MINNEAPOLIS — The number of Minnesotans who have health insurance is rising but so is the number of state residents struggling to pay their medical bills, a newspaper reported Sunday.

A Star Tribune analysis of court records finds in the past year, Minnesota’s main hospital and clinic groups filed nearly 9,000 lawsuits against people with large or long-standing medical debts. That’s a sharp increase since 2005.

Medical debt — once a leading cause of personal bankruptcy in the U.S. — was widely expected to decline as more Americans got health insurance following federal health reform. But shifts in the insurance market are pushing more people toward high-deductible policies that can require them to pay as much as $7,500 before any benefits kick in, the newspaper reported.

“Patients are being exposed to a greater proportion of their bill,” said Dan Fromm, chief financial officer of Minneapolis-based Fairview Health Services. “That is certainly a factor in what we are seeing in our bad debt.”

In Minnesota, the share of people with health insurance has climbed to 95 percent from 91 percent since 2013, as the federal Affordable Care Act has taken hold. But insurers such as Blue Cross and Blue Shield and Medica have competed to hold down premiums as more people shopped for coverage. One way to do that is to offer more products with high deductibles and other forms of “co-insurance.”