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Health care coverage

Most components of the Affordable Care Act (ACA) took full effect in 2014, including the mandate on individual insurance. Correspondingly, we saw pretty remarkable declines in uninsured rates between 2013 and 2015. We rarely see indicators tied quite so closely to policy changes, but this trend is very clearly tied to the full implementation of the ACA.

Since then, uninsured rates have been slowly creeping back up, with a particularly notable uptick since 2018 (i.e., the year after Republican-led Congress reduced the penalty for not having health insurance to $0). We’ve seen uninsured rates increase by about 1-2 percentage points in most regions across the state – all increases are statistically significant.

In 2020, uninsured rates ranged from 4% in Carver, Washington, and Chisago Counties to 13% in Nobles County. Looking at the county map of uninsured rates, you’ll see a good degree of overlap with counties that have greater concentrations of American Indian, Hispanic, and Latinx residents. (Note that coverage by Indian Health Service [IHS] is not considered comprehensive; individuals with IHS coverage alone are not considered insured by this measure.)