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Pres hsr mar5_pintor Presentation Transcript

  • 1. Putting Out the Welcome Mat: TargetingOutreach Under the Affordable Care ActProfile of Minnesota’s UninsuredJessie Kemmick Pintor, MPHMN Health Services Research ConferenceMarch 5th, 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 individuals who will be newly eligible for Medicaid coverage or subsidies through the exchange: – Overall uninsured – Medicaid-eligible: <138% FPG – Subsidy-eligible: 139-400% 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, 2011• 489,000, or 9.1% of, Minnesotans uninsured – 675,000, or 12.6% uninsured at some time in 2011• Uninsurance rates highest among: – 26-34 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 138% and 139-400% FPG, 2011 Public Uninsured 15% Uninsured 17% Individual 23% Public 6%Individual 45% 5% Group Group 27% 62% Source: 2011 Minnesota Health Access Survey 5
  • 6. Uninsured Medicaid- and subsidy-eligiblemuch younger than non-elderly adults overall50% 46%45% 41%40%35% 31% 30%**30% 29%* 26%25% 19% 19%20% 18% 16%15% 13% 11%10%5%0% 18-25 26-34 35-54 55-64 Uninsured Medicaid-eligible Uninsured subsidy-eligible Overall Source: 2011 Minnesota Health Access Survey 6
  • 7. Latinos greatly overrepresented among Medicaid-eligible; Blacks overrepresented among subsidy-eligible100% 90% 84% 80% 75% 70% 59% 60% 50% 40% 30% 20% 17%** 12%* 10% 10% 5% 6% 4% 4% 7% 5% 4% 1% 1% 4% * 2% 0% White Black Asian American Hispanic/Latino Other Indian Uninsured Medicaid-eligible Uninsured subsidy-eligible Overall *Less than 1% Source: 2011 Minnesota Health Access Survey 7
  • 8. Three in ten Medicaid-eligible have less thana high school education100% 8%90% 19%80% 34% 29%70% 32%60% College grad50% 34% Some college 33%40% HS grad30% 37% Less than HS20% 25% 30%***10% 13% 8% 0% Uninsured Medicaid- Uninsured subsidy- Overall eligible eligible Source: 2011 Minnesota Health Access Survey 8
  • 9. What else do we know about Medicaid- andsubsidy-eligible?• 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 subsidy- eligible have children under 21 in household 9
  • 10. Interaction of the uninsured Medicaid-eligible withMinnesota Public Health Care Programs, 2011100%90%80%70%60%50%40% Uninsured Medicaid-elgible30% Uninsured subsidy-eligble20%10% 0% Asked/given Would enroll if Of those who say Would information eligible no: would enroll participate in a about public if coverage was premium programs free assistance program Source: 2011 Minnesota Health Access Survey 10
  • 11. Main reason for not enrolling in Public Health Care Programs, 2011 Dont think the care/benefits are goodDont think the 3% Othercare or benefits Other 11% through these Too much 14% hassle/paperwork programs are 3% good Applied but not Too expensive Dont think eligible 4% 23% government should 23% pay for my health care Dont need or 4% want insurance Will get insurance right now/rarely soon sick 6% 10% Dont think Im eligible Do not know Dont need or want 14% Will get insurance insurance right now what to do/where soon 11% to go/how to 8% enroll Do not know Too much 21% what to hassle/paperwork do/where to Too expensive Applied but not go/how to 14% 9% eligible enroll 11% 11% Source: Minnesota Health Access Survey, 2011 11
  • 12. Next steps/Potential analyses for MN HealthInsurance Exchange• 3-year (2008-2010) 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 139-400% FPL, 2008-2010, by PUMA 13
  • 14. Conclusions/Implications for outreach toMedicaid-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 tosubsidy-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 612.624.2083Sign up to receive our newsletter and updates at @shadac