Medicaid agency: DHS
Medical Assistance is Minnesota's Medicaid program, administered by the Department of Human Services (DHS) and, distinctively, delivered at the county level: county and Tribal servicing agencies handle eligibility and much of the day-to-day administration. About 1 million people receive coverage through managed care, split across four programs: Prepaid Medical Assistance Plan Plus (PMAP+) for families and children, Minnesota Senior Health Options (MSHO) and Minnesota Senior Care Plus (MSC+) for older adults, and Special Needs BasicCare (SNBC) for adults with disabilities; all four are comprehensive products that include long-term services and supports rather than carving them out. Minnesota is one of the few states that bars for-profit health plans from holding Medicaid contracts: under Minnesota Statute 256B.035, an HMO must be a nonprofit corporation or a local governmental unit to contract with the state, and three current plans are county-owned purchasers rather than conventional insurers. UCare, the largest plan with roughly 380,000 members, is in court-ordered rehabilitation, and its Medicaid membership moves to Medica on October 1, 2026. Minnesota's governor has proposed eliminating managed care entirely for a single statewide administrative services organization, which would require legislative approval.
Eight health plans hold 2026 Medicaid contracts: Blue Plus, HealthPartners, Hennepin Health, Itasca Medical Care, Medica, PrimeWest Health, South Country Health Alliance, and UCare, with three of them (Itasca Medical Care, PrimeWest Health, South Country Health Alliance) organized as county-based purchasing organizations rather than conventional insurers under Minnesota Statute 256B.692. UCare, the largest plan across all four programs, was placed into rehabilitation by a Ramsey County court in December 2025; its members transition to Medica One Health Plan on October 1, 2026, with no gap in coverage. Minnesota Statute 256B.035 requires that an HMO contracting for Medical Assistance be a nonprofit corporation or a local governmental unit, which excludes for-profit plans from the market. The managed care model itself is under active political challenge: the state's governor has proposed replacing the eight managed care contracts with a single statewide administrative services organization and shifting eligibility administration from counties to the state, a proposal that would require legislative approval it has not received.
Long-term services and supports are built into the managed care benefit rather than carved out; all four programs are comprehensive MCO products that include MLTSS. Five Section 1915(c) waivers supply the underlying authority for home and community-based services by population: the Brain Injury (BI) Waiver, Community Access for Disability Inclusion (CADI) Waiver, Community Alternative Care (CAC) Waiver, Developmental Disabilities (DD) Waiver, and Elderly Waiver. Waiver case management is delivered through county and Tribal agencies, consistent with the county-administered structure of the program generally.
Integrated into managed care
Mental health services are part of the comprehensive managed care benefit rather than a separate carve-out. Substance use disorder treatment is funded differently: the Consolidated Chemical Dependency Treatment Fund operates under its own Section 1915(b) waiver authority (MN-01), separate from the comprehensive benefit. A Section 1115 Substance Use Disorder System Reform demonstration, approved in June 2019, runs through March 2031.
Carved in
There is no single statewide dental administrator; each health plan arranges dental itself, most through a subcontracted administrator, with Delta Dental of Minnesota serving Blue Plus, Hennepin Health, Medica, and South Country Health Alliance, UCare using DentaQuest since 2025, and PrimeWest Health administering its own. Fee-for-service dental is billed directly to DHS, and comprehensive adult dental benefits, eliminated in 2008, were restored in 2024. Minnesota Statute 256B.0371 requires DHS to contract with a single dental administrator covering both fee-for-service and managed care once dental utilization falls below statutory benchmarks; utilization remains below that benchmark, and DHS has said a carve-out is planned for January 1, 2028, though no administrator has been procured.
Pharmacy is split: Prime Therapeutics has administered the fee-for-service pharmacy benefit since November 2024, taking over point-of-sale claims processing, prior authorization, drug rebate administration, and the Preferred Drug List from DHS. Each health plan administers its own pharmacy benefit for managed care members, but all must use a single state-set Uniform Preferred Drug List, mandatory since July 2019.
