Getting insurance is just the start

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Good news from MNsure: in the first seven months of its operation, Minnesota’s uninsured rate has dropped by 40 percent. That represents over 180,500 more people with health insurance. The majority of these enrollees have signed up for expanded public insurance programs, but many others have purchased private coverage. (Many people who previously had coverage have also switched to more affordable MNsure options.) Minnesota’s uninsured rate is currently just 4.9 percent, which is our state’s lowest rate ever and the second-lowest in the nation.

As impressive as this accomplishment is, it’s not the end of our efforts to help people access affordable healthcare. Not only do we still have five percent of Minnesotans left to reach, approximately 260,000 people, but we need to make sure that those who have gained health insurance continue to stay insured. That’s the true test of our success, and it will require ongoing effort on a few fronts.

Many, many people don’t fully understand how their health insurance works (even my own husband needs my help to comprehend his). They avoid seeking medical care because they’re not sure how much it will cost them. They find doctors’ bills confusing (as most of us do). If they make a costly mistake, such as using an expensive out-of-network provider, they might be hesitant to use their insurance in the future for fear of another unexpected expense. If we’re truly going to improve health and lower costs, we need to help people use their insurance wisely and confidently.

We also need to make sure that people keep the health insurance in which they’ve enrolled. I often meet clients who tell me, “I used to have insurance, but the renewal paperwork was confusing and I missed the deadline to send it in,” or, “I couldn’t afford my insurance anymore and I didn’t think there was anything more-affordable out there.” Whether due to a life change, a missed payment, or a paperwork error, it’s not hard to lose coverage. Insurance exchanges and providers need to make it easy for people to understand what is required to maintain coverage and easy to make changes to their insurance when their life circumstances merit it (one major weak point for MNsure at present).

People also need to want to keep their insurance. One year’s worth of big publicity around enrolling in insurance isn’t enough to convince everyone that they should always be covered. We need ongoing education about the value of insurance, the affordability of insurance, and the cost of not having insurance. Consumers will need to believe that their insurance is worth having, or they might not renew it–penalties nonwithstanding.

One last note. We also need to keep expanding affordable coverage. There are still people left out of the new marketplace, such as people with certain immigration statuses who are not eligible for insurance. There are also people whose coverage still strains their budget (as I’ve written about here and here). Lowering our uninsured rate is going to require some serious conversations about serving these populations.

This year has been the start of something very promising for Minnesota. But, it’s only the start. We can’t stop working together to keep our state healthy and vibrant.