Uninsured and unsure in Minnesota: The Pessimistic Optimist

If you asked Brian Dobbs, he would tell you he was a very lucky guy. After years without health insurance, he’s only had to go to the doctor once. And that was during the brief period his employer provided health care. Other than that, Brian has come up with his own brand of insurance…don’t do anything.

Part One of a three-part series from MN 2020.

“People don’t even expect me to be available for anything anymore. Because I’m in retail, I work when everyone else is free. It’s hard to plan anything when my weekend is double booked with shifts.”

And by shifts, he means shifts. Brian is currently working 2 jobs, and last Friday, he was interviewing for a 3rd. Each of his employers makes sure to keep Dobbs under the hours that would make him full time. They can’t afford to offer him health care either. The last one that did ate his paycheck away and left him with no option but to keep booking those double shifts.

“Last time I was full time, it’s like I was a part time employee because the health insurance ate up my paycheck. So I had to keep the other job just to pay for my life.”

This means no spare change to buy medicine or pay copays if he was sick. Brian makes between 1000.00 and 1200.00 a month after taxes. Between student loans, credit cards, and living expenses, Brian can’t afford to be sick. That means no touch football league. No downhill skiing on a friend’s birthday. For people like Brian, the risk is too great.

“My friends call me the most pessimistic optimist they’ve ever met. I hope for the best, but I’m not surprised that things are this bad.”

Brian’s story is a familiar one. There are 375,000 people in Minnesota without health care. That’s roughly the population of Metro Minneapolis. 375,000 people who think about their lives not so much as when they will get sick or injured, but how best to prevent it.

“It’s a big problem” says Sarah Greenfield, Health Care Organizer for Take Action Minnesota.

TAM, in conjunction with Families USA, released a report Thursday that takes a look at where Minnesota ranks against other states in several areas of health care. And while Minnesota ranked fairly well overall, people like Brian fall through the cracks.

“I work, you know, pretty hard. But if it wasn’t for selling a car and the stimulus package, I wouldn’t have made my bills this year.”

Brian could be covered, if he would just work a little less. Under MinnesotaCare, as a single man with no children, he had to make less than $1700.00 before taxes. The first time he applied, he was rejected. And since Dobbs was pretty sure that a job with health care would come through, he didn’t see the need to try again.

A single adult in Minnesota can be eligible for MinnesotaCare if they make at or below 200% of the federal poverty guideline (FPG), have been Minnesota residents for 6 months, and have been without health care for 4 months. The personal asset limit is set at $10,000 for an individual.

MinnesotaCare was a system put in place in order to cover those who fall through the healthcare gap between Medicaid and affordable health insurance. It is one of the only programs like it in the country. Since its inception, MnCare has covered 526,000 individuals who otherwise would have gone without insurance. But the program has restrictions such as income, residency, and assets. As many already know, MnCare is funded by a tax on insurers and a percentage of premiums Minnesotans pay. These taxes have been able to cover hundreds of thousands of Minnesotans over the years, with an ample surplus left over. Last year, the surplus was well over 200 million. And with a surplus like that, it’s been hard to keep money-hungry legislators at bay.

Over the past several years, the Health Care Access Fund has seen its coffers raided in order to cover deficits in other area. Money from the surplus has found its way into the general fund, with an ever-increasing chance that more would trickle in during the next legislative session.

The legislature is on the right track. In 2009, the FPG will be increased for people like Brian, with more to come in 2010. But by then, there may not be any funds left to cover them. If we do not hold policymakers accountable for the money already taken out of the Health Care Access Fund, we almost guarantee more of the same in the not too distant future. And while a surplus during a lean year can often signal a need for a shift of assets, these funds are not available. They are there so in the future, the Brian Dobbs of Minnesota can stop working 70-90 hours a week and engage in some of those activities that he may need the coverage for.