The federal component of Medicaid does not provide health coverage to undocumented individuals but states such as Minnesota have expanded their programs to serve them. It has become a flashpoint in budget debates at the state and federal level. (Adobe Stock)

Minnesota lawmakers remain in crunch time mode in getting a budget passed, with a special session needed and there is spirited debate about whether health coverage for undocumented adults should be included.

Earlier this year, the state expanded eligibility for its public health insurance program MinnesotaCare to cover those without legal status. With a projected deficit forecast for 2028 and 2029, GOP lawmakers said the expense should be cut. A compromise would keep the benefit in place for children in such situations.

Alexandra Fitzsimmons, senior policy director for the Children’s Defense Fund Minnesota (CDF-MN), warned about removing it for their caregivers.

“We want people to be accessing the care for preventive visits, for chronic conditions and things like that,” Fitzsimmons explained. “Because we know when people are healthier, they’re better able to care for their children.”

She added it can include households where grandparents are the caregivers. According to state data, roughly 17,000 Minnesotans who are noncitizens have enrolled since Jan. 1. The Department of Human Services only received about 4,300 claims for health care services in the first quarter. The state only pays claims after services are administered, with current costs at nearly $4 million.

Advocates said there is misinformation out there about how much money the state will spend on expanded eligibility. Republicans argue the current enrollment pace is higher than initially predicted.

Rep. Jeff Backer, R-Browns Valley, said earlier in the legislative session it would be great to help more people, but Democrats need to prioritize.

“We are looking at a tremendous hurt to our system,” Backer contended.

Fitzsimmons countered the health care system would feel stress if caregivers are stripped of health coverage.

“We know, too, that if people don’t have access to preventive care, they’re going to go to the emergency room,” Fitzsimmons pointed out.

Immigrant assistance groups and charitable organizations have urged Democratic leaders to reject the compromise, saying it goes against pledges made in 2023 to fully invest in vulnerable populations.