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On July 4, President Donald Trump signed into law the One Big Beautiful Bill, legislating the biggest cut to Medicaid in the program’s nearly 60-year history. The Congressional Budget Office estimates the act will cut more than $1 trillion over the next 10 years, restricting benefits and coverage for more than 17 million people currently served by Medicaid.
The federal cuts could eliminate coverage for between 152,000 and 253,000 Minnesotans, state officials say, while increasing insurance premiums and costs for health care providers.
In June, the Minnesota Legislature cut an estimated 15,000 undocumented Minnesota residents from the state’s health care program, MinnesotaCare, starting in 2026. That action reversed the MinnesotaCare Immigrant Inclusion Act, passed in 2023, which granted undocumented residents access to MinnesotaCare.
In the wake of these sweeping changes to health care access, Sahan Journal invited two experts to help explain what Minnesotans need to know. Those panelists:
- Ryan Pérez, organizing director of Communities Organizing Latine Power and Action (COPAL)
- Dr. Nathan Chomilo, medical director for the State of Minnesota’s Medicaid and MinnesotaCare programs
Here are 10 key takeaways from the July 23 Instagram Live conversation.
How much money is being cut from Medicaid?
The federal government plans to cut more than $1 trillion from Medicaid over 10 years. This could shift financial burdens of health care services to states. Dr. Nathan Chomilo, medical director for the State of Minnesota’s Medicaid & MinnesotaCare programs, explained this dynamic. “Quite frankly, the federal government is backing away from things that they’ve historically been committed to supporting,” Chomilo said. “They are putting policies into place that will make it harder for folks to get access to Medicaid.”
How many Minnesotans could lose their health care coverage?
State officials say Medicaid cuts could push between 152,000 to 253,000 Minnesotans off of Medicaid. About 20-25% of Minnesotans are covered by Medicaid to some extent, including pregnant people, children, and elderly people who receive Medicaid to help fill gaps in Medicare coverage (which serves seniors).
How could cuts to Medicaid impact Minnesota’s health care system?
According to Chomilo, Medicaid cuts threaten the overall health care system in Minnesota, as clinics and hospitals may face financial strains and service reductions. The loss of individual health coverage, he said, will likely lead to people either not paying for services or not going in for services altogether. The drop in patient visits, Chomilo explained, may cause clinics and hospitals to close. “We’re all potentially going to have a weaker system because of these cuts to Medicaid,” notes Chomilo.
How is the federal government changing Medicaid eligibility?
As the federal government raises work requirements for patients to receive Medicaid, states will need to build new tracking systems, from the ground up, to determine eligibility. Chomilo estimates that creating such tracking systems will cost Minnesota $165 million a year.
How will these federal budget cuts affect Latinos in Minnesota?
COPAL, a Latino advocacy organization, believes that federal cuts will disproportionately affect immigrants, people of color, and working individuals — communities often already struggling to meet other financial burdens. Ryan Pérez, organizing director of COPAL, notes that Latinos are the most uninsured or underinsured demographic in the United States. Cuts to state healthcare services will widen this insurance gap, Pérez says.
How could Medicaid cuts impact rural communities in Minnesota?
Nearly half of Minnesota’s Medicaid enrollees live outside the Twin Cities metropolitan area, both Pérez and Chomilo say. Cuts to services could force longer travel times for essential care. “The costs of providing care for folks who don’t have insurance add up over time,” said Chomilo. The common result: providers reduce the care they offer.
How are Latinos in Minnesota keeping track of changes to federal and state policy?
COPAL translates and interprets health care information for Latinos across Minnesota, with the goal of helping Spanish-speaking immigrants to better navigate the American health care system. However, rapid changes to federal and state policies have forced COPAL and its community to change the messages they share about health care access. For example, COPAL spent years supporting expanded health care signups for undocumented Minnesotans. Now, COPAL has to backtrack on those education efforts.
What’s happening with MinnesotaCare?
In June, the Minnesota Legislature elected to eliminate MinnesotaCare coverage for more than 15,000 undocumented adults. Until the end of 2025, undocumented adults who are already registered for MinnesotaCare will retain coverage — though new enrollments won’t be possible. However, this revocation applies only to those above the age of 18. Undocumented children under 18 can still enroll for coverage and will be covered until one month after they turn 18.
How are undocumented Minnesotans looking at the risks and rewards of using state health care?
According to Pérez, mixed-status and immigrant families have already expressed heightened fear about public programs like MinnesotaCare. As deportations and ICE investigations have become more frequent, some Latinos may hesitate to seek vital health services. According to Pérez, “People are concerned about the public charge, which is this idea that I’m going to rack up a public debt. And if I want to become a citizen one day, I’m going to have to pay that back, and it’s going to be a penalty against me.”
Will the new Trump health care cuts actually save money?
Chomilo makes the case that wider access to preventative health care services can prove significantly cheaper — for states and individuals — than relying on emergency services. For example, catching cancer in its early stages leads to more effective — and cheaper — treatment. Chomilo added “if you can prevent something by helping folks stay healthy… there’s a lot of benefit, both to the health, the finances of the hospital and our health care system.”
Disclosure: For this story, Sahan newsroom staff used artificial intelligence to help us quickly transcribe audio from the video livestream and compile an outline of key takeaways. A Sahan reporter and editor took these starting materials to draft the list, above. Using AI allowed us to efficiently adapt our live video interview into a story for Sahan’s website.
You can watch a recording of the livestream below:
