The rate of Minnesotans without insurance rose to 6.3 percent in 2017, a huge jump from the 4.3 percent it was in 2015.
The Minnesota Department of Health released the latest insurance figures on Tuesday, calling it "one of [Minnesota's] largest, one-time increases in the rate of people without health insurance since 2001.
That means in 2017 there were 116,000 more Minnesotans without health insurance than two years earlier. In total, around 349,000 Minnesotans didn't have coverage.
Poorer Minnesotans, young adults aged 18 to 34 and people of color are more likely to be uninsured. Those without insurance also have lower educational attainment.
Why has it spiked?
Minnesota's health insurance rate dropped dramatically following the introduction of the Affordable Care Act, falling from 8.2 percent in 2013 to 4.3 percent in 2015.
But Minnesota Health Commissioner Jan Malcolm says there are now a number of factors at play that cause more people to slip into being uninsured, including the following:
– Fewer people are being covered by their employers, with group coverage dropping from 55.9 to 52.9 percent.
– A decline in sign-ups on the individual marketplace (including via MNSure) from 6.2 to 4.4 percent.
– The increasing cost of health insurance that's keeping people from signing up on the individual market, or finding new insurance after losing their job.
– The federal government is "undercutting" the Affordable Care Act as it seeks to pass an alternative plan to replace it.
The only area of coverage that increased was on public programs like Medicare, Medical Assistance and MinnesotaCare, which rose by 3 percent to cover 36.5 percent of Minnesotans.
This was predominantly driven by the aging Minnesota population, which makes more people eligible for Medicare, but wasn't enough to make up for the shortfall in private coverage.
Rising public coverage could be undermined further in the coming years, given that MinnesotaCare – which provides subsidized coverage for low-income Minnesotans who don't qualify for Medicare – is facing funding cuts from the federal government.
"It is particularly concerning that we are seeing a decrease in health insurance coverage of this magnitude during a time of economic growth and low unemployment," said State Health Economist Stefan Gildemeister in a news release.
"Historically, this is an anomaly and it raises the question of whether the tools in place to address such shocks to insurance coverage – subsidized public health insurance – are sufficient for the conditions of today."