SHADAC Expertise

MINNESOTA HEALTH ACCESS SURVEY

Overview of the MNHA Survey
The Minnesota Health Access (MNHA) survey is a statewide web and telephone survey that collects information on how people access health care and health insurance coverage in Minnesota. The survey dates back to 1990 and has been conducted biennially in partnership with the Minnesota Department of Health since 2001. The data collected are used to monitor rates of insurance coverage and uninsurance across different groups of Minnesotans (geographic, income, ethnicity, etc), and experiences using care to determine specific barriers to insurance and health care services. It is used to inform policy that can help improve health care access for all Minnesotans. 

Historical Context
The MNHA was first funded in 1990 to provide a state-specific rate of uninsurance at the time of the survey; this point-in-time estimate was not available through any federal data sources until 2007. The MNHA data is credited with informing sweeping bipartisan health care reform in the early 1990s - known as MinnesotaCare - and continues to directly inform health policy to this day. 

SHADAC’s Kathleen Call first got involved with the survey in 1995. Call quickly learned the value of the data because analysts at the Minnesota Department of Health and the Minnesota Department of Human Services requested access to the data (without identifiers) for fiscal notes and policy analyses. This was the start of a great partnership. State staff asked hard questions about the veracity of the insurance estimates, which eventually inspired a line of research exploring the accuracy of health insurance reporting in surveys and potential bias to uninsurance estimates. The findings consistently support confidence in using insurance coverage estimates from survey data to monitor and inform health policy. Beginning in 2001, Call and staff from MDH’s Health Economics Program worked together to fund the MNHA. This early collaboration led to a formal partnership and MNHA funding through the legislature, which began in 2007. MNHA also provides rich data around health care experiences and inequities, including the impact of insurance-based, race-based and gender-based discrimination on access to health care services. 

What's Ahead
The biennial MNHA also spurred several follow-up surveys. The first was the Minnesota Health Insurance Transitions Study (MH-HITS), a follow-up telephone survey of children and adults in Minnesota who had no health insurance in the fall of 2013 to examine gains in coverage in 2014; 1 year after passage of the Affordable Care Act. Most recently, willing participants from the 2021 MNHA completed the 2023 Minnesota Telehealth and Access Survey (MNTAS) that focused on health care experience and access, particularly related to telehealth. MNTAS findings will be shared as they become available. Beginning in 2023, MNHA participants are invited to join the Minnesota Voices on Health Panel (MNVoices). This panel provides an opportunity to conduct short policy focused follow-up surveys and to look at patterns over time. 

Read more about the survey or check out SHADAC products that use MNHA data: