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18 recordsLinked to original sources
PubMed1997

Rural enrollment in MinnesotaCare.

Many rural Americans remain underserved and uninsured. Attempts to initiate national health care reform and universal health insurance coverage have stalled. The impetus to continue reform and universal coverage efforts has shifted back to the state level. Minnesota's health reform efforts resulted in the 1992 MinnesotaCare legislation, which included a subsidized insurance program. As of October 21, 1995, a total of 91,140 people were enrolled in MinnesotaCare. Enrollees are found in every county in the state and represent approximately 2.1% of Minnesota's total population and 2.4% of the state's population under age 65. Estimates of Minnesotans who are uninsured and therefore potentially eligible for this subsidized insurance plan range from 6% to 13%. MinnesotaCare enrollment estimates vary from a high of 10.8% of Red Lake County's population who are under age 65 and report incomes over 100% of the poverty level to a low of 1.5% for similar residents of Nicollet County. Counties with the lowest percentage of MinnesotaCare enrollees are clustered in southern Minnesota, especially the southeastern counties. Those with the highest percentage of enrollees appear to cluster in central Minnesota. MinnesotaCare enrollment is negatively associated with the size of the county's minority population and population density.

Adolescent↗
PubMed1997

Who is still uninsured in Minnesota? Lessons from state reform efforts.

OBJECTIVE: To describe Minnesota's health care system reform efforts and their implications for other state and national reform initiatives, document the rate of uninsurance in 1990 and 1995 with special attention to childrens' access to health insurance, and examine the effectiveness of MinnesotaCare, a voluntary state-subsidized health care plan, in serving its target population. DESIGN: Three cross-sectional telephone surveys: 2-stage random samples of Minnesotans of all ages in 1990 and 1995 and a stratified random sample of MinnesotaCare enrollees in 1994. PARTICIPANTS: For the 2 statewide surveys, 10310 respondents participated in 1990 and 11519 in 1995; more detailed information was collected on approximately 1600 respondents in each survey. Eight hundred MinnesotaCare enrollees participated in the third survey conducted in 1994. MAIN OUTCOME MEASURE: Changes in rates of uninsurance. RESULTS: While the rate of uninsurance increased at the national level, the point-in-time Minnesota rate remained stable and low at 6% between 1990 and 1995. The proportion of children uninsured for 12 months or more decreased from 5.2% in 1990 to 3.1% in 1995, while the proportion of uninsured single adults remained stable at approximately 11%. There was no evidence that MinnesotaCare enrollees are gaming the program, or that the program has resulted in significant erosion from the private market. CONCLUSIONS: MinnesotaCare has enabled the state to maintain a low rate of uninsurance and has reduced this rate among its primary target: children. The program has been less effective in enrolling single adults, although it may be too early to witness the effects of recent expansions targeting this group. Minnesota's experience suggests that other state and national reform efforts aimed at reducing uninsurance, particularly among children, are likely to be successful.

Adult↗
PubMed1995

Distributive justice and the Minnesota health access initiative.

As I have suggested, from the perspective of distributive justice MinnesotaCare's reforms are inadequate. But to coin (and alter slightly) a phrase of Kant's, if its authors do not deserve our moral esteem, perhaps they do merit our encouragement, and it is on a note of the latter that I will conclude. MinnesotaCare is an experiment in systemic incremental change being performed in a complex health care system, the only true laboratory for such an experiment. For this reason, it will provide us important information concerning the ethics, economics, [and] the politics of health care reform while improving the position of some Minnesotans in a significant way. Thus, while MinnesotaCare is susceptible to forceful moral criticism, as an experiment in reform it holds out the promise of providing us some of the data necessary for discovering a just solution.

Delivery of Health Care↗
PubMed2006

Lead poisoning in Minnesota Medicaid children.

This article presents data on blood-lead testing in Minnesota children from 1999 through 2003. The number of Minnesota children younger than 6 years of age who were tested for blood lead increased from approximately 38,000 in 1999 to 61,000 in 2003. The rate of blood-lead testing in 9- to 30-month-old children enrolled in Medical Assistance and MinnesotaCare, the state's Medicaid programs for children, increased from 17% to 29% between 1999 and 2003. The rate of elevated blood-lead levels (10 microg/dL or greater) in all tested children declined from 6% in 1999 to 2.7% in 2003. However, the rate of elevated blood-lead levels in children enrolled in the 2 public programs in 2003 (3.4%) was 2-fold higher than that in children who were not on Medical Assistance or MinnesotaCare (1.5%). The percentage of all children with elevated blood-lead levels who were retested within 3 months increased from 39% in 1999 to 50% in 2003.

Child↗
PubMed2003

Hospital provision of uncompensated care and public program enrollment.

Hospital provision of uncompensated care is partly a function of insurance coverage of state populations. As states expand insurance coverage options and reduce the number of uninsured, hospital provision of uncompensated care should also decrease. Controlling for hospital characteristics and market factors, the authors estimate that increases in MinnesotaCare (a state-subsidized health insurance program for the working poor) enrollment resulted in a 5-year cumulative savings of $58.6 million in hospital uncompensated care costs. Efforts to evaluate access expansions should take into account the costs of the program and the savings associated with reductions in hospital uncompensated care.

Adolescent↗
PubMed1993

State 'laboratories' test health care reform solutions.

Widely recognized by the states as a pressing policy issue, health care reform appears to have moved up on the national policy agenda as well. President Clinton has promised to address the issue during his first 100 days in office. Previously, however, the federal government has been deadlocked on health care reform, leaving the states to become the laboratories for developing and testing proposed solutions to our health care crisis. By passing MinnesotaCare in last year's legislative session, Minnesota joined the growing number of states attempting to provide access to affordable, quality health care to their citizens.

Cost Control↗
PubMed1994

Minnesota public opinion on health care resource allocation.

Creating workable policies for allocating or rationing finite health care resources to meet the needs of individuals as well as the broader society vexes policymakers, providers, and consumers. This paper presents results of a March 1994 Lou Harris survey of 1,006 Minnesotans about health care allocation. Minnesotans believe that allocative or rationing decisions are inevitable and can be discussed. Individualized bedside allocative decisions are preferable to categorical or universal exclusions of some health care benefits. People want comprehensive health care and are willing to let sound clinical judgment, perhaps informed by practice guidelines, selectively withhold some services. The integrity of plan-based allocation or rationing may be best secured and safeguarded by standards that ensure that the decisions are based on patients' best interests, involve trusted clinical decision makers, and include lay participation in the decision making.

Adolescent↗