Gizmo Warehouseby Joe Eichenbaum | 17A

Medicaid work requirements · Minnesota

Medicaid work requirements in Minnesota: who is subject and who loses coverage (2027)

Data snapshot 2026-06-03 · part of These 5 Million People Are About to Lose Their Medicaid — But They Don't Have To

Minnesota expanded Medicaid, so the federal work requirement that takes effect January 1, 2027 applies to its expansion adults. About 198,564 of them (5.9% of an expansion pool of 212,268) will have to prove 80 hours a month of work, school, or service, or an exemption, to keep coverage.

This model's bottom-up estimate is that 48,600 people in Minnesota lose coverage by 2034: 42,643 of them still eligible but lost to paperwork and reporting failures, and 5,957 not meeting the requirement. Nationally the same model gives 5,461,400, against CBO's 5,200,000.

Whether those eligible people keep coverage depends on the state's ability to renew them automatically (ex parte) from data it already holds. Minnesota scores 74 of 100 on this model's ex parte capability index, a low band; its eligibility system is METS.

Key figures

Model v2-2026-06-03. "Strict" counts adults whose ACS record shows them subject with no observable exemption; "permissive" allows the broader exemption reading.
MeasureMinnesota
Expansion stateYes
Subject to the requirement via waiverNo
Expansion pool (adults 19 to 64)212,268
Adults subject, strict definition198,564
Adults subject, permissive definition194,593
Share of expansion pool subject5.9%
Projected coverage loss by 203448,600
Hardship exception statusAdopting
Early implementerNo
Ex parte capability score (0 to 100)74 (low)

Who is subject in Minnesota

Of the 198,564 subject adults, 33% already work 80 or more hours a month and 55% are not working. 11% have a child under 14 at home. Among those not working, 57% report a disability and 6% are caregivers.

ACS PUMS 5-year 2020 to 2024, subject adults only.
CharacteristicShare of subject adults
Age 19-2420%
Age 25-3417%
Age 35-4414%
Age 45-5418%
Age 55-6431%
Not working55%
1 to 19 hours a month2%
20 to 79 hours a month11%
80 or more hours a month (meets the bar)33%
Not working: Disabled57%
Not working: Caregiver6%
Not working: Postpartum0%
Not working: Student3%
Not working: Other34%

Why eligible people lose coverage

Of the 48,600 projected to lose coverage in Minnesota, 42,643 meet the requirement or qualify for an exemption but fail to document it. 18,205 of those are working people who cannot prove their hours through data the state can see, and 24,438 qualify for an exemption the state does not detect automatically.

Bottom-up model v8.0-2026-05-30; documentation-failure buckets compound over the 14 six-month renewal cycles through 2034.
GroupProjected to lose coverage
Multiple part-time jobs (aggregation failure)6,773
Variable shifts / on-call work3,828
Self-employed (other)2,876
Full-time students not auto-verified1,562
Seasonal: agriculture, hospitality, food service1,094
Cash-paid construction & trades827
Volunteering / job training732
Gig / courier (DoorDash, Uber, Lyft, Instacart)512
Medically frail without auto-match12,769
Caregivers of a disabled adult5,370
American Indian / Alaska Native (tribal exemption)2,817
SUD treatment not flagged in claims data1,417
Kinship caregivers (non-parent) of children ≤13802
Other categorical exemptions (foster, AYA cancer, SNAP/TANF)513
Recent incarceration (data-match gap)511
Parent caregivers of children ≤13 without auto-match195
Pregnancy / postpartum data lag44

Can the state renew people automatically?

The ex parte capability index blends the state's observed automatic-renewal rate (76% in CMS eligibility-processing data), the wage, disability, and other data sources it can query, and its history of churn. Minnesota's composite score is 74 (low band). A low score means more eligible people will be dropped for paperwork unless the state changes its process before January 1, 2027.

ComponentScore
Composite74
Observed ex parte76
Core capability96
Data sources80
Historical churn50

How subjects overlap across exemption categories

Each subject adult sits in exactly one cell. Categories: Working ≥ qualifying hours / income; Parent caregiver of child ≤13; Medically frail; Full-time student.
CombinationAdultsShare
None of the four81,97241.3%
Working ≥ qualifying hours / income49,27624.8%
Medically frail41,19820.8%
Working ≥ qualifying hours / income + Full-time student9,9955.0%
Full-time student9,0474.6%
Working ≥ qualifying hours / income + Medically frail4,7572.4%
Medically frail + Full-time student7610.4%
Working ≥ qualifying hours / income + Parent caregiver of child ≤137230.4%

Counties in Minnesota

Subject adults concentrate: Hennepin County (40,799), Ramsey County (17,432), and Dakota County (14,752) account for 37% of the state's subject population.

