What you need to know about changes coming to Medicaid

Federal changes are coming to Medicaid – the backbone of the health care system.

The changes will make it harder for some people to get and keep health insurance.

Some changes will affect certain immigrants starting in October 2026.

Other changes beginning in January 2027 will affect adults ages 21 to 64 who don’t have dependent children or a certified disability.

Another change in January 2027 may affect anyone who qualifies for Medicaid but isn’t signed up.

Learn the facts by visiting the Minnesota Department of Human Services’ federal changes website.

Medicaid – called Medical Assistance in Minnesota – is the largest provider of health insurance in the state, covering 25% of the people who live here.

Here’s how the changes could affect people living in Minnesota:

Changes affecting some immigrants

The earliest federal change begins in October 2026, when some immigrants will lose Medicaid eligibility. Families may experience higher medical bills when these changes begin.

Those affected include refugees, people with humanitarian parole, people who have been granted asylum, some abused spouses and children, victims of human trafficking, and others with humanitarian protections.

Medicaid will remain available to some lawful permanent residents, as well as Cuban and Haitian entrants and migrants under the Compact of Free Association (COFA).

More medical debt

Another federal change starting in January 2027 is likely to leave more people with bills they can’t pay.

Consider a 62-year-old farmer near Bemidji who’s hospitalized for a serious infection. Three months later, his adult daughter takes him to the county to submit a Medicaid application. He is determined to be eligible and enrolls.

Today, Medicaid would cover his hospitalization under a longstanding three-month retroactive coverage period.

But starting in 2027, the federal government will cut the period down to one month for adults ages 21 to 64 without dependent children or a certified disability. With that change, Medicaid won’t pay for the farmer’s hospitalization. Instead, he will receive the bill.

Retroactive coverage will decrease to two months for children, adults 65 and older, and everyone else.

This change may hurt anyone who qualifies but isn’t signed up yet – especially people who experience a medical emergency or mental health issue, find out they have a health condition, or get sick.

Contact a navigator to learn if you qualify for Medicaid and enroll now. Don’t wait for a medical emergency. Protect yourself, your family and your community.

Administrative barriers to Medicaid coverage

Two other changes starting in January 2027 will add new administrative requirements that may cause eligible people to lose Medicaid.

Tasha, 29, manages multiple chronic health conditions that limit her ability to work in rural Otter Tail County. Despite severe fatigue and mobility challenges, she has never been formally certified as disabled. She qualifies for Medicaid based on her income.

Beginning in January 2027, to qualify for Medicaid, adults ages 21 to 64 who don’t have dependent children or a certified disability will have to meet administrative reporting requirements. They will have to verify they are working, in school, in a work program or doing community service. Or they will have to get an exemption.

People who don’t meet the requirements or get an exemption can lose Medicaid. Exemptions include being medically frail, caring for a family member with a disability, receiving substance use disorder treatment, being incarcerated or within 90 days of release, and other circumstances.

Tasha may qualify for an exemption – but getting one won’t be easy because of her limited ability to complete paperwork.

Even if Tasha keeps Medicaid, she will have to renew her insurance more frequently.

Starting in January 2027, adults ages 21 to 64 who don’t have dependent children or a certified disability will have to renew Medicaid every six months, instead of once a year.

People can lose coverage if they miss important mail or don’t respond in time – even if they remain eligible.

What can I do now?

• Visit the Minnesota Department of Human Services’ federal changes page.
• Apply for Medical Assistance (Minnesota’s Medicaid program) now if you are not currently enrolled. Contact a navigator today.
• Keep your contact information up to date so you don’t miss important, time-sensitive materials.
• Renew Medical Assistance on time so you don’t lose your insurance. Look up your renewal date.
• If you’re enrolled and your renewal is current, there’s nothing else you need to do right now.
• Share your story about Medicaid by visiting the Faces of Medicaid page.