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.

And we in the insurance industry know that visits to emergency rooms can be more expensive than health care under the supervision of a primary care provider.

The governor and the Legislature should take decisive action to include diagnosis of an illness caused by an epidemic to be included as a life event that qualifies for immediate enrollment in MNsure. If this can't be done at the state level, let's ask our fine congressional delegation to take the lead in getting Congress and the president to respond quickly. Too many people believe that you can buy health insurance at any time during the year. Not true.

Giving the uninsured an opportunity to buy coverage through MNsure if they are diagnosed COVID-19 will bring down costs, improve access to care and possibly save lives.

Jeffrey Smedsrud is a longtime health insurance executive and reform activist. He is the chair of Communicating for America, a Fergus Falls, Minn.-based advocacy organization with about 100,000 members nationwide.