¶ Overview
- Finstad voted for a bill that would kick 17 million Americans off their health insurance, including nearly 12 million Americans off of Medicaid. More than 19,000 Minnesotans could lose their health coverage as a result of his votes. The Minnesota Hospital Association also warned that funds the state received through the Rural Health Transformation Program would not cover the losses incurred by Republican budget bill cuts.
- Finstad also voted against extending critical health care tax credits, allowing them to expire, and dooming Minnesotans to higher premium costs.
¶ Finstad Voted To Kick More Than 19,000 Of His Constituents And Nearly 12 Million Americans Off Medicaid
¶ Finstad Voted Three Times To Take Health Coverage From Minnesotans
¶ July 2025: Finstad Voted For The Final Version Of Republicans’ Reconciliation Bill
7/3/25: Finstad Voted For The Senate FY 2025 Budget Reconciliation Bill That Cut Medicaid And Other Social Programs To Offset The Bill’s Costs. In July 2025, Finstad voted for, according to Congressional Quarterly, the “motion to concur in the Senate amendment to the bill that would permanently extend nearly $4 trillion in expiring individual and business tax cuts, create several new tax breaks and fund border and immigration enforcement and air traffic control upgrades. It would cut Medicaid and other safety net programs to partly offset the cost. Among other provisions, it would raise the statutory debt ceiling by $5 trillion and appropriate more than $448 billion in mandatory funding for Trump administration priorities and other needs, including $153 billion for defense, $89 billion for immigration enforcement, and $89.5 billion for border control and security. It also would increase the state and local tax deduction cap to $40,000 annually for five years for households making up to $500,000 a year until 2030, when it would permanently revert to $10,000.” The House passed the bill by a vote of 218 to 214. [House Vote 190, 7/3/25; Congressional Quarterly, 7/3/25; Congressional Actions, H.R. 1]
- HEADLINE: "At Least 17 Million Americans Would Lose Insurance Under Trump Plan" [Washington Post, 7/1/25]
- The Congressional Budget Office Estimated That 11.8 Million People Would Become Uninsured As A Result Of The Medicaid Cuts In Republicans’ Reconciliation Bill. According to the Washington Post, "The bill, which narrowly passed the Senate on Tuesday and now heads back to the House, would effectively accomplish what Republicans have long failed to do: unwind many of the key components of the ACA, President Barack Obama’s signature domestic achievement, which dramatically increased the number of Americans with access to health insurance. To start, the Congressional Budget Office estimated that the Senate version of the bill would result in 11.8 million more uninsured in 2034, mostly because of Medicaid cuts, compared with 10.9 million if the House version became law." [Washington Post, 7/1/25]
¶ May 2025: Finstad Voted For House Republicans’ Budget Bill, Which Would Kick Millions Of People Off Medicaid
5/22/25: Finstad Voted For The FY 2025 Budget Reconciliation Bill That Included $3.8 Trillion In Tax Cuts Offset By $1.5 Trillion In Spending Reductions To Programs Like Medicaid And The Supplemental Nutrition Assistance Program. In May 2025, Finstad voted for, according to Congressional Quarterly, “the bill that would provide for approximately $3.8 trillion in net tax cuts and $321 billion in military, border enforcement and judiciary spending, offset by $1.5 trillion in spending reductions, as instructed in the fiscal 2025 budget resolution (H Con Res 14). It would raise the statutory debt limit by $4 trillion and provide for increased spending on defense and border security, spending cuts on social safety net programs, such as Medicaid and the Supplemental Nutrition Assistance Program. It also includes a mix of tax breaks for businesses and individuals; tax increases on universities and foundations; and a phase-down of clean energy tax credits. […] It would reduce federal spending on the Supplemental Nutrition Assistance Program by requiring states to shoulder more of the cost, expand work requirements for SNAP, extend programs authorized under the 2018 farm bill, and prohibit the U.S. Department of Agriculture from increasing the cost of the Thrifty Food Program. As amended, it would cap state and local tax deductions at $40,000 for households with incomes below $500,000.” The House passed the bill by a vote of 215 to 214. [House Vote 145, 5/22/25; Congressional Quarterly, 5/22/25; Congressional Actions, H.R. 1]
- The House GOP Budget Bill Was Estimated To Increase The Uninsured Population By 8.6 Million By 2034. According to CNN, “The Medicaid and Affordable Care Act provisions in the package could result in 8.6 million more people being uninsured in 2034, according to an early CBO estimate released by Democratic lawmakers. That number is expected to grow with the latest changes.” [CNN, 5/28/25]
- The House GOP Budget Bill Codified A Trump Administration Proposal That Restricted Access To The Affordable Care Act. According to CNN, “The bill also calls for codifying a Trump administration proposal that would make changes to the Affordable Care Act enrollment process, including shortening the open enrollment period and eliminating the ability of low-income Americans to sign up year-round.” [CNN, 5/28/25]
