2025. Minnesota Veterans' Health Insurance Status and Access to Care
Y Jonk, Center for Chronic Disease Outcomes Research, KT Call, Division of Health Services Research and Policy, UMN, V Bansiya, Division of Health Services Research and Policy, UMN, K Harrison, Minneapolis VA Medical Center

Objectives: Factors influencing Minnesota veterans' decision to use VA services, including geographic location, socioeconomic characteristics, health, and health insurance status are analyzed. Differences between veterans and non-veterans, VA users and non-users, and insured and uninsured veterans are described.

Methods: Data are from the 2001 Minnesota Health Access Survey, the fourth in a series of statewide telephone surveys conducted since 1990 to monitor and address health insurance coverage and access to care. The survey identifies 3,400 veterans who have served in the armed forces. For state planning purposes, any veteran not using VA medical services and having no other source of insurance coverage are uninsured. Differences in weighted population characteristics are analyzed using comparisons of proportions.  Logistic regression analysis was used to identify factors influencing veterans' use of VA services.

Results:  Veterans comprise 13.4% of the state's 2001 adult population, with 6.8% of veterans' using VA services. The aging veteran population and their subsequent eligibility for Medicare as well as their entitlement to VA coverage of services helps explain why a significantly lower percentage of veterans (3.9%) report having no source of insurance coverage relative to the rest of the state's population (5.9%). Of the state's 4.3 million people, these percentages translate to 231,831 uninsured, of which 17,517 are uninsured veterans. Compared to non-veterans, veterans are typically older, white, married males who are less educated, and less healthy.  As are VA users, uninsured veterans are more likely to be low income, rural residents than their respective insured and non-using counterparts. Uninsured veterans are less likely to have a usual source of care, and less confident about getting the care they need than insured veterans.

Conclusions: Lower socioeconomic and health status are highly predictive of veterans' use and reliance on VA coverage.  Approximately 20% of all veterans and the majority of uninsured veterans are low income and eligible for free VA services.

Impact: A significant proportion (9.3%) of the state's uninsured non-elderly adult population are young, low-income, working, adult male veterans living in rural areas. These findings can be used to target outreach efforts, inform veterans of their eligibility for VA services, and improve access to care.