Non-emergency medical transportation remains county- and Tribal-administered for fee-for-service members, with health plans arranging rides for their own managed care enrollees; MNET, brokered by Medical Transportation Management under a Hennepin County host-county contract, covers thirteen Twin Cities-area counties; SmartLink coordinates another group, and the rest administer transportation directly. Minnesota Statute 256B.0625, subdivision 18i directs DHS to contract with a single statewide or regional NEMT administrator covering both fee-for-service and managed care; the 2026 Legislature removed the statute's original fixed timeline in favor of an implementation-triggered transition with six months' notice to counties and health plans. DHS issued and then withdrew a procurement for the administrator in January 2026, and no vendor is in place.
Minnesota operates its own Medicaid Management Information System in-house, a mainframe administered by Minnesota IT Services (MNIT) on behalf of DHS, rather than contracting a fiscal agent. Eligibility runs on a separate system, METS, built on IBM Cúram.
67 agency updates tracked for Minnesota. Available with Pro.
See them with ProAt an MPR News debate on Oct. 2, Republican attorney general candidate Ron Schutz committed to placing his stock portfolio in a blind trust and divesting from companies in litigation with Minnesota if elected, responding to reports about his 174 individual stock holdings. Democratic incumbent Keith Ellison, seeking a third term, defended his enforcement record, citing more than 350 Medicaid fraud convictions and his pursuit of pharmaceutical and employer fraud cases. Schutz criticized Ellison for not doing enough to stop fraud affecting Minnesota government, referencing the state's ongoing fraud scandals since 2022. The debate also covered lawsuits against the Trump administration, pardons, and prediction markets ahead of the competitive statewide race.
Minnesota's Department of Commerce announced average 2027 premium increases of 17% for individual and small group health insurance plans, affecting roughly 203,000 individual market enrollees and 184,000 small group enrollees. This marks a second consecutive year of double-digit hikes, following a 22% individual market increase and 14% small group increase in 2026. State officials cited rising medical and drug prices, increased utilization, and growth of "profit-driven entities" in healthcare delivery and financing as drivers. The announcement coincided with a state Senate hearing where health economists linked hospital consolidation, including a newly announced merger between Essentia and HealthPartners, to rising premiums, and comes amid reduced federal premium tax credits and election-year political blame-shifting.
HealthPartners of Bloomington and Essentia Health of Duluth announced plans on Sept. 29 to merge into a combined 22-hospital health system, marking the third major deal involving a Minnesota-based system in 2026. The consolidation underscores accelerating hospital and health system M&A activity concentrated in Minnesota this year. Terms and a target closing date were not detailed in the announcement. HealthPartners also operates a Medicaid managed care plan, so the combined entity's scale could affect provider networks and negotiating leverage in the state.
A rural Minnesota hospital has maintained its maternity ward operations while similar facilities nationwide continue closing obstetric services. The hospital's operational model may offer a replicable strategy for other rural providers facing financial pressures that force maternity unit closures. Rural maternity ward closures directly affect Medicaid beneficiaries, who account for approximately 42% of all U.S. births and face increased travel distances and reduced access to prenatal and delivery care when local services close.
Sanford Health has completed its acquisition of North Memorial Health, finalizing the deal after agreeing to 10 years of state oversight and committing $600 million in investments. The agreement allows South Dakota-based Sanford to expand into the Twin Cities market. The oversight agreement addresses state concerns about the consolidation's impact on healthcare access and costs. The deal represents significant market consolidation in Minnesota's Twin Cities region.
16 active waivers tracked for Minnesota. Available with Pro.
See them with Pro1 active solicitations tracked for Minnesota. Available with Pro.
See them with Pro21 managed care contracts tracked for Minnesota. Available with Pro.
See them with Pro64 bills tracked for Minnesota. Available with Pro.
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