Health care safety net braces for higher demand after cancellation of coverage for undocumented immigrants
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This week, Minnesota’s state lawmakers finalized the state budget, voting to remove undocumented immigrants from the state’s public health insurance program, MinnesotaCare.
It was a controversial vote after more than five hours of debate on the House floor. Some Democrats against the bill worried more uninsured people would increase financial demand on health care systems.
To learn more about the anticipated impact on health care systems, MPR News host Nina Moini spoke with Kimberly Spates, CEO of NorthPoint Health and Wellness, a community health center in north Minneapolis.
Click on the audio player above to listen to their conversation. The transcript below has been edited for length and clarity.
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Tell me a little bit about the clientele you serve at NorthPoint.
At NorthPoint Health and Wellness Center, we serve anyone regardless of their ability to pay. The majority of our patients are patients of color who have socioeconomic challenges, usually those who are at or below the poverty level and have multiple chronic conditions that we’re trying to manage, either diabetes, hypertension or other chronic conditions.
We know that immigrant adults are more likely than U.S.-born adults to rely on so-called ‘safety net’ health care. Tell me about the undocumented population you are serving, and what may happen now?
We don’t ask anyone about their status. We’re here to provide care. What we have seen is an uptick in our Latino/Hispanic populations that come in for care. We also have seen an uptick in individuals who are on our sliding-fee or a discount program, regardless of an individual’s ability to pay. Our hope is that individuals who have insurance come to see us and those who don’t have insurance come to see us as well.
Are you anticipating increased demand for your services, given that people who were on MinnesotaCare will no longer be covered?
Yes, we are. We’re anticipating that we will see more individuals coming to us for care who will pay at the sliding-fee rate, which is much less than our normal rate that we get through those who have medical insurance, either through a private payer or through a public program.
In Hennepin County, we’re part of a safety net of care that’s provided, and we’re anticipating seeing more individuals show up at the emergency rooms without access to insurance or even knowing about federally qualified health care centers.
People will go to the emergency rooms, and it will be much more expensive to the whole system. I use the analogy, “You pay now, much less, in a primary care setting, or you pay more later in the emergency room setting.”
More than 20,000 undocumented immigrants who were enrolled in MinnesotaCare will lose that coverage. At the same time, the Minnesota Legislature increased its investment in Minnesota Community Health Centers. Will that extra funding make up for any financial hit you might take?
The recent investment is a recognition of historic underfunding for primary care services, both in Minnesota and across the U.S. Every dollar that we spend in our health care center system in primary care, we only receive about 5 to 7 cents on those dollars.
This one-time funding and the support that we will receive from the legislature this year just gets us to continue to be able to stay afloat. It doesn’t increase our ability to cover the true cost of care. And with the increase in the number of individuals who will be coming to us who are uninsured, that just widens the gap.
