Minnesota Legislature must limit the damage of federal health care cuts

I am a 32-year-old adult living in Minnesota. I don’t smoke. With those health factors, I should be eligible for one of the most affordable individual health coverage plans available.

This year, I have been on a “bronze” individual marketplace plan with a high out-of-pocket maximum for my health care provider’s network. I plan to stay on that plan in 2026 because it still is the best value for me, even when prescriptions max out the out-of-pocket maximum.

Next year, my premiums are rising sharply, from $3,168 in 2025 to $4,084, an increase of over 28.9%. Wowza! My out-of-pocket maximum is also going up — by $200 — from $8,300 to $8,500. With those increases — because my prescription medications usually max out my out-of-pocket — my overall health care costs will increase by $1,116.

What are the causes of Minnesotans’ health coverage cost increases?

Related: Minnesota’s Affordable Care Act marketplace is about to become unaffordable. What happened?

More than 167,000 Minnesotans like me buy their health care coverage through MNsure, the public-run health coverage marketplace. A majority of those Minnesotans qualify for Affordable Care Act (ACA, also known colloquially as “Obamacare”) health coverage premium tax credits that lower the cost of a monthly health coverage premium.

In 2021, and extended in 2022, the Democratic majorities in Congress and President Joe Biden added “Enhanced Premium Tax Credits” that subsidized premiums further than the ACA had before. In Minnesota, 90,000 residents qualify for these extra tax credits.

With H.R. 1, the “One Big Beautiful Bill Act,” President Donald Trump and the GOP chose not to extend the tax credits past the current expiration at the end of this year. According to Kaiser Family Foundation (KFF) research, the average premium payments for ACA enrollees without the credits will rise by over double, an increase of $1,016. This doesn’t include any increase in out-of-pocket maximums. According to the KFF study, an individual with $55,000 in income could see an annual increase in premium costs of $1,469.

For Minnesotans on Medical Assistance (the federal-state partnership of Medicaid in the state of Minnesota), the GOP H.R. 1 passed in July cut over $1 trillion from Medicaid over the next 10 years. That includes reimbursements to hospitals and nursing homes, many of which generate a large share of their revenue from Medical Assistance patients in Minnesota. For example, 45% of Hennepin Healthcare patients are covered by Medical Assistance. KFF estimates that 152,000 to 253,000 Minnesotans could lose their Medical Assistance health coverage.

Related: The big, not beautiful, mental health care gap in rural Minnesota

The double-blow of higher strain on local hospitals and clinics and the loss of ACA Enhanced Premium Tax Credits will hurt everyday Minnesotans hard starting Jan. 1, 2026. Already, Allina Health and the Mayo Clinic announced they are closing clinics in Inver Grove Heights, Maplewood, Minneapolis, Oakdale and across southern Minnesota. In a media statement, Allina Health said the decision was partly due to “expected impacts of funding cuts for critical health care programs like Medicaid.”

With what is expected to be an equally divided Minnesota House, both parties will have to work together to backfill these federal cuts to health care if Minnesotans are to avoid the worst consequences. We are also seeing trickling effects of the federal shutdown, which has no end in sight. If Minnesota was to fill the gap created by federal funding cuts with state tax dollars, that would necessitate a Minnesota tax increase of billions of dollars in the mid-biennium.

But we cannot let hundreds of thousands of Minnesotans lose access to life-saving health care. No matter how short-sighted the federal government may be. I hold out hope that Minnesota leaders can negotiate with purpose and protect health care coverage for Minnesota families.

Conrad Lange Zbikowski lives in Minneapolis and is a former chair of the Minneapolis DFL Party. 

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