2015 Minnesota Health Access Survey Presentation to MNsure Board - - PowerPoint PPT Presentation

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2015 Minnesota Health Access Survey Presentation to MNsure Board - - PowerPoint PPT Presentation

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2015 Minnesota Health Access Survey Presentation to MNsure Board March 9, 2016 Stefan Gildemeister Alisha Simon 1 Minnesota Health Access Survey General Population Telephone Survey Sampling designed to results of specific geographic

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Presentation to MNsure Board

March 9, 2016 Stefan Gildemeister Alisha Simon

2015 Minnesota Health Access Survey

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Minnesota Health Access Survey

  • General Population Telephone Survey
  • Sampling designed to results of specific geographic

regions, ages, and racial/ethnic groups

  • Sample telephone numbers in landline and cell frame
  • Biennial Survey
  • Conducted in partnership w/School of Public Health,

SHADAC (PI: Dr. Kathleen Call)

  • Customized to address timely and relevant policy

questions in MN

  • Revised with input from range of stakeholder groups

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As Reported on February 29, 2016

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Source: Minnesota Department of Health, Health Economics Program, 2001, 2004, 2007, 2009, 2011, 2013 and 2015 Minnesota Health Access Survey.

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Uninsurance in Minnesota – 2001-2015

Minnesota Health Access Survey

6.1% 7.7%* 7.2% 9.0%* 9.0% 8.2% 4.3%* 0% 2% 4% 6% 8% 10% 2001 2004 2007 2009 2011 2013 2015

* Indicates statistically significant difference from previous year shown at the 95% level Source: Minnesota Department of Health, Health Economics Program, 2001, 2004, 2007, 2009, 2011, 2013 and 2015 Minnesota Health Access Survey.

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Changes in the Number of Uninsured

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  • Compared to 2013, in 2015:
  • About 200,000 more Minnesotans had

coverage

  • This includes 35,000 more children
  • The decline in the long-term uninsured

accounted for nearly all of the decline in the uninsured

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Alternate Measures of Uninsurance

* Indicates statistically significant difference from previous year shown at the 95% level Source: Minnesota Department of Health, Health Economics Program, 2011, 2013 and 2015 Minnesota Health Access Surveys.

6.6% 6.1% 2.1%* 2.4% 2.1% 2.2% 3.8% 4.1% 3.8% 0% 2% 4% 6% 8% 10% 12% 14% 2011 2013 2015 Insured now, but was uninsured during the year Uninsured now, but had some insurance during the year Uninsured all year Point in time rate: 9.0% Point in time rate: 8.2% Point in time rate: 4.3%*

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Sources of Health Insurance Coverage

68.1% 62.5%* 55.2%* 55.9% 4.8% 5.1% 5.4% 6.3% 21.1% 25.2%* 31.1%* 33.6%* 6.1% 7.2% 8.2% 4.3%* 0% 20% 40% 60% 80% 100% 2001 2007 2013 2015 Group Non-Group Public Uninsured

* Indicates statistically significant difference from previous year shown at the 95% level Source: Minnesota Department of Health, Health Economics Program, 2001, 2007, 2013 and 2015 Minnesota Health Access Survey.

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  • Highest gain in coverage

ever recorded

  • Coverage improvements

across virtually all demographic groups

  • Long-term uninsured

see structural barriers fall

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  • Historical patterns in

disparities largely

  • remain. Uninsured are:
  • More likely to have

household incomes below 200% FPG

  • More likely to have fair or

poor self-reported health

  • More likely to have high

school or less education

  • Less likely to be white
  • Less likely to be married

Coverage Gains – A Mixed Story

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Reasons For Being Uninsured, 2015

* Indicates statistically significant difference between short- and long-term uninsured at 95% level Other/Don't know includes just moved to state, getting coverage soon, immigration issues, IHS, other and don't know Source: Minnesota Department of Health, Health Economics Program, 2015 Minnesota Health Access Survey.

