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

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 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 2

As Reported on February 29, 2016 3 Source: Minnesota Department of Health, Health Economics Program, 2001, 2004, 2007, 2009, 2011, 2013 and 2015 Minnesota Health Access Survey.

Uninsurance in Minnesota – 2001-2015 Minnesota Health Access Survey 10% 9.0% 9.0%* 8% 8.2% 7.7%* 7.2% 6% 6.1% 4% 4.3%* 2% 0% 2001 2004 2007 2009 2011 2013 2015 * Indicates statistically significant difference from previous year shown at the 95% level 4 Source: Minnesota Department of Health, Health Economics Program, 2001, 2004, 2007, 2009, 2011, 2013 and 2015 Minnesota Health Access Survey.

Changes in the Number of Uninsured  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 5

Alternate Measures of Uninsurance 14% 12% Point in time rate: Point in 3.8% 4.1% 10% 9.0% time rate: 8.2% 8% 2.4% 2.1% Point in 3.8% time rate: 6% 4.3%* 4% 6.6% 2.2% 6.1% 2% 2.1%* 0% 2011 2013 2015 Insured now, but was uninsured during the year Uninsured now, but had some insurance during the year Uninsured all year * Indicates statistically significant difference from previous year shown at the 95% level 6 Source: Minnesota Department of Health, Health Economics Program, 2011, 2013 and 2015 Minnesota Health Access Surveys.

Sources of Health Insurance Coverage 100% 4.3%* 6.1% 7.2% 8.2% 21.1% 80% 25.2%* 33.6%* 31.1%* 4.8% 5.1% 60% 6.3% 5.4% 40% 68.1% 62.5%* 55.9% 55.2%* 20% 0% 2001 2007 2013 2015 Group Non-Group Public Uninsured * Indicates statistically significant difference from previous year shown at the 95% level 7 Source: Minnesota Department of Health, Health Economics Program, 2001, 2007, 2013 and 2015 Minnesota Health Access Survey.

Coverage Gains – A Mixed Story  Highest gain in coverage  Historical patterns in ever recorded disparities largely remain. Uninsured are:  Coverage improvements  More likely to have across virtually all household incomes below demographic groups 200% FPG  More likely to have fair or  Long-term uninsured poor self-reported health see structural barriers  More likely to have high fall school or less education  Less likely to be white  Less likely to be married 8

Reasons For Being Uninsured, 2015 Short Term Uninsured Long Term Uninsured Lost Job/Job doesn't offer coverage Cost Not eligible/Doesn't think 23.0% eligible 24.2% 24.5% 29.3% Paperwork problems Family situation changed 5.6%* 14.9% 18.9%* 2.7% Didn't like benefits/doesn't want insurance 16.3%* 12.2% Don't know how 2.4% 12.2% 4.8%* Other/Don't know 4.9% 4.4% * 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 9 Source: Minnesota Department of Health, Health Economics Program, 2015 Minnesota Health Access Survey.

Pathways to Coverage for the Uninsured, 2013 and 2015 More Than 90 Percent of the Uninsured Have Some Path to Coverage 80% 67.4% 60.7% 60% 40% 23.1% 22.4% 19.6% 17.7% 20% 7.7%* 0% Eligible for employer Potentially eligible for Potentially eligible for Not eligible for coverage public coverage APTC employer or public coverage 2013 2015 * 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. 10 Source: Minnesota Department of Health, Health Economics Program, 2015 Minnesota Health Access Survey.

Potential Access to Advanced Premium Tax Credits (APTC) 30% 100,000 24.6% 82,000 22.4% 80,000 20% 62,000 60,000 51,000 40,000 10% 20,000 20,000 - 0% Uninsured Non-Group Non-Group Non-Group Uninsured Non-Group Coverage Coverage Coverage Coverage (total) (total) (MNsure) (not MNsure) 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 11 Source: Minnesota Department of Health, Health Economics Program, 2015 Minnesota Health Access Survey.

Estimates of APTC for Potentially Eligible Minnesotans, 2015 80% 71.8% 70% 64.3% 60% 50% 40% 30% 20.8% 20% 14.4% 10.3% 7.9% 6.7% 10% 4.6% 0% $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. 12 Source: Minnesota Department of Health, Health Economics Program, 2015 Minnesota Health Access Survey.

Average Monthly APTC Amount, Select Demographics $175.06 $175.06 $200 $137.09 $124.50 $115.87 $150 $73.52 $100 $58.09 $48.95 $38.32 $24.98 $21.20 $50 $3.25 $- $- Total 0 to 17 18 to 34 35 to 64 65+ Non-Group Uninsured Coverage 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. 13 Source: Minnesota Department of Health, Health Economics Program, 2015 Minnesota Health Access Survey.

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 14

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  15