All 87 counties in Minnesota with subject adults, sorted by count. County figures are model allocations of the state estimate by ACS tract characteristics.
CountyAdults subjectSubject rateProjected lossPoverty rateWorking-age population
Hennepin County40,7995.2%9,98610.0%782,251
Ramsey County17,4325.4%4,26713.0%324,713
Dakota County14,7525.6%3,6116.0%263,336
Anoka County12,4295.6%3,0426.0%221,510
Washington County9,4955.9%2,3245.0%161,046
St. Louis County7,9316.8%1,94114.0%116,824
Stearns County6,2886.7%1,53913.0%93,640
Olmsted County5,3065.5%1,2998.0%95,956
Scott County5,0545.4%1,2375.0%93,184
Wright County4,8505.6%1,1875.0%85,938
Carver County3,7585.8%9204.0%64,922
Sherburne County3,3065.4%8096.0%61,094
Blue Earth County3,0317.0%74216.0%43,238
Rice County2,5956.5%6359.0%40,216
Crow Wing County2,5356.9%62110.0%36,649
Otter Tail County2,3457.5%5749.0%31,366
Clay County2,3366.0%57215.0%39,104
Winona County2,0966.9%51314.0%30,190
Chisago County1,9995.8%4896.0%34,553
Beltrami County1,7946.9%43916.0%25,980
Itasca County1,7907.5%43812.0%24,008
Goodhue County1,7116.3%4199.0%27,096
Kandiyohi County1,6176.8%39611.0%23,724
Douglas County1,5047.1%3689.0%21,074
Isanti County1,4956.0%3669.0%24,940
Mower County1,4566.6%35612.0%22,150
Becker County1,3417.2%32811.0%18,660
Benton County1,3375.4%3279.0%24,790
Steele County1,3076.3%3208.0%20,722
McLeod County1,2966.2%3177.0%20,904
Cass County1,2958.1%31712.0%16,010
Morrison County1,2696.8%31110.0%18,756
Nicollet County1,2436.2%30410.0%19,935
Carlton County1,2105.6%29613.0%21,490
Freeborn County1,1316.8%27710.0%16,520
Polk County1,1096.6%27112.0%16,894
Pine County1,1086.5%27111.0%17,032
Le Sueur County1,0406.3%2557.0%16,638
Brown County9987.1%2448.0%14,094
Todd County9797.4%24012.0%13,263
Mille Lacs County9225.9%22611.0%15,540
Lyon County9046.5%22112.0%13,974
Meeker County8897.0%2188.0%12,778
Hubbard County8867.9%21710.0%11,212
Nobles County8287.2%20312.0%11,534
Wabasha County8066.9%1978.0%11,628
Fillmore County7867.0%1929.0%11,230
Martin County7697.5%18812.0%10,208
Houston County7247.2%1777.0%10,072
Dodge County7025.8%1725.0%12,174
Aitkin County6978.8%17112.0%7,884
Waseca County6606.1%1617.0%10,759
Kanabec County6066.7%14810.0%9,104
Roseau County5766.7%14110.0%8,574
Redwood County5567.0%13610.0%7,960
Sibley County5436.4%1339.0%8,538
Renville County5396.9%13210.0%7,770
Faribault County5307.1%13011.0%7,406
Koochiching County5118.1%12512.0%6,280
Pennington County5006.2%12210.0%8,112
Wadena County4726.3%11612.0%7,478
Lake County4547.9%1119.0%5,720
Chippewa County4486.8%11011.0%6,608
Pope County4487.5%11010.0%5,964
Cottonwood County4447.6%10913.0%5,832
Stevens County4027.1%9812.0%5,625
Watonwan County3926.7%9613.0%5,858
Swift County3857.4%9411.0%5,166
Jackson County3737.0%9110.0%5,362
Yellow Medicine County3687.1%9010.0%5,164
Rock County3406.6%839.0%5,168
Marshall County3387.2%837.0%4,692
Pipestone County3336.9%8213.0%4,798
Murray County3318.0%817.0%4,117
Clearwater County3146.9%7711.0%4,546
Lac qui Parle County2637.8%649.0%3,358
Wilkin County2476.9%6014.0%3,580
Norman County2376.9%589.0%3,441
Grant County2337.3%5710.0%3,205
Cook County2267.4%559.0%3,039
Lincoln County2097.2%519.0%2,908
Mahnomen County2047.6%5021.0%2,670
Big Stone County2017.8%4910.0%2,588
Lake of the Woods County1688.1%4111.0%2,060
Red Lake County1587.8%399.0%2,040
Kittson County1577.5%3911.0%2,089
Traverse County1247.3%308.0%1,682

State brief and methodology

Estimates, not counts. The model rakes to CBO's national subject total and allocates by ACS microdata; state agencies hold the administrative data that would replace these figures.

Sources

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