Democrats block legislation to clean Medicaid rolls, remove eligibility for noncitizens

Democrats in the Minnesota House of Representatives blocked legislation that would clean state Medicaid rolls, remove Medicaid eligibility for noncitizens, and codify Medicaid work requirements. That legislation would bring Minnesota into conformity with federal law.

Last year, Republicans in Washington, D.C. passed the One Big Beautiful Bill Act (OB3). Among its many provisions, OB3 authorized new work requirements for Medicaid eligibility and prohibits noncitizens such as refugees and asylees from enrolling in Medicaid.

Further, OB3 requires states to check the Death Master File on a quarterly basis to remove deceased individuals from Medicaid. The Death Master File is a Social Security database.

On Wednesday, Minnesota lawmakers in the House Health Committee considered two bills that would ensure state law conforms with the Medicaid provisions of OB3. Both of those bills are authored by GOP Rep. Danny Nadeau.

Nadeau warned the committee that nonconformity could result in the Centers for Medicare and Medicaid Services (CMS) withholding funds. Nadeau also said CMS could demand reimbursements if nonconformity leads to Minnesota issuing improper Medicaid payments.

The first bill, HF 3439, would adapt state law to keep noncitizens from receiving Medicaid and codify the quarterly examination of the Death Master File. Democrats objected to HF 3439, saying it was being rushed by the committee and needed proper consideration.

DFL Rep. Tina Liebling said she recalled that Republicans were not interested in federal conformity when Obamacare was passed many years ago. She criticized OB3 as an “ugly bill” that cuts funding and denies care to legal refugees and asylees.

Another DFL lawmaker, Rep. Robert Bierman, called Tuesday’s vote to advance HF 3439 “premature” but said the state legislature is required to react to OB3. Bierman also said HF 3439 goes beyond what is required by Congress and he is opposed to the bill.

Nadeau said his bill does not go further than what was required by the federal government.

Speaking about the need for federal conformity, Republican Rep. Jeff Backer said “when the parent, the federal government, gives you money, they [set] the guardrails. I think it’s a huge irresponsibility if we do not conform with [OB3].”

Backer warned that nonconformity would harm Minnesota’s healthcare system “to the tune of anywhere from three, three-and-a-half-billion, and more.”

Eventually, the committee tried to send HF 3439 on to another House committee for consideration. However, that vote failed 11-11; Republicans voted to advance the bill while DFLers voted against advancement. As such, HF 3439 will stay in the Health Committee.

At present, the House is evenly split with 67 Republicans and 67 Democrats. The Health Committee is therefore comprised of an equal number of Republicans and Democrats.

Afterward, the Health Committee considered HF 3763. That bill would ensure Minnesota law conforms with new Medicaid work requirements. In short, a Medicaid recipient either needs to work 20 hours a week or receive an exception to that requirement.

Veterans, the disabled, participants in drug and alcohol recovery programs, and parents of young children are among those who can receive an exception to the work requirement.

Scott Centorino, a former Trump administration staffer who worked on OB3, told the Health Committee that the new work requirements represent the “largest pro-work welfare reform in American history.”

Like the previous bill, the vote to send HF 3763 on to another House committee failed in a 11-11 vote. Republicans voted for advancement, and DFLers voted against advancement. As such, HF 3763 will also stay in the Health Committee.

The DFL’s opposition appeared to be connected to their overall concern that conformity is being rushed through without due consideration. After the hearing, a spokesperson for the House Republican Caucus released a statement which slammed the DFL.

“While they all voted no, not a single House Democrat articulated a plan to fill the hole in Minnesota’s Medicaid budget that will occur if we do not comply with [OB3], preferring instead to talk about the Trump Administration,” the statement said.

Luke Sprinkel

Luke Sprinkel previously worked as a Legislative Assistant at the Minnesota House of Representatives. He grew up as a Missionary Kid (MK) living in England, Thailand, Tanzania, and the Middle East. Luke graduated from Regent University in 2018.