Big Changes Coming to Medicaid in Minnesota

New enrollment and reporting requirements will impact many Minnesotans, including Native Americans

Published on Feb. 10, 2026

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Significant changes are coming to the Medicaid program in Minnesota, including cuts to subsidies, new enrollment and eligibility requirements, and more frequent reporting obligations for recipients. These changes will impact many Minnesotans, including the state's Native American population, raising concerns about potential coverage losses and increased burdens for enrollees and their caregivers.

Why it matters

Medicaid provides health coverage for one in five Minnesotans, and the upcoming changes could result in as many as 140,000 people losing their coverage. This disproportionately affects vulnerable populations, including Native Americans who may face additional barriers to enrollment and maintaining coverage due to historical trauma and complex tribal enrollment processes.

The details

The changes include: 1) Cuts to subsidies that have already raised premium costs; 2) New enrollment and eligibility requirements starting in October 2026 that will mostly impact immigrants; 3) More frequent reporting requirements every 6 months in 2027 for adults ages 21-64 without dependent children or disabilities (excluding Native Americans); and 4) Work reporting responsibilities in 2027 for the same adult group, which may be difficult for those paid in cash or tips.

  • Cuts to subsidies approved by Congress took effect in 2026.
  • New enrollment and eligibility requirements start in October 2026.
  • More frequent reporting requirements every 6 months begin in January 2027.
  • New work reporting responsibilities start in 2027.

The players

Minnesota Department of Human Services

The state agency responsible for administering the Medicaid program in Minnesota and informing residents about the upcoming changes.

Indian Health Board of Minneapolis

A community organization that provides navigators to help eligible individuals and their caregivers enroll in and maintain Medicaid coverage.

Dr. Nathan Chomilo

The medical director at the Minnesota Department of Human Services.

Takayla Lightfield

The Tribal Policy Consultant for the Minnesota Department of Human Services.

Laurelle Myhra

A licensed marriage and family therapist and director of the Mino Bimaadiziwin Wellness Clinic in Minneapolis, who discusses the complexities faced by urban Native Americans in accessing healthcare.

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What they’re saying

“Everyone eligible to enroll in Medicaid should do so now before having a medical emergency to avoid encountering medical bills they cannot pay.”

— Dr. Nathan Chomilo, Medical Director, Minnesota Department of Human Services (The Circle News)

“What many people don't understand is that a majority of Native Americans now live in urban areas and not on reservations where they might have access to free tribal healthcare.”

— Laurelle Myhra, Director, Mino Bimaadiziwin Wellness Clinic (The Circle News)

What’s next

The judge in the case will decide on Tuesday whether or not to allow Walker Reed Quinn out on bail.

The takeaway

These Medicaid changes highlight the need for increased outreach and support to vulnerable populations, including Native Americans, to ensure they can navigate the complex enrollment and reporting requirements and maintain their critical health coverage. Navigators and community organizations will play a vital role in helping people stay informed and enrolled.