Adult immigrants in Minnesota lost access to state-funded health care on Jan. 1, after the state ended MinnesotaCare benefits for most people who entered the country illegally, according to the Minnesota Department of Human Services. About 15,000 adults were affected by the change.
MinnesotaCare is a state health care program for low-income people that began in the 1990s, and the program helps residents who are ineligible for Medicaid but cannot afford private health insurance. In 2023, Minnesota lawmakers with a Democratic-Farmer-Labor trifecta passed a bill expanding MinnesotaCare eligibility to immigrants who entered the country illegally.
The MinnesotaCare expansion was tied to other state policy changes the same year. Lawmakers also passed “Driver’s License for All,” allowing immigrants in the country illegally to get a driver’s license. Enrollment for the health care eligibility opened in 2024, and beginning in 2025, immigrants could receive care through MinnesotaCare if they met income-based eligibility requirements.
Midway through 2025, however, a divided Legislature voted to end the benefits for adult immigrants. Immigrant children under age 18 will still be able to receive care, the department said, and about 5,000 immigrant children were enrolled in MinnesotaCare in 2025.
The state action comes as immigrants who entered the country illegally generally are not eligible for Medicaid except under specific circumstances such as pregnancy. With health insurance premium costs continuing to rise, the rollback means many people may be unable to afford private coverage.
John Connolly, deputy commissioner and state Medicaid director in the Minnesota Department of Human Services, said people who no longer have coverage can still seek care at federally qualified health centers or community health centers, which provide services regardless of a patient’s ability to pay. But Connolly said the change could strain those clinics because they will not be reimbursed for the services they provide.
“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,” Connolly said.
Clinicians and patient advocates said the coverage loss could also affect how and when patients seek care. Ann Rogers, the CEO of the People’s Center Clinic in Cedar-Riverside, said she worries people won’t come in for care or get vaccinated for illnesses like measles.
“I think that’s a really big risk, waiting to come in for care, and then have it be much more catastrophic,” Rogers said. She added that people may delay until they need to go to an emergency room, where the situation can be more dire and costs higher.
Hennepin Healthcare also described how it plans to handle the change. Pam Quast, director of patient access and financial security for Hennepin Healthcare, said the system’s uncompensated care program allows patients without health insurance to receive care without being billed, using Hennepin Healthcare’s own financial calculations and write-offs that are reimbursed through state and federal government programs. Quast said, though, that Hennepin Healthcare is not always fully reimbursed.
“If you get reimbursed for anything through the state or the federal government, it’s very minimal,” Quast said. “Sometimes you don’t even get anything back.” She said Hennepin Healthcare has been working with patients and notifying them of the changes and what they might be eligible for since lawmakers passed the budget in June.
“They might put off care, and we don’t want that to happen, and that’s why we were trying to be proactive, to let them know, ‘You’ll still be able to come and have services rendered,’” Quast said.
Ma Elena Gutierrez, who leads Fe y Justicia, said the coverage rollback would likely lead people to avoid care they need. “This is really sad,” she said. “More people are going to get sick.”
Gutierrez said the decision has already drawn backlash among some supporters of Minnesota’s prior eligibility policies, including a news conference where Gov. Tim Walz faced a protest calling for opponents not to “kill immigrants.” As the end of 2025 approached, Gutierrez encouraged people who had coverage through MinnesotaCare to get as much care as possible before the benefits ended.
The Department of Human Services said it issued guidance for immigrants in English, Oromo, Somali and Spanish.