There are nearly 400,000 Minnesotans without health insurance. Why are there still people who are uninsured? Many reasons:
• They couldn't afford insurance, or believed they could not.
• They could afford insurance, but made a choice to roll the dice and not have any coverage. Or perhaps they have religious beliefs about the very nature of insurance.
• They did not understand — because of language, education or other barriers — how and when to buy health insurance.
• They were misinformed about open enrollment, incorrectly believing they could buy health insurance at any time.
The Affordable Care Act (ACA) guarantees coverage for individuals but only during a 45-day open enrollment period. Minnesota's open enrollment period is slightly longer but it is still limited. Additionally, there are many "special enrollment" life events that allow consumers to buy MNsure plans for up to a 60-day period following a defined list of qualified events such as the loss of a job, divorce or birth of a child. However, these life events don't cover every important event. For example, pregnancy is not a life event that allows an uninsured woman to immediately have health insurance. If a natural disaster happens in your county, you can buy coverage. If there is an epidemic? No.
What will those without insurance do if they are diagnosed with the coronavirus? Will they act in the same way Minnesotans with health insurance act? Probably not.
There is abundance of evidence that those without health insurance respond to medical situation in ways that are different from those with coverage. They wait longer to seek treatment, and they are less like to take prescribed medications. They are more likely to skip follow-up visits and less likely to proceed with recommended lab and diagnostic tests.
