Profile of Minnesota s Uninsured

Transcription

1 Putting Out the Welcome Mat: Targeting Outreach Under the Affordable Care Act Profile of Minnesota s Uninsured Jessie Kemmick Pintor, MPH MN Health Services Research Conference March 5 th, 2013 Funded by a grant from the Robert Wood Johnson Foundation

2 Purpose/Overview To provide an in-depth profile of the uninsured in Minnesota in order to inform targeted outreach to non-elderly adults who will be newly eligible for Medicaid coverage or subsidies through the exchange: Overall uninsured Potentially Medicaid-eligible non-elderly adults: <138% FPG Potentially subsidy-eligible non-elderly adults : % FPG 2

3 2011 MN Health Access Survey Conducted by MDH and SHADAC (Sep to Dec 2011) Purpose: Document trends in health insurance coverage and access to insurance and health care Describe characteristics of the uninsured, and economic and demographic factors associated with lack of coverage Establish baseline data for evaluating health reform Dual frame survey targeting 11,000 completes 62% landline, 38% cell Stratified sampling to produce reliable estimates for: Regions of the state Most populous racial/ethnic groups 3

4 Uninsured Minnesotans, ,000, or 9.1% of, Minnesotans uninsured 675,000, or 12.6% uninsured at some time in 2011 Uninsurance rates highest among: year olds, individuals with lower education/income levels, Hispanics/Latinos, and foreign-born Uninsured as likely to be employed as overall However, more likely to be self employed or work for smaller employers, work part-time, hold more than one job, and hold temporary or seasonal jobs Most report lack of coverage due to cost, and loss of coverage due to job termination 4

5 Nearly half of Medicaid-eligible already have public coverage, most subsidy-eligible have ESI Insurance coverage among non-elderly adults at or below 138% and % FPG, 2011 Individual 5% Uninsured 23% Public 45% Individual 6% Uninsured 17% Public 15% Group 27% Group 62% Source: 2011 Minnesota Health Access Survey 5

6 Uninsured Medicaid- and subsidy-eligible much younger than non-elderly adults overall 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% Age distribution of non-elderly adults, % 41% 31% 29%* 30%* 26% 18% 19% 16% 13% 11% Uninsured Medicaid-eligible Uninsured subsidy-eligible Overall 19% *Indicates statistically significant difference (95% level) from overall non-elderly population Source: 2011 Minnesota Health Access Survey 6

7 Latinos greatly overrepresented among Medicaideligible; Blacks overrepresented among subsidy-eligible 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 59% Race/ethnicity among non-elderly adults, % 84% 10% 12%* 5% 6% 4% 4% 4% 1% 1% White Black Asian American Indian 17%* 7% 4% 5% ƚ 2% Hispanic/Latino Uninsured Medicaid-eligible Uninsured subsidy-eligible Overall Other *Indicates statistically significant difference (95% level) from overall non-elderly population ƚ Less than 1% Source: 2011 Minnesota Health Access Survey 7

8 Three in ten Medicaid-eligible have less than a high school education Level of education among non-elderly adults, % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 8% 29% 33% 30%* Uninsured Medicaideligible 19% 32% 37% 34% 34% 25% 13% 8% Uninsured subsidyeligible Overall College grad Some college HS grad Less than HS *Indicates statistically significant difference (95% level) from overall non-elderly population Source: 2011 Minnesota Health Access Survey 8

9 What else do we know about Medicaid- and subsidy-eligible non-elderly adults? Males slightly overrepresented Less likely to be in excellent/very good health Similar distribution across TC metro/greater MN Just over half of Medicaid-eligible employed, compared to 76% of nonelderly overall 11% of Medicaid-eligible and 19% of subsidy-eligible have access to ESI Over half of Medicaid-eligible and 1/3 of subsidyeligible have children under 21 in household 9

10 Interaction of uninsured non-elderly adults with Minnesota Public Health Care Programs, % 90% 80% 70% 60% 50% 40% Uninsured Medicaid-elgible 30% Uninsured subsidy-eligble 20% 10% 0% Asked/given information about public programs Would enroll if eligible Of those who say no: would enroll if coverage was free Would participate in a premium assistance program Source: 2011 Minnesota Health Access Survey 10

11 Main reason for not enrolling in MN Health Care Programs among uninsured non-elderly adults, 2011 Don't think the care/benefits are good 4% Don't need or want insurance right now/rarely sick 10% Will get insurance soon 8% Other 14% Too much hassle/paperwork 9% Applied but not eligible 11% Too expensive 23% Medicaid-eligible Do not know what to do/where to go/how to enroll 21% Don't think the care/benefits are good 3% Other Too much 11% hassle/paperwork 3% Don't think government should pay for my health care 4% Will get insurance soon 6% Don't need or want insurance right now 11% Do not know what to do/where to go/how to enroll 11% Applied but not eligible 23% Too expensive 14% Subsidy-eligible Don't think I'm eligible 14% Source: 2011 Minnesota Health Access Survey 11

12 Next steps/potential analyses for MN Health Insurance Exchange 3-year ( ) pooled sample of the American Community Survey (ACS) allows for geographic specificity (PUMA) in answering a number of questions Characteristics of uninsured across PUMAs: Education levels across PUMAs Individuals in linguistically-isolated households across PUMAs Individuals in households where someone receives TANF/SNAP benefits across PUMAs Potential to generate regions designed by the state Adding layer information such as location of schools, community centers, libraries, etc. 12

13 Percent uninsured nonelderly US citizens, <=138% FPL and % FPL, , by PUMA 13

14 Conclusions/Implications for outreach to Medicaid-eligible Medicaid outreach will need to target younger Minnesotans with lower levels of education Over half of uninsured Medicaid-eligible have inquired about MHCP and 4 in 5 report they would enroll in Medicaid if they were eligible Still, many report that they do not know where to go, how to apply and/or that the process is too much of a hassle/too much paperwork Many live in households with children under 21, which may be a potential avenue for outreach 14

15 Conclusions/Implications for outreach to subsidy-eligible Slightly younger and lower levels of education compared to nonelderly overall Only 1 in 5 of the uninsured who are potentially eligible for subsidies under the exchange have access to employer-sponsored insurance Over half have inquired about MHCP and most report they would enroll in a premium assistance program if eligible Still, again, they report problems accessing MHCP 15

16 Jessie Kemmick Pintor Sign up to receive our newsletter and updates at