Sixty-eight thousand Minnesota children were without health insurance in 2004. That compares to 60,000 uninsured kids in 2001, the last time the Department of Health collected the data.
Jim Koppel, the executive director of the Children's Defense Fund Minnesota, says the spike in uninsured kids is most noticeable in the youngest age group. "There has been an increase of 11,000 children under the age of 5. The very youngest children in Minnesota have seen the most dramatic rise of all children," Koppel said.
Koppel attributes some of the growth in this group to changes in state eligibility rules.
Before 2003, he says newborns were automatically enrolled in Medical Assistance until age 2, if their mothers qualified for the program when they were pregnant. Medical Assistance is Minnesota's version of the federal Medicaid program.
Koppel says lawmakers decided to cut off automatic enrollment at age 1, as a way to help balance the state budget in 2003. As a result, 3,800 kids were kicked off the program.
Koppel says many of those kids still qualified for the state's other subsidized health insurance program, MinnesotaCare, but he says many didn't realize it -- in part because lawmakers cut the budget to promote MinnesotaCare. The number of enrollment forms to be filled out has tripled, and families now have to re-enroll every six months, rather than every year.
That's how you get rid of kids in coverage. That's how you cut participation. Just make it complicated.Jim Koppel, Children's Defense Fund Minnesota
"That's how you get rid of kids in coverage. That's how you cut participation. Just make it complicated," Koppel said.
Of the 68,000 uninsured kids in Minnesota, it's believed that more than three-fourths are eligible for public health insurance programs.
Department of Human Services Commissioner Kevin Goodno says many of the eligibility changes were prompted by a desire to make the program more accountable.
"What we want to do is make sure we're covering the kids that are uninsured, and not covering kids that already have good insurance in the private sector, by taking away some of those elements that were preventing the erosion from the private sector," Goodno said.
Goodno is referring to parents who decline their employer-sponsored health insurance to buy cheaper state-subsidized insurance. The state has a rule that if a family has access to employer-based insurance where the employer pays at least 50 percent of the premium, the family cannot use MinnesotaCare.
On the complexity issue, Goodno agrees that enrollment paperwork can be daunting. He says the state is working on a project right now that would streamline the eligibility process by helping parents get connected with the right programs. But he says there's only so much the state can do.
"Parents do have to take responsibility for ... coming into the counties or coming into our agency, and asking how they can cover their kids for health insurance. So there is some personal responsibility involved in all this as well," he said.
Goodno says while he does think it's a serious problem that so many children are uninsured in the state, he points out that Minnesota is doing well compared to other states. He says the state has one of the lowest overall uninsured rates in the country. He says it's also one of the healthiest states.
But that doesn't satisfy the Children's Defense Fund's Jim Koppel. He says other states are showing more progress when it comes to kids.
"Forty states in this same time period we're talking about, 40 states, decreased the number of uninsured children in their state," he said.
Koppel says three other states -- Massachusetts, Illinois and Maine -- have recently passed legislation that makes sure that all of their children have health insurance. Legislative proposals to do the same thing in Minnesota have not gone anywhere.