¶ February 2025: Finstad Voted For A Budget Resolution That Spelled Out Future Medicaid Cuts
2/25/25: Finstad Voted For The FY 2025 Budget Framework That Included $2 Trillion In Cuts, Raised The Statutory Debt Limit By $4 Trillion, And Required House Committees To Recommend Legislation That Would Implement Trump’s Agenda. In February 2025, Finstad voted for, according to Congressional Quarterly, “the concurrent resolution that would recommend a budget for fiscal 2025 and budget levels through fiscal 2034. The resolution would assume minimum savings of $1.5 trillion over 10 years and 2.6 percent economic growth over the same period. It also would require the statutory debt limit to be raised by $4 trillion. It also would authorize the House Ways and Means Committee to increase deficits by $4.5 trillion over 10 years to extend the 2017 tax cuts and implement new tax cuts proposed by the White House. It also would provide instructions for the budget reconciliation process through which separate legislation could be considered and passed in the Senate via a simple majority vote. The measure would deliver instructions to 11 House committees to report legislation that would implement President Donald Trump’s agenda, such as expanding tax cuts and bolstering border security and immigration enforcement. The committees would be required to report their legislative recommendations to the House Budget Committee by March 27, 2025. It also would set a $2 trillion target for the spending cuts to be submitted to the House Budget Committee. The resolution also would stipulate that if the committees don't reach that target, the Ways and Means’ reconciliation instructions to increase the deficit by a maximum of $4.5 trillion would be decreased by the amount the other committees come in below the target. Similarly, it would stipulate that Ways and Means could increase the deficit above the $4.5 trillion level by the amount of savings the committees achieve above the $2 trillion target.” The vote was on passage. The House passed the resolution by a vote of 217 to 215. [House Vote 50, 2/25/25; Congressional Quarterly, 2/25/25; Congressional Actions, H. Con. Res. 14]
- HEADLINE: “What Can House Republicans Cut Instead Of Medicaid? Not Much.” [New York Times, 2/25/25]
- HEADLINE: "House Republican Budget Takes Away Health Care, Food Aid To Pay For Expanded Tax Cuts For Wealthy" [Center on Budget and Policy Priorities, 2/21/25]
- New York Times Reported The $880 Billion In Cuts Required By The Republican Budget Proposal Would Have To Come From Medicaid, Medicare, Or CHIP. According to the New York Times, "The budget resolution itself is silent on whether Congress cuts Medicaid, which provides health coverage to 72 million poor and disabled Americans. But it instructs the House Energy and Commerce Committee, which has jurisdiction over the program, to cut spending by $880 billion over the next decade. If the committee can’t save at least that much, the entire effort could be imperiled because of the special process Congress is using to avoid a Senate filibuster. Ten other committees have their own instructions to follow, though none have been assigned with cutting nearly as much. It’s not so simple as finding the cuts elsewhere. The special process, known as budget reconciliation, means Republicans will have to find all $880 billion from within the Energy and Commerce Committee’s jurisdiction. That leaves them with fewer options than one might think. […] If Republicans want to avoid major cuts to Medicaid, the largest pot of available money is in the other big government health insurance program: Medicare. […] Even if the committee cuts everything that’s not health care to $0, it will still be more than $600 billion short. The committee could also save around $200 billion by eliminating the Children’s Health Insurance Program, but that option has not been raised by the budget committee or anyone in House leadership. […] Even if all of these cuts, revenues and rule cancellations from outside health care can pass muster, the committee will still be left with hundreds of billions of dollars to cut to hit its goal. Mathematically, the budget committee’s instructions mean the committee would need to make major cuts to either Medicare, Medicaid or both." [New York Times, 2/25/25]
¶ Finstad Applauded The Passage Of The Republican Budget Bill
5/22/25: Finstad Called The Republican Budget Bill “Once-In-A-Generation Legislation” And Claimed It Secured A “Historic $1.6 Trillion In Savings.” According to a press release from Rep. Brad Finstad, “Congressman Brad Finstad (MN-01) issued the following statement after the House of Representatives passed H.R. 1, the One Big Beautiful Bill Act: ‘Since my first day in Congress, I have worked to support policies that grow our economy, rein in Washington’s out-of-control spending, and let hardworking families keep more of their paychecks. The House’s ‘One Big Beautiful Bill’ does exactly that. Not only does this once-in-a-generation legislation prevent the largest tax hike in our country’s history, it delivers what the American people voted for: a secure border, national security, energy dominance, and an end to government waste, fraud, and abuse.’ Rep. Finstad continued, ’For far too long, Washington has disrespected the hard-earned dollars of American taxpayers. This budget resolution secures a historic $1.6 trillion in savings, and quite simply, puts America – and Americans – first, which is why I was proud to cast a ‘yes’ vote on this legislation on behalf of southern Minnesota’s families, farmers, and small businesses.’” [Press Release – Rep. Brad Finstad, 5/22/25]
