Minnesota ranked 8th overall for the quality of child health care, but 51st in adequacy of insurance for kids.
Minnesota ranks No. 8 nationally in a new survey of child health -- but dead last in adequacy of health insurance for kids, a sign that rising co-pays and deductibles are squeezing family finances and affecting when parents take children to the doctor.
While 23 percent of parents with private insurance nationally felt their out-of-pocket medical costs were sometimes or always too high, that figure jumped to 33 percent in Minnesota.
The low ranking on insurance "adequacy'' is based on a 2007 federal survey of parents about the costs of their children's health plans. It single-handedly hurt Minnesota's ranking in the new report, released on Wednesday by the Commonwealth Fund, a national health policy group.
Minnesota was best in the nation on teen obesity and child oral health and among the best for its low rates of infant mortality, childhood deaths and uninsured children. A section of the report even highlighted Minnesota's $47 million public health investment in recreational trails, tobacco cessation programs and other health promotions.
The low rating for health insurance was jarring by comparison, but not completely unexpected. Minnesotans aren't grumpier than other people about out-of-pocket costs, after all: They really do pay more. The average deductible for family health plans in Minnesota rose from $1,191 in 2003 to $1,998 in 2009, according to a separate Commonwealth study released last month. It also found that 88 percent of insured Minnesotans paid deductibles in 2009, compared to 74 percent nationally.
"Families likely see they are paying more but getting less protection," said Commonwealth's Cathy Schoen.
Minnesota families do enjoy one advantage: Their premiums consumed only 17 percent of their incomes, compared to 19 percent nationally. That was 12th best in the study.
It's no secret that Minnesota insurers and employers have been shifting costs to families in an attempt to slow the skyrocketing growth of health care spending. Insurers have also promoted consumer-directed health plans that make people more responsible for their medical costs. Enrollment in one type of consumer plan, the Health Savings Account, increased in Minnesota from 243,000 in 2006 to more than 720,000 today.
Paying more and more
The strategies worked. Overall health care spending grew only 5.6 percent in 2007, while the consumer's out-of-pocket share grew nearly 14 percent. The trend was the same in 2008.
On the positive side, cost shifting prevented employers from cutting benefits altogether and putting workers and their families into the ranks of the uninsured, said Eileen Smith of the Minnesota Council of Health Plans. "As more and more employers are trying to keep coverage, they're having employees pay more and more of the cost," Smith said.
Rising costs did, however, apparently discourage some families from seeking recommended care. Minnesota ranked 41st in the Commonwealth study for its low rate of children who received preventive care.
Studies have found that higher co-pays and out-of-pocket expenses keep families away from doctor's offices. That trend might change under the federal health overhaul, which requires new or revised health plans to fully cover preventive health care, including recommended pediatric visits and immunizations.
Jeremy Olson • 612-673-7744