Federal proposals threaten Minnesotans' health care

Federal proposals threaten Minnesotans' health care

Minnesotans face threats to the health care they receive through Medicaid because of changes to the harmful “public charge” rule, a proposal to “block grant” Medicaid, and other proposed administrative regulations. 

“Minnesotans understand that our neighbors and families should be able to get the health care they need, when they need it,” said Susie Emmert, co-convener of the This Is Medicaid coalition. “Unfortunately, our communities are facing several threats to their ability to see a doctor or get their medications through Medicaid. We join advocates across the state and the nation in working to preserve the promise of Medicaid, and we won’t let these proposals limit access to health care in Minnesota.” 

The Center on Budget and Policy Priorities provides a full list of threats to Medicaid. Below are summaries of a few of the latest administrative rule changes and proposals that threaten the federal Medicaid program and the health care it ensures for hundreds of thousands of Minnesotans: 

Harmful “public charge” rule creates fear and confusion 

The United States Supreme Court weighed in last month essentially allowing a proposed new federal “public charge” rule to go into effect even as the rule faces continued scrutiny in the courts. The new rule would put expanded restrictions on Minnesota immigrants’ path to citizenship, and potentially limit their access to health care and other supports like food assistance. 

Fear and confusion about the rule is already preventing families from seeking supports in health care, housing assistance and food security for which they are in fact eligible, according to advocate leaders. Even though children are technically exempt from this rule change, advocates have already seen decreases in health care access and coverage due to the complexity of these policies. 

Advocates are working to counter the misinformation and the “chilling effect” this rule is having on impacted communities from accessing supports for themselves and their families, ultimately resulting in fewer children being vaccinated, parents delaying necessary care for themselves, and chronic illnesses like diabetes going untreated. For more information, visit Immigration Law Center of Minnesota, or Protecting Immigrant Families. 

Medicaid block grants would block care 

The Trump Administration’s new block grant guidance is a spin on past proposals that Americans have said no to many times. The newest proposal abandons Medicaid’s historic commitment to quality, affordable care for low-income people. The Section 1115 demonstration projects, known as “waivers,” are a lose-lose proposition both for people with Medicaid coverage, who would lose coverage and access to care, and for states, which would face added financial risk. The guidance marks the latest step in the Administration’s ongoing effort to end the Affordable Care Act’s (ACA) Medicaid expansion to low-income adults, many of whom are people with disabilities, people experiencing homelessness and other vulnerable populations. 

The waivers would directly harm people with Medicaid by taking away access to needed care, offering states new or fast-track authorities to cut coverage and benefits by: 

• Taking coverage away from people who don’t pay premiums, even those with very low incomes, leaving folks without access to their doctors. 

• Allowing states to deny coverage for prescription drugs, likely leading to denials of expensive but needed treatments. 

• Allowing states to impose higher copayments on doctor visits and prescription drugs, which could deter people from seeking needed care. 

Medicaid Fiscal Accountability Regulation could jeopardize care for millions 

A proposed rule from the Centers for Medicare and Medicaid Services (CMS) would affect how states fund Medicaid, especially safety-net providers like hospitals and nursing homes. The rule could prompt states to cut benefits and eligibility as well as provider payments, which would further exasperate the health care workforce shortage, and jeopardize access to care for millions of Medicaid beneficiaries, as Center on Budget and Policy Priorities’ comments explain. 


This Is Medicaid is a coalition of nonpartisan organizations from across Minnesota working to protect Medicaid from harmful changes and funding cuts. These organizations advocate for or directly serve people who access health care and supports through Medicaid. 

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