MNsure sets record as more than 167,000 Minnesotans sign up for health insurance

MNsure sign-ups grew at a rapid pace during the recently concluded open enrollment period as a record 167,163 people used the public platform to signup for private health insurance coverage.

Minnesota launched the MNsure health exchange — also called a “marketplace” — in 2014 as part of the federal government’s sweeping overhaul of the market where individuals under age 65 buy health insurance.

The federal government this month also reported record sign-ups at HealthCare.gov, the marketplace for enrollment in about 30 states.

The exchanges were created launched as part of the federal Affordable Care Act (ACA), which also provides consumers with premium tax credits to significantly lower premium costs.

“I think the continued growth in ACA marketplace signups is really remarkable considering there was not an obvious contributing factor to growth this year,” Cynthia Cox, a health care researcher who follows the individual market for California-based KFF, wrote in an email. “I had expected new record highs in previous years, but I thought enrollment growth would start to plateau this year.”

MNsure is part of Minnesota’s individual market, where about 3% of state residents obtain coverage, including those who don’t get insurance from their employer or qualify for a government program.

It’s part of how the state has maintained a high rate of health insurance coverage, which should help patients and health care providers avoid unpaid bills.

Minnesota’s individual market is bracing for premium jumps next year if the federal government doesn’t extend enhanced ACA tax credits for consumers and the state government doesn’t provide funding for a program called “reinsurance” that’s helping control premium costs.

MNsure saw 14% more signups during open enrollment, which ended Jan. 15, compared to last year’s sign-up period. It was the highest growth rate in eight years.

Higher signups for 2025 at the state and federal level followed the completion of a lengthy series of eligibility redeterminations trimming enrollment in Medicaid, the state-federal health insurance program for people with lower incomes and/or disabilities.

This process, also known as the Medicaid “unwinding,” might have been a contributing factor in signups, MNsure says, but it wasn’t a major driver. State officials say that by the end of Medicaid redeterminations, about 12,000 newly-eligible Minnesotans landed in qualified health plans sold via MNsure.

In Minnesota, enrollment in Medicaid-related public programs that are administered by HMOs fell by roughly 250,000 people over the past two years — from about 1.3 million people in January 2023 to about 1.05 million people this month.

About 61% of households signing up for coverage via MNsure are receiving federal tax credits, state officials say. The average annual tax credit per household is $6,452.

“Twelve years ago this month, state legislators introduced a bill to establish the marketplace with a vision that Minnesotans would have improved access to quality health coverage and save over $1 billion by using it to purchase insurance,” MNsure chief executive Libby Caulum said in a news release.

“I’m so pleased to say that, since we were established, MNsure has helped tens of thousands of Minnesotans get comprehensive health insurance and save more than twice the amount state leaders had hoped for — over $2.3 billion in savings, to date,” Caulum said.

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