Opinion: The great national funding burden — coming to a Minnesota county near you

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Recently, counties and their property owners staved off an attack by the Minnesota Legislature when the budget process proposed to shift funding responsibilities to counties and property owners (“The great Minnesota funding burden — coming to a county near you,” Strib Voices, May 6).

In an unfathomed effort, county leaders and Association of Minnesota Counties fought tirelessly to defeat the cost-shift barrage in the last hours of the 2025 regular session.

While counties are grateful to the Legislature for listening and reacting to our concerns, our battle continues.

Counties across the country, along with their citizens, are facing even bigger and more powerful forces in the name of the U.S. budget reconciliation bill, H.R. 1 — The One Big Beautiful Bill.

The bill puts a pincer move on people through direct payment cuts and dramatic increases in administrative responsibilities for county government. The weapons of choice are Medicaid (in Minnesota it is called Medical Assistance, or MA) and the Supplemental Nutrition Assistance Program (SNAP).

H.R.1 will cut nearly $500 million of federal funding to Minnesota. Approximately 1.2 million elderly, children and disabled Minnesotans receive some level of medical assistance. According to the Kaiser Family Foundation, between 152,000 and 253,000 Minnesotans could lose health insurance coverage.

They will either go without medical care or receive care for which clinics, hospitals and nursing homes will not be reimbursed. This will be especially onerous on rural facilities, because they will lose important revenue. Small hospitals and nursing homes will likely close their doors.

Minnesota is only 1 of 25 states where counties contribute financially to Medicaid, and 1 of 19 where that contribution is state-mandated. In addition, Minnesota is only 1 of 10 states in which counties administer Medicaid, providing most of the eligibility, enrollment and renewal work.

I can assure you that no one, and I mean no one, is against cutting waste and fraud. However, counties and property owners should not be the ones responsible to shoulder the costs.

Anticipated impacts on counties (read: property owners) due to Medicaid cuts include:

• New federal rules would require monthly and quarterly checks (addresses, deaths, eligibility), plus twice-yearly redeterminations.

• Workload for staff will double. This will require a nearly doubling of staff — if we can find staff to do the work. If not, serious backlogs will hold up payments to individuals and increase costs due to uncompensated reimbursement to hospitals and nursing homes — especially in rural Minnesota.

Retroactive Medicaid reimbursements will be cut from three months to one month. This means that if county staff is unable to get the work done due to staffing shortages and workload, the recipient — most often the hospital or nursing home — will not be covered.

The estimated financial impact to Kandiyohi County, where I am an elected board member, is $1.6 million. This additional cost represents a 3.8% increase in our levy.

Anticipated impacts due to SNAP (food stamps) cuts:

• Minnesota is one of only 10 states in which eligibility and enrollment is handled at the county level. That means the cost of staff, equipment and facilities, is on property owners.

• Julie Ring, executive director of the Association of Minnesota Counties, estimates that the One Big Beautiful Bill will reduce federal reimbursement to Minnesota by between $160 million and $185 million.

Kandiyohi County is estimated to receive cost shifts of about $1.5 million, resulting in a 3.55% to the county levy in 2026.

Combined, the cost increase resulting from the One Big Beautiful Bill to Kandiyohi County is estimated at $3.1 million. The levy increase from this bill is estimated at 7.35% for county property owners. We (Kandiyohi County) will have our own increased needs to cover step changes, cost-of-living, increased insurance costs, Earned Sick and Safe Time (ESST), Paid Family Leave and more.

Congress and the president are proposing to bombard our financial security by forcing counties to raise property taxes to pay for cuts to federal programs. It is an assault on property owners.

Again, this is only the cost to the county. It does not measure the cost to individuals who will lose support, or to the health care facilities that are threatened reduced reimbursements and potential closings.

H.R.1 is big, but to individuals, property owners, rural hospitals and nursing homes, it will not be beautiful.

Roger Imdieke, of New London, is a member of the Kandiyohi County Board.