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How much is Minnesota paying for undocumented people accessing MinnesotaCare? • Minnesota Reformer [1]
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Date: 2025-04-30
Minnesota Republicans held a press conference last week claiming that a program allowing undocumented people to receive free or discounted health insurance would cost the state over $600 million over four years.
State data show the figure is a wild exaggeration, however.
The Democratic-controlled Legislature in 2023 made undocumented immigrants eligible for MinnesotaCare — the state’s health insurance program for the working poor — as of Jan. 1, 2025.
Nearly 17,400 undocumented people have enrolled in MinnesotaCare. The program is fee-for-service, meaning the state only pays claims after services are administered.
The Department of Human Services in a statement said it had 3,378 claims for service, costing Minnesota about $3.3 million as of April 1 during the first quarter. The state budget office projects the cost for the next four years would be around $200 million — or one-third the GOP estimate.
As for now, DHS says per-enrollee spending is below projections.
“The number of enrollees is currently higher than what was expected, however the amount spent per person is currently lower than what was originally expected,” a department spokesperson said. DHS cautioned that one quarter is not enough data to reliably predict expenditures for the next four years.
What is MinnesotaCare?
MinnesotaCare was created in 1992 to help close the gap in coverage for low-income families who make more than the income threshold for Medicaid, which is called Medical Assistance in Minnesota.
Uninsured Minnesotans who are not eligible for Medical Assistance and have an income at or below 200% of the federal poverty guidelines can qualify for MinnesotaCare. This applies for undocumented people as well, as of Jan. 1.
Some MinnesotaCare enrollees pay a monthly premium, and the program is funded by a combination of payments from the state, taxes on hospitals and other health care providers and enrollee premium payments.
Under the expansion, many undocumented people receiving MinnesotaCare pay a monthly premium, similar to other residents who receive health care through the program. The premium is based on income and the number of family members in the household. If a person fails to pay the premium, their coverage is canceled.
The federal government kicks in money to pay for MinnesotaCare, but not the portion for undocumented people.
Minnesota hospital leaders have publicly supported expanding insurance access because it increases the number of paying patients and encourages people to seek preventative care before ailments become more costly, like if they were to seek emergency services.
Federal law requires hospitals to care for all patients who walk through their doors, regardless of whether they are able to pay or their immigration status. The Minnesota Hospital Association has said that revoking MinnesotaCare for undocumented people could make such care more expensive for hospitals across the state.
“Such a change won’t block health care for undocumented immigrants,” the Minnesota Hospital Association said in a February social media post.
Republicans are opposed to the program and have made cutting it one of their top priorities this session.
“It’s wrong when a person takes an oath of office to serve their constituents and to help them, but they instead prioritize illegal immigrants over their law-abiding constituents,” said Rep. Jeff Backer, R-Browns Valley and co-chair of the Health finance committee, at a press conference last week.
Sen. Alice Mann, DFL-Edina and chief author of the 2023 MinnesotaCare expansion bill, said Republicans have lied to Minnesotans about the program.
“Republicans are telling you that if we take away people’s health care, that’s gonna fix the problem. Those are absolute lies, and it was egregious what they said. They are taking our crumbling health care system and they’re blaming it on immigrants,” Mann said at a rally last week.
Leaders of the Health Finance and Policy Committee are deadlocked in budget negotiations, in part over the MinnesotaCare issue.
The Legislature is scheduled to adjourn May 19 and must pass a budget by June 30 or face a government shutdown.
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