Medicaid in Minnesota: The who, what, where, why, and how

Medicaid is the nation’s public health insurance program for low-income adults, children, pregnant women, older adults, and people with disabilities. It also provides long-term care coverage for people with lower incomes. Medicaid is administered by states, with total costs shared by states and the federal government.

Medicaid has received increased attention in recent months, with federal budget proposals currently under reconciliation that would drastically cut program spending. Budget cuts could lead to changes in Medicaid eligibility and financing, and accompanying reductions in Medicaid coverage for large numbers of people.

In this article, we offer a primer on the Medicaid program in Minnesota, including data on who uses it, where it gets used the most, and the potential impacts of budget cuts and changes that would impact us all.

What is Medicaid?

Medical Assistance (MA) is Minnesota’s Medicaid program and the largest health care program in the state. MA does not require members to pay a monthly premium and covers full or partial costs for health care services, including preventative care, clinic and hospital visits, and prescriptions. Minnesotans must meet income and asset eligibility requirements for the program, which may vary based on age, household relationships, pregnancy status, and disability status. The Minnesota Department of Human Services has more information about Medical Assistance and other Minnesota Health Care Programs on its website.

Who in Minnesota is covered by Medicaid?

The charts below show Medicaid coverage by select demographic characteristics. Hover over the dropdown to see charts by age, racial and ethnic group, gender, and employment status.

A few highlights from the chart stack:

• Children are, by far, one of the largest groups benefiting from Medicaid. In Minnesota, about one in three kids is covered by the program, including 133,000 of our youngest Minnesotans and 303,000 of our school-aged Minnesotans. Altogether, children make up 44 % of Medicaid recipients, despite being 24% of the state’s overall population.
• Medicaid covers more White Minnesotans by the numbers, but greater shares of Black, Indigenous, and Minnesotans of Color (BIPOC) by percentages. In 2023, 605,000 White Minnesotans and 470,000 BIPOC Minnesotans had Medicaid coverage. Percentagewise, shares of Minnesotans with Medicaid coverage ranged from 14% among non-Hispanic White Minnesotans to 50% among Black Minnesotans.
• Full-time employment does not fully prevent workers from needing Medicaid coverage. Eight percent of full-time, year-round workers – or 156,000 Minnesotans – have Medicaid coverage. Medicaid participation is higher among workers employed less than full-time, year-round and those who do not work, such as caregivers, students, and retirees. Still, findings across the research literature do not support a Medicaid work requirement. This fact sheet dispels myths about Medicaid work requirements.

Where in Minnesota are people covered by Medicaid?

The charts below show Medicaid coverage by select geographies. Hover over the dropdown to see charts by state, and a closer look at Minnesota by region, county, and select cities.

A few highlights from the chart stack:

• Compared to other states, Minnesota has a smaller share of Medicaid coverage. Across the nation, coverage rates range from 34% of residents in New Mexico to 11% in Utah.[1]
• Numerically, in Minnesota, the Twin Cities is home to the largest number of residents covered by Medicaid. In 2023, 538,000 residents of the Twin Cities and 509,000 residents of greater Minnesota had Medicaid coverage.
• By coverage rates, greater shares of greater Minnesota residents are covered by Medicaid. In 2023, 20% of greater Minnesota residents and 17% of Twin Cities residents had Medicaid coverage.
• Regions of the state with higher rates of Medicaid coverage often share geography with Tribal Nations. Across regions, Minnesota’s Northwest region has the highest rate of Medicaid coverage (23%). This region also shares geography with several tribes. Across counties, Mahnomen County has the highest rate of Medicaid coverage (43%) and shares geography with White Earth Nation. We also know from charts in the previous section that 45% of American Indian Minnesotans have Medicaid coverage, one of the highest rates of coverage across racial and ethnic groups.
• Rural and urban areas rely on Medicaid coverage. Minnesota legislative districts with higher rates of Medicaid coverage are broadly distributed across rural and urban areas of the state. Our research team has developed these one-page maps of Medicaid coverage for Minnesota House and Senate districts.

Why does Medicaid matter?

Our review of research reinforces why Medicaid matters, by demonstrating the potential consequences of several policy proposals.

• Reducing or removing Medicaid coverage will make Minnesotans and their families sicker and poorer. Reductions will also impact jobs within and outside the healthcare industry, health care clinics and hospitals (especially in rural areas), overall employment, and tax revenues. This fact sheet examines how spending cuts would harm Minnesota, its residents, and our future.
• There is no research evidence to suggest that adding a Medicaid work requirement incentivizes work, addresses barriers to employment, or increases workforce participation. Instead, work requirements have the potential to harm vulnerable populations and increase administrative burden.
• Proposals to restrict Medicaid federal dollars to states through per capita caps and block grants have the potential to harm vulnerable populations, including children, older adults, disabled Minnesotans, and low-income Minnesotans by destabilizing state health systems. This fact sheet dispels three myths about Medicaid per capita caps and block grants.

How can I get involved?

As researchers, our role is to put good data, analysis, and storytelling into your hands, so that you can make more informed, efficient, strategic decisions. The goal of this article was to equip you with information based on sound, reliable research. Taken together, our research suggests that maintaining Medicaid’s funding, eligibility requirements, and finance structure would be beneficial for our economy, health care infrastructure, communities, and families.[2]

This is where we hand things over to Wilder Foundation’s public policy team, which has been deeply involved in the work of protecting Medicaid for many years.[3] They are a supporting partner in This is Medicaid, a coalition of more than 150 organizations representing health care, insurers, nonprofits, service organizations, patient advocacy groups, and worker representatives. The coalition’s toolkit of fast facts and fact sheets, calls to action, and advocacy materials is a great starting point to learn more, get involved, and take action to protect public health care.

[1] If you live or work in a state other than Minnesota, Kaiser Family Foundation has produced well-researched Medicaid fact sheets for each state that include information on Medicaid coverage by select demographic characteristics, eligibility limits, program financing, and program expenditures.

[2] We are not alone. In addition to the sources cited in our three fact sheets above, other trusted research organizations and non-partisan government entities have come to similar conclusions, including the Congressional Budget Office, the Institute for Healthcare Policy & Innovation at the University of Michigan, Kaiser Family Foundation, the Leonard Davis Institute of Health Economics at the University of Pennsylvania, and the Minnesota Budget Project.

[3] Wilder Foundation champions stability and wellness through direct services, advocacy, and research. Wilder Research is a division of the foundation; Minnesota Compass is a project of Wilder Research.