Immigrants have only been eligible to enroll in MinnesotaCare (provided they meet program requirements) since January. Like other enrollees, they may pay modest premiums based on income and family size.
As of April 24, there were 20,187 people enrolled, according to the Minnesota Department of Human Services (DHS). But according to a legislative analysis cited by Minnesota Republicans, only 7,800 people were expected in the program.
The higher enrollment raises understandable concerns about the program’s price tag. That is especially on point given that the state shoulders the cost of this coverage alone vs. sharing it with the federal government, as is the case for most other medical assistance enrollees. In an interview, Rasmusson cited other states with similar programs that are struggling to finance this coverage, with California’s coverage-related budget woes a prime example.
While the GOP has claimed that “associated costs” of the coverage “may exceed $450 million over the next four years,” DHS’ estimate is much lower, though still a considerable sum:
“Based on the first three months of enrollment (Jan-March 2025), actual spending is in line with the February forecast, which also projected expenditures of approximately $200 million in FY 2025-28. To this point, there is no evidence to suggest expenditures will be significantly higher going forward.”
One data point that’s foundational for the DHS price tag: utilization, meaning the medical care costs incurred by the new enrollees. So far, just 4,306 enrollees have had a claim, with the total costs for paid claims amounting to $3.9 million. Given the program’s recent launch, it’s premature to draw any conclusions about utilization trends. But immigrant enrollees may skew younger than traditional participants, potentially keeping costs lower.
