(The Center Square) – The Minnesota House passed a healthcare and Medicaid oversight bill last week that Republicans say would strengthen accountability in taxpayer-funded assistance programs.
The House approved the legislation 69-63 after lengthy debate over how the state must respond to the “One Big Beautiful Bill,” the federal budget reconciliation package passed in Washington last year.
Republicans described the measure as "one of the most significant conservative victories on welfare reform in decades," aimed at tightening eligibility verification requirements, restoring Medicaid work requirements for some able-bodied adults, and strengthening oversight protections within public assistance programs.
“For decades, Republicans have fought to restore common sense and accountability to public assistance programs,” said Rep. Jeff Backer, R-Browns Valley, chair of the House Health Committee. “This legislation ensures Medicaid resources are protected for those who truly need them while encouraging able-bodied adults to work, pursue education, or participate in job training in exchange for benefits.”
Republicans warned that failing to comply with federal Medicaid requirements could expose Minnesota taxpayers to between $3.5 billion and $4 billion in annual federal funding penalties.
“This legislation protects Minnesota taxpayers from devastating federal penalties and future tax hikes,” Backer said. “Without action, working families across our state would ultimately be forced to foot the bill.”
Currently, the state Senate is held by Democrats, while the House is tied 67-67. Democrats argued they are effectively being forced into adopting policies they believe will reduce healthcare access and strain hospitals and local governments.
“The federal law will set the state and country back a decade,” said Rep. Robert Bierman, DFL-Apple Valley, the bill’s chief author and co-chair of the House Health Committee. “We will not do this because it’s a good thing for our constituents, but because we’re forced to.”
Bierman said as many as 140,000 Minnesotans could lose healthcare coverage under the federal changes, which he called “Trump’s One Big Ugly Betrayal.”
“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,” Bierman said.
The legislation would codify several federal Medicaid changes into state law, including:
• work requirements for adults without children using Medicaid
• six-month renewal periods
• cost-sharing requirements across departments
• shortening retroactive coverage for adults without children from three months to one month
The bill also invests $3 million over the next three years into the state’s Health Care Eligibility Program Integrity and Oversight Unit to reduce eligibility errors and ensure compliance with federal requirements.
Republicans argue the reforms would not be as disruptive as Democrats are suggesting.
“The idea that this is going to be some kind of an apocalypse is a complete misrepresentation,” said Rep. Nolan West, R-Blaine.
House Democrats unsuccessfully attempted to amend the legislation to lessen the impact on Medicaid recipients and hospitals. Rep. Tina Liebling, DFL-Rochester, argued the state still has time before full compliance is required.
“We don’t need to fully align until Oct. 1, 2028,” Liebling said. “We haven’t received guidance from the federal government.”
The legislation now heads to a House-Senate conference committee for further negotiations.
