Medicaid: Protecting Health Care for Minnesotans

Medicaid, known as Medical Assistance in Minnesota, provides lifesaving coverage to 1.3 million Minnesotans, ensuring access to preventive care, maternal health, chronic disease treatment, and long-term care. Under H.R. 1, new enrollment restrictions, work requirements, cost-sharing and other provisions are projected to cut off health care coverage for an estimated 140,000 Minnesotans. When these newly uninsured individuals inevitably need care, many will have no option but to turn to their local hospital. 

What H.R. 1 will mean for Minnesota hospitals: 

• Coverage loss: 140,000 Minnesotans are expected to lose Medicaid coverage starting in 2027 due to new enrollment restrictions. 

• Higher uncompensated care: Minnesota hospitals are projected to see an additional $269 million in charity care every year* as more uninsured patients seek care in emergency departments, inpatient units, and hospital clinics. 

• Lost Medicaid revenue: Hospitals are estimated to lose $354 million annually in Medicaid reimbursement* for services that would otherwise have been covered. 

• Additional financial risks: New Medicaid cost-sharing requirements, the phase-down of Directed Payment Program funding, and potential loss of 340B drug discount eligibility for some hospitals would further compound these losses. 

Minnesota hospitals are already under severe financial strain, with Medicaid fee-for-service rates reimbursing hospitals at 68 cents on the dollar. These cuts would deepen existing gaps, especially in rural communities where Medicaid is critical to keeping hospital doors open. As financial pressures grow, hospitals will face difficult decisions about services, staffing, and access, putting timely emergency care, maternity care, and other essential services at risk for patients across Minnesota. 

*MHA internal analysis as of November 2025