Minnesota Legislature votes to strip health care from adult undocumented immigrants

Minnesota lawmakers Monday voted to strip health care coverage from adult undocumented immigrants, a decision that came after more than five hours of debate and impassioned pleas from Democrats not to leave people without care.

Lawmakers, working against a 7 a.m. Tuesday deadline to pass a two-year $66 billion state budget, debated for almost four hours in the House over the measure. In the end, one Democrat — House DFL Leader Melissa Hortman of Brooklyn Park — voted with all Republicans in favor. The chamber is evenly split between Republicans and Democrats, so at least one DFL member had to cross over for the bill to pass.

“For a group of folks who proclaim to be pro-life, this is the least pro-life piece of legislation I have ever seen,” said Rep. Athena Hollins, DFL-St. Paul.

Senators voted 37 to 30 to pass the bill after more than 90 minutes of debate. Senate Majority Leader Erin Murphy, DFL-St. Paul, was one of four Democrats to vote for the bill. She and Hortman struck a deal with Republicans to balance the budget and avert a government shutdown, a deal that required their support for the change to immigrant care.

“I made an agreement. I gave my word,” Murphy said in an emotional floor speech. “I will vote for this, but it’s one of the most painful votes I’ve ever taken.”

Undocumented immigrants were allowed to enroll in MinnesotaCare as of January following legislation Democrats passed in 2023 when they held the House and Senate. Over the first few months of this year, more than 20,000 people enrolled, one-quarter of them children.

Now undocumented adults will be removed from the program at the end of the year.

Hollins said the proposal will result in increased costs and financial trouble for rural hospitals and questioned how Republicans would respond to constituents if they ask why rural providers are closing.

“What are you going to say — because I really hate immigrants?” she asked.

House Floor Leader Harry Niska, R-Ramsey, said providing health care to undocumented immigrants threatened to “blow a hole” in the budget, noting California and Illinois are considering rolling back similar programs.

“It will send the clear message to Minnesota taxpayers that taxpayer-funded benefits are not a reward for breaking federal immigration laws,” Niska said.

The legislation now goes to Gov. Tim Walz, a Democrat, who is expected to sign it because of a provision Republicans sought in the state budget that would defund the Minnesota Department of Health if the governor did not sign the bill.

“Republicans are saying [they] are so concerned about ripping away health care from a small number of Minnesotans, including pregnant women,” said Rep. Tina Liebling, DFL-Rochester, “that [they] would defund our entire Department of Health that impacts every single Minnesotan, their water, infectious diseases, lead in their pipes, all kinds of things that people depend on.”

Members of the People of Color and Indigenous (POCI) Caucus decried the legislation at a news conference just ahead of the vote. They said Democrats offered to enact a multitude of other Republican priorities — including modifications to paid family medical leave — to avoid stripping health care from undocumented immigrants, but Republicans wouldn’t budge.

Republicans said removing the coverage was not about being uncaring, but rather about costs.

Rep. Jeff Backer, R-Browns Valley, who sponsored the bill revoking coverage, said lawmakers take an oath to serve their constituents and “that’s what this bill does.”

“It serves the hardworking, lawful Minnesotans,” Backer said. He said undocumented immigrants could purchase private health insurance.

Niska said lawmakers are stewards of public money and allowing undocumented immigrants to access MinnesotaCare is “poor stewardship.”

“The government is not the church, it’s not a charity,” Niska said, “and the government is not your neighbor.”

Senators clashed during debate over Democrats’ criticisms of the legislation. Sen. Clare Oumou Verbeten, DFL-St. Paul, said the legislation is “cruel, it’s racist, it’s deadly.”

At that point, Sen. Eric Lucero, R-St. Michael, said it was “not acceptable” for senators to impugn their colleagues’ intentions in supporting the legislation.

A spreadsheet detailing the budget shifts says the legislation would save the state $148 million over four years, compared to Republicans’ claim of $600 million. Sen. Alice Mann, DFL-Edina, described Republicans’ claims about the cost of the program “made up.”

Democrats argued that taking away health coverage means immigrants will wait to seek care and wind up in emergency rooms with critical illnesses. Since hospitals are required to treat people experiencing medical emergencies regardless of ability to pay, they’ll provide more uncompensated care, and taxpayers will pay for it, they said.

House Democrats sought to amend the bill to allow undocumented seniors to stay on MinnesotaCare along with those with critical illnesses, including diabetes, cancer, hypertension, coronary artery disease and conditions that require dialysis services. It also would have allowed undocumented children who are on MinnesotaCare to remain enrolled when they turn 18.

That amendment failed on a party-line vote.