Ma Elena Gutierrez stands outside St. Joseph's Catholic Church on Nov. 19, 2020, in Waite Park, Minn. Once a month the church offices serve as a health clinic for members of the Latino community who lack access to health care. Credit: Paul Middlestaedt for MPR News

About 15,000 undocumented adults in Minnesota lost access to their state-funded health care on Jan. 1.

In 2023, the Minnesota Legislature —  which then had a DFL trifecta —  passed a bill that granted undocumented Minnesotans access to MinnesotaCare, a health care program for low-income people that began in the 1990s. The program helps those who are ineligible for Medicaid but unable to afford private health insurance. 

When the law was passed, it was heralded as progressive milestone. That same year, lawmakers passed Driver’s License for All, which allowed undocumented immigrants to get a driver’s license. 

Enrollment opened in 2024, and beginning in 2025, undocumented people were able to get care through the program if they were eligible based on their income.

But about halfway through the year, a divided Legislature voted to end those benefits for undocumented adults. 

Ma Elena Gutierrez leads the group Fe y Justicia, a faith-based nonprofit that has organized around health equity. She said undocumented people are likely to put off care like surgeries and preventative checkups, and to forgo medications. 

“This is really sad,” she said. “More people are going to get sick.”

The decision created an uproar among many DFLers, who during a news conference held by Gov. Tim Walz after the decision to roll back benefits banged on the door and yelled, “Don’t kill immigrants.”

Undocumented children under the age of 18 will still be able to receive care. According to the Minnesota Department of Human Services, which administers MinnesotaCare, about 5,000 undocumented children were enrolled in the program in 2025.

Undocumented immigrants are not eligible to receive care through Medicaid except under specific circumstances such as pregnancy. Now, with health insurance premium costs continuing to rise dramatically, many will be unable to afford care. 

John Connolly, deputy commissioner and state Medicaid director in the Department of Human Services, said that those who no longer have coverage can be seen at federally qualified health centers or community health centers, which provide care regardless of a patient’s ability to pay. But he said that might put a strain on those clinics, which won’t be reimbursed for those services. 

“We worry both for people in terms of their access to services, but also in terms of providers having a steady form of payment which strengthens them overall,” he said. 

Ann Rogers is the CEO of the People’s Center Clinic, a community health center in Cedar-Riverside that predominately serves East African patients. She said she worries people won’t come in for care or get vaccinated for illnesses like measles. 

“I think that’s a really big risk, waiting to come in for care, and then have it be much more catastrophic,” she said. 

Rogers said people may delay getting care until they need to go to an emergency room, where the situation is more dire and the costs are higher. 

Family nurse practitioner Muna Farah administers a vaccine at the Minneapolis Public Health vaccine clinic on August 30, 2024, at Corcoran Park. Public health officials are emphasizing vaccines amid a spike in measles cases. Credit: Dymanh Chhoun | Sahan Journal

Hennepin Healthcare frequently serves undocumented patients. Pam Quast, director of patient access and financial security for Hennepin Healthcare, said that those who no longer have health insurance coverage can still get care through Hennepin Healthcare’s uncompensated-care program. Under that program, patients don’t receive a bill. Hennepin Healthcare conducts their own financial calculations and write-offs, and is then reimbursed through the state and federal government. 

But Quast said Hennepin Healthcare isn’t always fully reimbursed for the services they provide.

“If you get reimbursed for anything through the state or the federal government, it’s very minimal,” she said. “Sometimes you don’t even get anything back.”

Quast said Hennepin Healthcare has been working with patients and notifying them of the changes and what they might be eligible for since the budget was passed by lawmakers in June. 

“They might put off care, and we don’t want that to happen, and that’s why we were trying to be proactive, to let them know, ‘You’ll still be able to come and have services rendered,’” she said. 

As the end of the year approached, Gutierrez encouraged those who had coverage through MinnesotaCare to get as much care as they could by the end of 2025. 

The Department of Human Services has issued this guidance for undocumented immigrants in English, Oromo, Somali and Spanish.

Katrina Pross is the social services reporter at Sahan Journal, covering topics such as health and housing. She joined Sahan in 2024, and previously covered public safety. Before joining Sahan, Katrina...