a professor with the University of Minnesota School of Public Health and an investigator at the State Health Access Data Assistance Center, stated in the press release.

“However, alongside the crisis of the pandemic, the long-term erosion of private coverage over the past two decades, combined with the fact that not all employees are offered insurance and not all Minnesotans can afford it, reminds us that continued commitments are needed to support and promote Medical Assistance, MinnesotaCare, and premium subsidies in the individual market available through MNsure.”

Maintaining healthcare coverage for Minnesotans is especially important as physical and mental health declined during the pandemic, the study found. The number of unhealthy days reported for 30 days rose to an average of 3.3 days for physical health and 4.3 days for mental health, compared to the previous 2.8 and 3.7 days in 2019.

The premium subsidies under the American Rescue Plan Act are among the federal supports set to expire at the end of 2022.

A report from the Urban Institute found that if policymakers do not extend the subsidies, the uninsured population may increase by 3 million. Young adults, low-income people, and Black individuals, in particular, will likely see significant coverage losses, further exacerbating racial disparities in coverage, researchers projected.