7/3/25: Finstad Said He Was “Proud” To Have Voted For The Final Version Of The Republican Budget Bill And Claimed It Secured Big Wins For Americans. According to a press release from Rep. Brad Finstad, “Congressman Brad Finstad (MN-01) issued a statement after final passage of H.R. 1, the One Big Beautiful Bill Act. The legislation now heads to President Trump’s desk to be signed into law. Congressman Finstad celebrated its passage, saying, ’This Republican majority was sent to Congress to change the failed policies of the last four years and move our country forward with policies that cut taxes, secure our borders, restore energy independence, and deliver peace through strength. The bill we voted on today secures those wins for southern Minnesotans and for the American people. ‘Importantly, this bill delivers meaningful and permanent tax relief for families and small businesses across the First District while also making government more accountable to taxpayers through much-needed checks on Washington’s waste, fraud, and abuse. I was proud to vote to get this done for the American people, ushering in the economic growth that puts American families first.’” [Press Release – Rep. Brad Finstad, 7/3/25]
¶ More Than 19,000 Minnesotans In The First Congressional District Could Lose Health Coverage AS A Result Of Finstad’s Votes
An Estimated 19,617 People In Finstad’s District On The Affordable Care Act And Medicaid Were Set To Lose Coverage Due To Republican Budget Bill Health Care Cuts. According to the Joint Economic Committee,
[Joint Economic Committee, Viewed 10/22/25]
2023: 121,900 Minnesotans In The 1st Congressional District Were Enrolled In Medicaid Or CHIP. According to the Center for American Progress,
[Center for American Progress, 3/11/25]
The Republican Budget Bill’s Medicaid Cuts Were Estimated To Reduce Minnesota’s Federal Funding By $1.4 Billion In The First Four Years Of The Law’s Implementation. According to the Sahan Journal, “For Minnesota, reductions in federal funding will total $1.4 billion in the first four years of the law, and counties will face hundreds of millions in new administrative costs, according to a July briefing for reporters by Minnesota Department of Human Services officials. In addition to the funding cuts, the package included new provisions for recipients including a requirement for 80 hours of ‘community engagement’ a month; eligibility renewals every six months, rather than once a year; and cuts in retroactive coverage from three months to a month.” [Sahan Journal, 9/25/25]
- The CEO Of Minnesota-Based Hennepin Healthcare Said The Work Requirements And Six-Month Eligibility Renewals Will Deter People Who Need Medicaid From Applying. According to the Sahan Journal, “Hennepin Healthcare CEO Dr. Thomas Klemond said the work requirement and the six-month eligibility renewals will have the biggest impact on the health care system’s ability to recoup the costs of care from patients. Those extra steps are a barrier for many, leading fewer to seek preventive care, he said. ’When patients and community members have to do extra steps to apply for Medicaid, many don’t accomplish them, or don’t accomplish them in a quick manner,’ Klemond told Sahan Journal. ‘Good primary care and good preventive care will help people avoid serious trouble, but when they do show up for care they’ll generally be sicker and use emergency services and the reimbursement will be poor.’” [Sahan Journal, 9/25/25]
- Hennepin Healthcare Was Forced To Make “Difficult Choices” About The Care It Can Offer Due To The Republican Budget Bill’s Medicaid Cuts. According to the Sahan Journal, “Klemond said Hennepin Healthcare is still determining how to move forward and blunt the impact of the federal cuts. ‘We look at being as efficient as we can, but we also probably can’t operate our health care system the way that we have been able to,’ he said. ‘We’ll have to make some difficult choices, and we’re still working on that because even without the Medicaid cuts, we’ve got significant challenges to that end.’” [Sahan Journal, 9/25/25]
Local Clinics That Primarily Served Minority Communities In Minnesota Were Facing As Much As A 20% Reduction In Revenue Due To The Republican Budget Bill’s Medicaid Cuts. According to the Sahan Journal, “The People’s Center Clinic, located in the Cedar-Riverside neighborhood of Minneapolis, sees around 6,500 patients per year — 65% to 70% of whom are East African, according to Ann Rogers, the clinic’s CEO. The clinic offers medical, dental and behavioral health services, in addition to ‘wraparound’ services for patients that include food assistance and delivery, assistance in finding housing and help filling out immigration and other legal paperwork. Rogers said about 90% of the patients that visit the clinic are on Medicaid, and as a federally qualified health center, they serve any patient that comes into the clinic regardless of lack of health coverage or immigration status. The impending cuts, Rogers said, will dramatically impact the availability of all of their services. ‘We know that right now the impact to our clinic is going to be about a 20% reduction in revenue for us. That’s about $1.4 million,’ Rogers told Sahan Journal. ‘That means that about 1,600 patients are going to lose their coverage.’” [Sahan Journal, 9/25/25]
