House passes Health Budget Bill aligning Minnesota with H.R. 1

SAINT PAUL, Minn. – Today, on a vote of 69-63, the Minnesota House approved the Health Supplemental Budget Bill, largely aligning Minnesota law with H.R. 1, the federal budget reconciliation enacted by President Trump and Republicans in Washington last year. H.R. 1 contained sweeping, damaging changes to Medicaid, referred to in Minnesota as Medical Assistance, putting thousands of Minnesotans at risk of losing their health care coverage.

The bill’s chief author and co-chair of the House Health Committee, Rep. Robert Bierman (DFL – Apple Valley), noted the impact H.R. 1 will have on patients, health care providers, and county governments, while warning that failure by Minnesota to align with the federal law could lead to even greater harm for people who rely on Medicaid.

“Trump’s One Big Ugly Betrayal will hurt real people. As many as 140,000 Minnesotans, including the most vulnerable among us, are set to lose coverage due to the cruel health care cuts from Trump and Republicans, all to pay for tax giveaways for the ultra wealthy. H.R. 1 will increase costs for the state and the counties, put additional strain on our hospitals that are already on the brink, and increase health care costs for all of us,” Rep. Bierman said. “While H.R. 1 is disastrous, it’s also here. If we don’t align, Minnesota could face even more harmful consequences, and as we know, Trump’s harsh retribution knows no bounds. Meanwhile, DFLers will keep fighting to lower the cost of care and make sure Minnesota’s health care system is structurally sound.”

Most notable among the alignment provisions are the so-called “community engagement requirements,” despite a Kaiser Family Foundation study showing 92% of adults on Medicaid under 65 years old and able to work are already working. As a result, H.R. 1 is creating a costly, burdensome paperwork mess both for enrollees and the counties that administer the program, with a huge potential for people losing coverage even though they’re eligible. 

Other federal alignment provisions in the budget bill include limits on retroactive coverage, six-month eligibility renewals for certain enrollees, and M.A. cost-sharing for certain adults without children. It invests $3 million over the next three years in the Health Care Eligibility Program Integrity and Oversight Unit aimed at decreasing health care eligibility errors to ensure the state meets federal requirements.

Earlier this year, the Trump administration withheld $260 million in Medicaid funding, and last week deferred another $91 million in payments. Not aligning with the new federal guidelines could lead to billions of additional federal funding cuts.

“House Republicans have ignored the devastation H.R. 1 will have on Minnesotans and were focused on walking in lockstep with Trump’s agenda, which is why our efforts to support local hospitals and lower the cost of care fell flat for this bill,” Rep. Bierman added. “Regardless, DFLers are committed to keep fighting for a health care system that works for all Minnesotans – the bulk of this work may just have to come next year.”

Aside from H.R. 1 alignment, the bill contains the Governor’s proposed supplemental budget items for the Department of Health, as well as several miscellaneous health care measures, including those related to mortuary science, changes to physical therapy scope of practice, clarifying certain definitions under Minnesota’s insulin safety net program, and allowing private residential pools to be used for swimming classes.

Next, the bill is expected to be considered by a House/Senate conference committee. Video of the House Floor session will be available from House Public Information Services’ YouTube channel. A nonpartisan research brief is available here, and a fiscal tracking spreadsheet is available here.