As of January 1, roughly 15,000 undocumented adult immigrants in Minnesota no longer have access to the state's subsidized healthcare program, MinnesotaCare. This program, initiated in the 1990s, targets low-income individuals who are ineligible for Medicaid but cannot afford private insurance. In 2023, when the Minnesota Legislature was controlled by the Democratic-Farmer-Labor (DFL) party, lawmakers passed legislation to extend MinnesotaCare eligibility to undocumented immigrants meeting income criteria. The bill was hailed as a progressive advance in providing healthcare access. That same legislative session also approved a measure allowing undocumented immigrants to obtain driver’s licenses.
Enrollment for MinnesotaCare under this policy began in early 2024, allowing qualifying immigrants to receive care starting in 2025. However, midway through 2024, a legislature divided along party lines voted to repeal these benefits for adult immigrants.
Ma Elena Gutierrez, director of Fe y Justicia, a faith-based nonprofit focused on health equity, highlighted the consequences of these changes. She noted that immigrants without coverage might delay critical surgeries, skip preventative examinations, or forego medications altogether due to cost. Gutierrez expressed concern over the public health implications, emphasizing that delays in care generally lead to worsening health conditions.
The decision to rescind benefits provoked a strong reaction from many DFL members. At a news conference featuring Governor Tim Walz, some lawmakers vocally opposed the rollback, appealing to protect immigrants’ access to healthcare services.
Importantly, immigrant children under 18 remain eligible for MinnesotaCare. The Minnesota Department of Human Services reported that about 5,000 immigrant children were enrolled in this program during 2025. Adults who entered the US illegally generally remain ineligible for Medicaid, except under specific circumstances such as pregnancy. Given the continuing rise in health insurance premiums, many adults are now at risk of being uninsured and unable to afford medical care.
John Connolly, Deputy Commissioner and Medicaid Director at the Department of Human Services, remarked that individuals losing MinnesotaCare coverage may seek services at federally qualified health centers or community health centers. These centers provide care regardless of a patient's ability to pay, but face financial challenges as they do not receive reimbursement for uninsured patients. Connolly voiced concerns regarding both patient access to necessary services and providers maintaining stable funding.
Ann Rogers, CEO of the People’s Center Clinic in Cedar-Riverside, which primarily serves East African communities, echoed these worries. She anticipates reduced clinic visits for routine care and vaccinations, which could increase risks of preventable illnesses. Rogers also warned that deferred care may eventually lead to more emergency room visits, a more costly and critical situation for patients and the healthcare system alike.
Hennepin Healthcare, a major provider serving significant immigrant populations, continues to offer treatment through its uncompensated care program, which waives bills for uninsured patients. Pam Quast, director of patient access and financial security at Hennepin Healthcare, noted that reimbursement from state and federal sources for uncompensated care is minimal and sometimes absent. Since the legislative budget passed in June, Hennepin Healthcare has proactively informed affected patients about coverage changes and alternative care options, aiming to prevent delays in treatment.
As the coverage termination date approached, Gutierrez urged those currently enrolled in MinnesotaCare to utilize their benefits before the end of 2025 to the fullest extent possible. The Department of Human Services has provided guidance for affected immigrants in multiple languages, including English, Oromo, Somali, and Spanish.