Minnesota’s State-Funded Health Care: A Setback for Adult Immigrants
About 15,000 adult immigrants in Minnesota lost access to their state-funded health care on Jan. 1, marking a significant setback for a community that has been struggling to access affordable healthcare. The move comes after the Minnesota Legislature voted to end benefits for adult immigrants who were previously eligible for MinnesotaCare, a health care program for low-income people.
In 2023, the Minnesota Legislature, which had a Democratic-Farmer-Labor majority in both houses, passed a bill that granted immigrants who entered the country illegally access to MinnesotaCare. The program helps those who are ineligible for Medicaid but unable to afford private health insurance. At the time, the law was hailed as a progressive milestone, and enrollment opened in 2024. However, in 2025, a divided Legislature voted to end those benefits for adult immigrants, citing concerns about the cost and sustainability of the program.
Impact on Immigrant Communities
Ma Elena Gutierrez, who leads the group Fe y Justicia, a faith-based nonprofit that has organized around health equity, expressed concern about the impact of the decision on immigrant communities. “This is really sad,” she said. “More people are going to get sick.” Gutierrez noted that immigrants in the country illegally are likely to put off care like surgeries and preventative checkups, and to forgo medications, which can lead to more severe health problems and higher healthcare costs in the long run.
Immigrant children under the age of 18 will still be able to receive care through MinnesotaCare, with about 5,000 enrolled in the program in 2025, according to the Minnesota Department of Human Services. However, immigrants who entered the country illegally are not eligible to receive care through Medicaid except under specific circumstances, such as pregnancy. With health insurance premium costs continuing to rise dramatically, many will be unable to afford care, leaving them vulnerable to health crises and financial ruin.
Alternatives and Challenges
John Connolly, deputy commissioner and state Medicaid director in the Department of Human Services, noted that those who no longer have coverage can be seen at federally qualified health centers or community health centers, which provide care regardless of a patient’s ability to pay. However, he acknowledged that this might put a strain on those clinics, which won’t be reimbursed for those services. “We worry both for people in terms of their access to services, but also in terms of providers having a steady form of payment which strengthens them overall,” he said.
Ann Rogers, CEO of the People’s Center Clinic, a community health center in Cedar-Riverside that predominantly serves East African patients, expressed similar concerns. “I think that’s a really big risk, waiting to come in for care, and then have it be much more catastrophic,” she said. Rogers noted that people may delay getting care until they need to go to an emergency room, where the situation is more dire and the costs are higher.
Hennepin Healthcare frequently serves immigrant patients, and Pam Quast, director of patient access and financial security for Hennepin Healthcare, said that those who no longer have health insurance coverage can still get care through Hennepin Healthcare’s uncompensated care program. Under that program, patients don’t receive a bill, and Hennepin Healthcare conducts their own financial calculations and write-offs, and is then reimbursed through the state and federal government. However, Quast noted that Hennepin Healthcare isn’t always fully reimbursed for the services they provide.
As the end of the year approached, Gutierrez encouraged those who had coverage through MinnesotaCare to get as much care as they could by the end of 2025. The Department of Human Services has issued guidance for immigrants in English, Oromo, Somali, and Spanish, providing information on alternative care options and resources.
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