Hest, Emily
Hest, Robert

Community and Uninsured Profile In Action: Local Case Studies

With the recent end of the public health emergency and subsequent “unwinding” of the Medicaid continuous coverage requirement, many Americans are now having to navigate changes in health insurance coverage. And while coverage transitions aren’t unique to this moment, the unwinding has spurred many states to think critically about how to mitigate the impacts of this event on potentially vulnerable populations.

Existing data on local communities is invaluable for states considering their approach for helping their residents secure coverage both now and beyond this historic moment. The Minnesota Community and Uninsured Profile is one example of the type of data that can make a meaningful difference in efforts to reach and cover communities. The Minnesota Community and Uninsured Profile features population details and characteristics that can be applied for a variety of different purposes; below are two case studies highlighting how the profile can support the enrollment efforts of local organizations and departments.

Community and Uninsured Profile in Action

Open Door Health Center Case Study

Open Door Health Center (ODHC) is a community health center that serves southern Minnesota. Given that ODHC serves a broad geographic area with limited staffing and resources, the team has to be strategic about how they do community outreach and enrollment. The profile helps ODHC identify specific areas in southern Minnesota with concentrations of uninsured individuals who are potentially disconnected from health care resources. Their navigators can then conduct enrollment and educational events within those areas, equipped with the important context on the local population found in the profile.

Staff at ODHC used the “ZIP Code Uninsured Rates” tab in the profile to hone in on the 24 community ZIP Codes in their region (South Central, MN) with available data. Among those communities, Mankato (56001) has the largest number of uninsured at 1,719 people which could make it a logical site for enrollment and outreach efforts.

By entering “56001” in the Uninsured Profile tab, they could get more pertinent information about Mankato to help effectively target outreach. For example, they would see that among the uninsured in this community:
 

• More than a quarter are likely income eligible for Minnesota Medical Assistance (<138% of the federal poverty level [FPL]) and more than half are likely income eligible for subsidized coverage through MNsure (138-400% FPL)
   
• Nearly 70% are male;
  
  
  
  
   
• More than 80% are currently employed;

• And nearly 60% are between the ages of 26 and 44.
  
  
  
  
  
  
   

Based on these characteristics, staff at ODHC could set up enrollment events in partnership with employers of low-wage workers, or target outreach with messages and venues that speak to male residents or adults in early to middle age. ODHC could be confident that many of the uninsured community members they reach would be income-eligible for some type of free or subsidized coverage.

Further, looking at the profile, ODHC staff could observe that though there are a relatively small number of uninsured Hispanic/Latino residents of this community (211 persons), that group has a high uninsured rate (10.1%), especially compared to Mankato’s comparatively low community uninsured rate of 3.5%. This could indicate that further work needs to be done specifically to cover the Hispanic and Latino residents of Mankato.

Nicollet County Case Study

Nicollet County's local public health department serves a population of about 33,000. Like ODHC, they use the profile to review the demographics of those who are uninsured in their community to inform outreach efforts. The Community and Uninsured Profile also helps them target influenza and COVID-19 vaccinations for underinsured and uninsured community members. The department also uses the profile to better understand the characteristics of individuals who are uninsured in their communities through demographic filters such as race and ethnicity.

Looking in the ZIP Code Uninsured Rates tab, there are two ZIP-Code-defined communities (with available data) in Nicollet County: St. Peter (56082) and North Mankato (56003). Both have relatively low uninsured rates at 3.6% and 3.1%, respectively, and both have around 500 uninsured residents.

However, there are important differences between these communities that are evident when looking in the Uninsured Profile tab. For example, though less than 5% of the uninsured in North Mankato appear to be income-eligible for Medical Assistance (<138% FPL), more than 36% of the uninsured in St. Peter appear to be income-eligible for that program.

Further, whereas none of the uninsured in North Mankato are Hispanic or Latino, Hispanic or Latino residents make up more than 60% of the uninsured in St. Peter. And there is a similar story by citizenship status and nativity; whereas all of North Mankato’s uninsured are U.S. born, more than 50% of St. Peter’s uninsured are foreign born, and more than 90% of those are not citizens, which creates policy and financial barriers to accessing insurance and health care.

The different characteristics of the uninsured in these two communities call for different strategies for outreach and enrollment efforts, such as providing culturally appropriate materials, selecting different sites or partners for enrollment events, and being prepared to enroll uninsured community members into different types of health coverage programs.

What are your Community and Uninsured Profile stories?

Are you a part of an organization that uses the Minnesota Community and Uninsured Profile? We would love to hear stories of how you have used the profile in your work. If you have a story to share, please send it to shadac@umn.edu.