UMN works to identify areas lacking health insurance

The findings from a University of Minnesota researcher will be used by MNsure.

Lew Blank

With Minnesota’s open enrollment period starting in two weeks, a University of Minnesota researcher is looking into hotspots across the state where people are less likely to have health insurance.

By analyzing health insurance data, University public health professor Kathleen Call hopes to discover what factors and locations in Minnesota are associated with gaps in health coverage. This data will be used by MNsure, the state’s health insurance marketplace, to locate communities with deficiencies in health insurance once its open enrollment period begins on Nov. 1.

“There are definitely pockets where we are seeing some higher rates of uninsurance,” Call said. “Having a much broader and more nuanced picture of who the uninsured are … will be really interesting.”

Although Call’s research has yet to find conclusive results, preliminary research indicates that clusters with below-average insurance rates are largely placed in the upper third of the state. They’re also found in counties in southern Minnesota like Watonwan, Nobles and Fillmore. 

In the Twin Cities, these clusters of uninsurance are typically located in urban areas with more difficult economic conditions, Call said.

Demographics such as being a man, low-income or a person of color can increase chances of not having insurance in Minnesota, she said.

Race in particular is one of the largest predictors of a lack of health insurance in Minnesota, according to 2015 data from the Minnesota Department of Health. While 3.8 percent of white Minnesotans are uninsured, there is significantly less coverage for black, Hispanic and Native American Minnesotans, with uninsurance rates of 9.3 percent, 11.5 percent and 23.1 percent, respectively.

The Minnesota county with the highest uninsured rate is Mahnomen County, with 18.5 percent of its citizens lacking coverage, according to data from the State Health Access Data Assistance Center. More than one-third of its population is composed of Native Americans, primarily from the White Earth Reservation.

The three counties in Minnesota with the highest uninsured rates — Mahnomen, Clearwater and Beltrami — are all located in northwestern Minnesota, according to SHADAC data.

Call hopes her research into the geographic and demographic disparities of Minnesota’s uninsured can better inform MNsure staff in their abilities to identify and reach out to Minnesotans who are uninsured.

“The research that [Call] is doing is going to give us really local, really important information about where [Minnesota’s uninsured residents are] and what are their individual and community characteristics,” said Carolyn Link, president of the Blue Cross and Blue Shield of Minnesota Foundation, which helps fund Call’s research. “The more we understand about people who are without insurance coverage, the better we can … find those people and support them.”

Between 2015 and 2017, Minnesota’s uninsured rate rose from 4.3 percent to 6.3 percent, according to data from the Minnesota Department of Health. To reduce this uninsured rate, MNsure hopes to use Call’s research to direct education, resources and outreach to hotspots of high uninsurance rates, said Jessica Kennedy, the policy director at MNsure.

“In the big picture, it really helps us know where … to target those outreach campaigns,” she said. “[This includes] putting out more education, putting out more tools and resources [and] getting people more information so that they can make confident choices about their healthcare options.”