In 2007, slightly more than nine percent of Minnesota residents reported they were unable to see a doctor when needed due to cost. Between 2003 and 2009, the cost of health insurance for Minnesota families rose 31 percent to an average annual premium of $13,202. Single policyholders saw their rates increase 25 percent over the same period.  Of the Minnesota residents who do have health insurance, 57 percent are covered through their employment. Public programs such as Medicaid and Medicare insure 28 percent of the population, and five percent of Minnesotans purchase individual private policies. This leaves nearly 500,000, or nine percent of the population, uninsured. 
Who are the uninsured in Minnesota?
Minnesota’s children are uninsured at a rate of seven percent. Of the non-elderly adult population–those younger than 65–13 percent lack health insurance. The uninsured rate more than doubles to 15 percent for children living in households with incomes less than 139 percent of the Federal Poverty Level. Adults in these lower-income homes are uninsured at a rate of 31 percent.  Disparities in insurance coverage exist between ethnic groups in Minnesota. Twenty-eight percent of the non-elderly Hispanic population is uninsured. Fifteen percent of the non-elderly Black population is uninsured. Nine percent of the non-elderly White population lack health insurance. 
How does the Affordable Care Act affect Minnesota residents?
The Affordable Care Act (ACA) requires states provide access to an online marketplace, also called an exchange, where individuals and small businesses may compare, select and purchase private health insurance policies that offer a minimum level of coverage. States have the option of establishing their own exchange, operating an exchange in cooperation with the federal government, or turning all administration of the health care marketplace over to the federal government. In December 2012, Minnesota’s plan to create its own exchange was conditionally approved by the Department of Health and Human Services.
Under ACA, all new policies, and in-force policies upon renewal, must cover a package of essential health benefits, including hospitalization, emergency services and mental health treatments. Annual wellness checkups and other preventative screenings must be covered with no co-payments or deductibles. Residents may not be denied health insurance for pre-existing health conditions, and insurers may not place a lifetime cap on benefits. Households with incomes at or below 400 percent of the Federal Poverty Level may be eligible for tax credits to offset premium costs.
Minnesota’s health insurance exchange
The Minnesota exchange is governed by a seven member board of directors as an agency within the executive branch.  The marketplace, called MNsure, is the portal through which Minnesota residents and small businesses may purchase health insurance. Insurance policies sold through the Minnesota exchange will cover essential health benefits based on the HealthPartner’s, Inc. 500 25 Open Access plan. For 2014, the exchange will operate as a clearinghouse for all qualified plans. In future years, the board may act as active purchasers, selecting plans and negotiating premiums with insurers to offer the best value for Minnesota consumers.
All unincarcerated Minnesota residents who are legal U.S. citizens may participate in the exchange. Small businesses may enroll at one time of their choosing throughout the year. The state has opted to expand Medicare, a program that offers free health care coverage, to include households with incomes up to 133 percent of the Federal Poverty Level. Income eligible residents may enroll in Medicare through MNsure. For an estimate of premium costs, access the MNsure’s health insurance premium estimator.
Small Business Health Options Program (SHOP)
Under the ACA, small business employers with fewer than 50 full-time workers, or full-time equivalent workers, will not be required to offer health insurance to their employees. (Check here for a definition and calculator to determine who qualifies as a full-time worker.) However, the ACA encourages many small business employers to provide health insurance by offering small business health care tax credits.
Many small businesses were already offering health insurance packages to their employees before the ACA was passed and signed into law. These plans are accepted, or grandfathered in, under the ACA.
For small business owners who wish to change their coverage plans, or for those who did not offer health insurance before the new law, the ACA establishes the Small Business Health Options Program or SHOP. SHOP allows employers to compare and shop for quality insurance plans side by side for their employees. Minnesota small business owners may access SHOP through Minnesota’s health insurance exchange.
Minnesota government approved enrollment assistance centers
- Cook Area Health Services
- Hennepin County Community Health Department
- Indian Health Board Of Minneapolis, Inc.
- Lake Superior Community Health Center
- Migrant Health Service, Inc.
- Native American Community Clinic
- Neighborhood Healthsource
- Open Cities Health Center
- Open Door Health Center
- People’s Center Health Services
- Sawtooth Mountain Clinic, Inc.
- Southside Community Health Services, Inc.
- United Family Practice Health Center
- West Side Community Health Services, Inc.
External resources for Minnesota residents
- Centers for Medicare & Medicaid Services
- Cover USA.org
- The Kaiser Family Foundation
- Minnesota Department of Commerce
- State Refor(u)m
Gillian Burdett is a freelance writer covering all things home and living. Her work can be found on Examiner.com.