With full implementation of the Affordable Care Act’s (ACA’s) health insurance coverage provisions on January 1, 2014, there has been great interest in assessing the law’s early impact on health insurance coverage in Minnesota. At the request of Minnesota’s State-Based Health Insurance Marketplace, MNsure, researchers from the University of Minnesota’s State Health Access Data Assistance Center (SHADAC) compiled data from a variety of sources to analyze, at an aggregate level, the shifts in health insurance coverage that have taken place in Minnesota since the fall of 2013. Support for this work was provided through the Robert Wood Johnson Foundation’s State Health Reform Assistance Network.
To our knowledge, this report is the first assessment of early state-level impacts of the ACA on health insurance coverage. The major findings of this report include the following:
Between September 30, 2013 and May 1, 2014, the number of uninsured Minnesotans fell by 180,500, a reduction of 40.6 percent. The number of uninsured in Minnesota fell from 445,000 (8.2 percent of the population) to about 264,500 (4.9 percent of the population).
This increase in health insurance coverage was primarily driven by an increase in the number of Minnesotans enrolled in state health insurance programs, Medical Assistance (Minnesota’s Medicaid program) and MinnesotaCare. Enrollment increased by over 155,000 for these two programs combined.
Coverage in the private health insurance market also increased. The total number of Minnesotans with private group coverage (primarily employersponsored coverage) was relatively stable with a decline of about 6,000 (a 0.2 percent change); growth in self-insured plans was balanced by a decline in fully-insured coverage. The nongroup market grew by almost 36,000 and included gains both inside and outside of MNsure.
Our findings on the change in the number of uninsured are consistent with national reports of early ACA impact, and with research on the impacts of Massachusetts reforms implemented in 2007 which are quite similar to the access expansion provisions included in the ACA. Further research and analysis are needed to answer questions such as what are the characteristics of Minnesotans who gained or lost coverage from different sources, how many Minnesotans who purchased coverage through MNsure were previously uninsured, and what are the characteristics of the remaining uninsured population in Minnesota.
The State Health Access Data Assistance Center (SHADAC) is a program of the Robert Wood Johnson Foundation and a part of the Health Policy and Management Division of the School of Public Health at the University of Minnesota.