Approaching Universal Coverage: Minnesota's Health Insurance Programs

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Among the many states that have worked to bring health insurance to more of their residents, Minnesota stands apart. According to the Minnesota Department of Health, 95 percent of the state's nonelderly population had health insurance in 2001—one of the highest coverage rates in the nation. The state's secret, a new study reveals, is an effective combination of public programs and publicly sponsored private insurance that complements existing private coverage.

In their report, Approaching Universal Coverage: Minnesota's Health Insurance Programs, Deborah Chollet and Lori Achman of Mathematica Policy Research, Inc., find that although widespread private coverage is partly responsible for Minnesota's achievement, also of central importance are five state-sponsored programs that work together to provide coverage for low-income children and adults, as well as for individuals who have trouble finding insurance in the private market because of health problems. Together, these programs cover about 11 percent of the state's nonelderly population.

""Minnesota is unusual in its overarching commitment to extending health insurance coverage and its practice of seizing opportunities to do so,"" noted Chollet, the report's lead author. ""Its lessons for success are simple: start programs modestly, expand them as they demonstrate their value, and serve populations in need at all levels of income.""

Minnesota has three public health coverage programs: Medical Assistance targets low-income children and families, the elderly, and the disabled; General Assistance Medical Care aids adults without children; and MinnesotaCare, which requires premiums and some cost-sharing, assists families and adults with modest incomes. The state is now taking steps to integrate these three public programs—and reduce gaps in coverage—by automating eligibility determinations, making referrals among programs, and blending benefits and financing. Meanwhile, a single, simplified application form, available online and in eight languages other than English, has dramatically increased enrollment.

The state also operates the nation's largest high-risk pool for individuals who have trouble finding insurance because of health problems. In addition, a small-group purchasing pool is open to town and county governments as well as to school districts.

Facts and Figures

  • In 2000, four of five Minnesotans under age 65 without private coverage participated in a state-sponsored health insurance program.
  • Minnesota's public health insurance is available to families with incomes up to 275 percent of the federal poverty level and for childless adults with incomes up to 175 percent of poverty.
  • Among Minnesota's remaining uninsured, 77 percent said that they would enroll in public health insurance if they knew they were eligible.

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Publication Details

Publication Date: February 1, 2003
Authors: Lori Achman, Deborah Chollet
Citation:

Approaching Universal Coverage: Minnesota's Health Insurance Programs, Deborah Chollet and Lori Achman, The Commonwealth Fund, February 2003

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