Minnesota’s Community Health Centers Warned of Significant Coverage Risks

The Minnesota Association of Community Health Centers (MNACHC) has released a new analysis warning that federal H.R. 1, also known as the One Big Beautiful Bill Act, could jeopardize health coverage for over 71,000 patients in the state. The report, prepared by Facktor and Capital Link, highlights the potential financial and operational challenges that community health centers in Minnesota will face.

According to the analysis, by 2030, the federal changes could result in the loss of coverage for 71,619 health center patients due to the expiration of enhanced Affordable Care Act (ACA) Marketplace tax credits, twice-yearly Medicaid redeterminations, and work requirements. This is a significant concern, as it could lead to a rise in the state’s uninsured rate, which has already increased from 3.8% in 2023 to 5.8% in 2025. New federal immigrant eligibility restrictions that took effect on October 1, 2026, and administrative barriers further exacerbate the risk for low-income families, immigrants, and rural Minnesotans.

MNACHC’s CEO, Jonathan Watson, emphasized the critical role that community health centers play in providing primary care access to the state’s most vulnerable residents.

The report projects that health centers will face a cumulative net loss of $100.3 million from reduced patient revenue and rising uncompensated care. This financial strain could lead to a reduction in local economic contributions, falling from $41 million to $25 million, and potentially eliminating 78 jobs statewide. MNACHC has called on state leaders to take urgent action to prevent coverage loss and protect the safety net.

MNACHC thanked state leaders for using state funds to preserve the three-month retroactive Medicaid coverage period through 2027. However, Watson stressed that more is needed. He urged state agencies, counties, managed care organizations, and health systems to strengthen eligibility processes, fund in-person enrollment navigators, protect safety-net revenue, and build cross-sector coalitions to ensure continuous patient screening and enrollment.