Medicaid is vital for the health of Kadija Omar’s children.
Six of Kadija’s children receive health insurance through Minnesota’s Medicaid program, known as Medical Assistance, including her 22-year-old daughter, Bahja Muse, who has a developmental disability. Two of Kadija’s other children previously relied on Medicaid.
But on Tuesday, Congress passed a massive spending bill, also known as President Donald Trump’s “One Big Beautiful Bill,” that proposes cutting more than $1 trillion from Medicaid, which could impact the health care coverage for Bahja, her siblings and 17 million others nationwide.
“There’s no other option if my kids lose their health coverage,” Kadija said. “If [Bahja] loses her coverage, there’s nowhere else to go.”
Medicaid, a government-run health insurance program that has provided health care coverage for people with low incomes for nearly 60 years, faces its largest reduction in its history.
State officials say the cuts would be disastrous, causing the state to lose billions in funding and eliminating coverage for between 152,000 and 253,000 Minnesotans while increasing insurance premiums and costs for health care providers.
How Minnesota will fare
The proposed cuts to Medicaid, which would total around $1 trillion over the next 10 years, are part of Trump’s massive policy and spending package.
The bill features cuts to health care and nutrition safety net programs like Medicaid and the Supplemental Nutrition Assistance Program (SNAP), which helps low-income individuals buy food, in order to fund a $4 trillion permanent extension of Trump’s 2017 tax cuts, which are set to expire later this year.
Changes in the bill would cost Minnesota about $500 million annually in lost funding and increased administrative costs, according to an analysis the Minnesota Department of Human Services (DHS) conducted on the House version of the bill.
The cuts include a $330 million-per-year reduction in funds. The move is a penalty from Trump and Republicans in Congress prompted by Minnesota using state funds for an expansion of its state health care program, MinnesotaCare, this year to include undocumented residents. (As part of a compromise to pass a state budget, state lawmakers voted in early June to eliminate coverage for undocumented adults starting next year.)
The cuts to Minnesota also include prohibitions on the use of federal Medicaid dollars for family planning clinics and gender-affirming care, which DHS estimates will cost the state $170 million and $12 million per year, respectively.
Administrative costs to the state are expected to increase due to added work requirements: the yearly eligibility checks for Medicaid will change to every six months, which is also expected to make it more difficult for people to acquire and maintain health care coverage.
The U.S. Senate version of the bill goes beyond and worsens the cuts’ impacts, said John Connelly, deputy commissioner of the Minnesota Department of Human Services, and state Medicaid director.
“The result of these cuts is that health outcomes worsen in our communities and costs rise for everyone, not just the people who lose coverage as a result of less Medicaid coverage,” Connelly said during a briefing last week. “Those costs ripple into our community through workers who have to call in so they can care for a loved one who isn’t getting the treatment they need, through uncompensated care that already overburdens providers, and through different diagnoses that could have been prevented if timely care had been available.”
Patients, providers on the losing end
Alicia Schaupp was angry at first when she learned about the proposed cuts to Medicaid going through Congress. Then, she was scared.
Schaupp, who has an 11-year-old daughter with an immune deficiency called hypogammaglobulinemia, said the state’s Medicaid program has helped pay for their daughter’s treatment since she was 5. The medication — which costs between $5,000 and $6,000 per month — helps them avoid severe illness and constant hospital visits.
“The first five years were awful, and she was constantly sick,” Schaupp said. “She was constantly going to the doctor, she was constantly on antibiotics. She missed school and I missed a lot of work but since she’s been on it, her health has been stable.”
The program also helped pay for a surgery to repair her daughter’s spinal cord when she was 5 years old, allowing her to learn how to walk.
The loss of their ability to pay for their daughter’s treatment would be devastating, Schaupp said.
“It makes me want to fight tooth and nail, because it is not fair,” she said. “It is disgusting, and it’s going to hurt and possibly kill thousands of people.”
For Muse, losing Medicaid would also mean losing dental care for her family at Hennepin County Medical Center’s dental clinic. The clinic sees many patients who are already admitted to the hospital, like cancer patients or those awaiting transplants.
But it is also unique in that 90% of its patients are on Medicaid, and operates as a referral source for community clinics to treat sensitive patients like those with developmental disabilities and patients with complex conditions, said Dr. Mary Seieroe, Hennepin Healthcare’s chief of dentistry.
“We are a resource to the community when it comes to patients who need to go under anesthesia to have routine dental work done, and the majority of those patients are people with developmental disabilities, and we are one of the only hospitals left that does that,” Seieroe said.
Seieroe said any cuts to Medicaid would be devastating for Medicaid recipients and health care providers. Providers treat clients who have health insurance and those who don’t, and if more people don’t have health care coverage, the costs increase for providers.
The changes would also cause people to avoid seeking preventive care because they can’t afford it, causing increases in visits to emergency rooms statewide, said Seieroe.
“It puts a burden on the emergency departments throughout the state, and in a way, it actually increases the cost of the care because of the setting they’re going to now,” she said. “If people can’t get care, they’re going to go somewhere. The problems don’t just go away.”
