Minnesota’s free healthcare program for illegal immigrants has exploded to over 20,000 enrollees—more than triple the state’s original estimate—triggering a severe budget crisis and legislative battle over the program’s fate.
At a Glance
- Minnesota’s MinnesotaCare program for undocumented immigrants has enrolled over 20,000 people, far exceeding the projected 5,700 enrollees
- Program costs have ballooned nearly 30% above initial estimates, potentially reaching over $600 million
- Republican lawmakers have introduced legislation to end coverage for illegal immigrants by December 21, 2025
- Democrats vow to “fight until the very end” to maintain the program despite budget overruns
- Similar healthcare programs for illegal immigrants in Illinois and California are also under scrutiny due to financial constraints
Budget Explosion Forces Lawmakers to Reconsider Program
What began as a Democratic initiative to provide healthcare coverage to approximately 5,700 undocumented immigrants in Minnesota has rapidly transformed into a major budgetary concern. Enrollment numbers have skyrocketed to over 20,000 participants in just the first few months of the program, more than tripling initial projections. This surge has caused program costs to balloon from an estimated $220 million over four years to potentially exceeding $600 million, creating significant strain on the state’s finances.
Republican legislators have responded with House Bill HF 10, which would exclude undocumented immigrants from MinnesotaCare eligibility. They argue this action could save Minnesota taxpayers more than $100 million annually. Senator Jordan Rasmusson, a Republican from Fergus Falls, points to the enrollment surge as evidence the program is attracting more illegal immigration to the state.
“We should not be surprised by this dramatic increase because this program creates an incentive for illegal immigrants to come here to Minnesota.”, said Sen. Jordan Rasmusson.
Partisan Divide Deepens Over Healthcare Priorities
The controversy has intensified partisan divisions in the Minnesota legislature. Republicans argue that funding healthcare for illegal immigrants diverts resources from citizens and legal residents. They point to potential cuts in nursing home funding and services for families with disabilities as evidence that state priorities are misaligned. Some Republican lawmakers have used notably strong language to characterize their opposition to the program.
“This is the closest thing that you will ever see to treason, where taxpayer dollars are going to fund people who are here illegally.”, said Rep. Isaac Schultz, R-Elmwood Township.
Democrats, meanwhile, continue defending the program despite its budgetary challenges. They argue that undocumented immigrants contribute to Minnesota’s economy and society as taxpayers and workers. Senate Majority Leader Erin Murphy and other Democratic lawmakers maintain that cutting healthcare access would ultimately cost more through increased emergency room visits and uncompensated care costs.
Healthcare Organizations Support Continued Coverage
Minnesota healthcare providers, insurance companies, and religious organizations have largely aligned with Democrats in supporting continued coverage for undocumented immigrants. The Minnesota Council of Health Plans, hospitals, and medical professionals argue that preventative care ultimately reduces costs compared to treating uninsured patients in emergency settings. They emphasize both humanitarian and financial reasoning.
“When people are covered and they have access to care, they can seek preventative care as well as vaccinations, which improves public health.”, Dan Endreson of the Minnesota Council of Health Plans, said.
As of April 2025, Minnesota has spent $3.9 million on healthcare claims for 4,306 undocumented enrollees, with projections suggesting annual costs around $12.5 million. While this represents a small fraction of the state’s overall healthcare budget, the political significance far outweighs the immediate fiscal impact. The controversy occurs against a backdrop of similar debates in other states, including California and Illinois, where similar programs face budget challenges.
Solution Remains Elusive as Budget Deadline Approaches
With state budget negotiations intensifying, lawmakers face difficult choices. A compromise budget deal currently includes provisions to end coverage for undocumented adults by December 21, 2025, while maintaining services for children and pregnant women. Democratic legislators, however, have vowed to “fight until the very end” to preserve the full program. The Minnesota Legislature, still controlled by Democrats, appears unlikely to completely roll back the program despite Republican opposition.
“What we did two years ago is make sure we add them to our health insurance coverage because we see a need for that. These folks contribute to our economy, they contribute to our society, they are taxpayers.”, said Sen. Zaynab Mohamed, DFL-Minneapolis.
The controversy highlights broader national tensions over immigration policy and public benefits. As Minnesota grapples with these challenging fiscal and policy decisions, the outcome may influence similar programs in other states facing comparable budget pressures. Advocates on both sides recognize the issue extends beyond immediate healthcare concerns to fundamental questions about immigration enforcement, resource allocation, and state priorities.