24.2% 5.6%* 16.3%* 12.2% 2.4% 14.9% 24.5% Short Term Uninsured 23.0% 18.9%* 4.8%* 4.9% 4.4% 12.2% 2.7% 29.3% Long Term Uninsured

Lost Job/Job doesn't offer coverage Cost Not eligible/Doesn't think eligible Paperwork problems Family situation changed Didn't like benefits/doesn't want insurance Don't know how Other/Don't know

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Pathways to Coverage for the Uninsured, 2013 and 2015

19.6% 67.4% 17.7% 23.1% 60.7% 22.4% 7.7%* 0% 20% 40% 60% 80% Eligible for employer coverage Potentially eligible for public coverage Potentially eligible for APTC Not eligible for employer or public coverage 2013 2015

More Than 90 Percent of the Uninsured Have Some Path to Coverage

* Indicates statistically significant difference from previous year shown at 95% level. Eligibility for public coverage is based on age, family income and eligibility for employer–based coverage (for MinnesotaCare) for 2015. Estimation of access to Advanced Premium Tax Credits (APTC) is based on a combination of family income and eligibility for employer coverage. The data does not allow us to determine if employer coverage is affordable. Source: Minnesota Department of Health, Health Economics Program, 2015 Minnesota Health Access Survey.

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Potential Access to Advanced Premium Tax Credits (APTC)

Estimation of access to Advanced Premium Tax Credits (APTC) is based on a combination of family income and eligibility for employer coverage. The data does not allow us to determine if employer coverage is affordable. Approximately 26,500 MNsure enrollees received APTC in 2015 through October Source: Minnesota Department of Health, Health Economics Program, 2015 Minnesota Health Access Survey.

22.4% 24.6%

0% 10% 20% 30%

Uninsured Non-Group Coverage (total)

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51,000 82,000 20,000 62,000

  • 20,000

40,000 60,000 80,000 100,000

Uninsured Non-Group Coverage (total) Non-Group Coverage (MNsure) Non-Group Coverage (not MNsure)

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Estimates of APTC for Potentially Eligible Minnesotans, 2015

64.3% 4.6% 10.3% 20.8% 71.8% 14.4% 7.9% 6.7% 0% 10% 20% 30% 40% 50% 60% 70% 80% $0 $0 to <$50 $50 to $100 More than $100 Non-Group Uninsured

Estimates for amount of APTC assume the survey target is the only person in the household who needs non-group coverage and is a non-tobacco user; the amount is based on reported income, 2015 reference premiums by county adjusted by age. Source: Minnesota Department of Health, Health Economics Program, 2015 Minnesota Health Access Survey.

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Average Monthly APTC Amount, Select Demographics

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$38.32 $- $3.25 $58.09 $175.06 $48.95 $21.20 $115.87 $24.98 $124.50 $175.06 $137.09 $73.52 $- $50 $100 $150 $200 Total 0 to 17 18 to 34 35 to 64 65+ Non-Group Coverage Uninsured All Eligible Those with APTC > $0

Estimates for amount of APTC assume the survey target is the only person in the household who needs non-group coverage and is a non-tobacco user; the amount is based on reported income, 2015 reference premiums by county adjusted by age. Source: Minnesota Department of Health, Health Economics Program, 2015 Minnesota Health Access Survey.

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Future Research

  • Extend analysis of APTC
  • Awareness of tax credits
  • Study resources used to gain coverage
  • Internet, banking, etc.
  • In-person assisters
  • Consider impact of health insurance Literacy
  • Study access barriers
  • Analyze geographic differences
  • Study disparities in health access/insurance

coverage

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Contact Information

  • MDH – Health Economics Program
  • Health Economics Program Home Page

(www.health.state.mn.us/healtheconomics)

  • Specific questions about the Minnesota Health

Access Survey

  • health.mnha@state.mn.us
  • Use the Survey Data
  • Minnesota Health Access Survey Data Tool

(https://pqc.health.state.mn.us/mnha/PublicQuery.action)

  • Additional Contacts
  • Alisha Simon (alisha.simon@state.mn.us)/651-201-3557
  • Stefan Gildemeister (stefan.gildemeister@state.mn.us)/651-201-3554

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