According To The Minnesota Hospital Association, The Funds The State Would Receive Through The Rural Health Transformation Program Would Not Cover The Amount Lost Due To The Republican Budget Bill Cuts. According to MPR News, “The Minnesota Department of Health applied for $1 billion over five years. Its 62-page application lays out detailed plans for the funds, including fellowships aimed at getting more medical students training and working in rural areas, adding more telehealth opportunities and providing more preventative care screenings in local venues, such as schools, pharmacies and tribal clinics. […] The Minnesota Hospital Association estimates that the state could lose $2.4 billion in federal health care funding in the first year alone, fiscal year 2028. The MHA also finds that 140,000 Minnesotans on Medicaid could lose their healthcare coverage while another 60,000 Minnesotans will likely drop their ACA health insurance because of the rising costs.” [MPR News, 11/18/25]
¶ Finstad Voted Against Extending Premium Health Care Tax Credits, Dooming Minnesotans To Higher Premium Costs
¶ 2025: Finstad Opposed Extending Affordable Care Act Premium Tax Credits
¶ Finstad Voted Three Times Against Extending ACA Premium Tax Credits For Three Years
1/8/26: Finstad Voted Against Extending The Affordable Care Act Tax Credits For Three Years. In January 2026, Finstad voted against, according to Congressional Quarterly, “the bill, as amended, that would extend for three years, through the end of calendar year 2028, the enhanced tax credits to subsidize premiums for health insurance purchased on the Affordable Health Care Act health insurance markets. It would allow taxpayers whose household income exceeds 400 percent of the federal poverty line to receive tax credits for three more years. The measure would retroactively take effect Jan. 1, 2026.” The vote was on passage. The House passed the bill by a vote of 230 to 196. [House Vote 11, 1/8/26; Congressional Quarterly, 1/8/26; Congressional Actions. H.R. 1834]
- 17 Republicans Voted For Passage Of The “Clean” Extension, Following A Procedural Vote The Day Before That Had Support From Nine Republicans. According to Politico, “Seventeen Republicans joined Democrats in passing legislation Thursday that would revive enhanced Affordable Care Act subsidies for three years, rebuffing opposition from GOP leadership. The 230-196 vote follows a procedural vote Wednesday to advance the bill, where nine Republicans joined Democrats in favor of moving forward.” [Politico, 1/8/26]
- Speaker Johnson Called The Bill “Really Bad Policy.” According to Politico, “Johnson’s office, in a last-ditch effort Thursday morning to undermine the effort, blasted out a memo accusing ‘Democrats [of] want[ing] to expand a COVID subsidy system already flagged for massive fraud and abuse, with absolutely zero reforms.’ After the vote Thursday evening, Johnson said in an interview of the Republicans who defected, ‘I think it’s a really bad policy, and I wish they hadn’t, but everybody had a vote.’” [Politico, 1/8/26
1/8/26: Finstad Effectively Voted Against Extending The Affordable Care Act Tax Credits. In January 2026, Finstad voted against, according to Congressional Quarterly, the “adoption of the rule (H Res 780) providing for consideration of the bill (HR 1834). It would consider as adopted the McGovern, D-Mass., substitute amendment that would extend, through 2028, the enhanced tax credits to subsidize premiums for health insurance purchased on the Affordable Health Care Act health insurance markets. The rule would direct the clerk to transmit to the Senate a message that the House has passed HR 1834 no later than one calendar day after passage.” The vote was on the adoption of the rule. The House agreed to the motion by a vote of 224 to 202. [House Vote 10, 1/8/26; Congressional Quarterly, 1/8/26; Congressional Actions, H.Res. 780; Congressional Actions. H.R. 1834]
1/7/26: Finstad Effectively Voted Against Extending The Affordable Care Act Tax Credit. In January 2026, Finstad voted against, according to Congressional Quarterly, the “motion to discharge from the House Rules Committee the rule (H Res 780) providing for consideration of the anticipated ACA tax credit extension vehicle (HR 1834).” The vote was on the motion to discharge the rule. The House agreed to the motion by a vote of 221 to 205. [House Vote 4, 1/7/26; Congressional Quarterly, 1/7/26; Congressional Actions, H.Res. 780; Congressional Actions. H.R. 1834]
¶ Finstad Did Not Sign Discharge Petitions Aimed At Extending Premium ACA Tax Credits
Finstad Was Not One Of The Republican Signers On A Discharge Petition Led By House Minority Leader Hakeem Jeffries.
[Clerk of the U.S. House of Representatives, Discharge Petition No. 10, 11/12/25]
- House Minority Leader Jeffries’ Discharge Petition Sought To Extend ACA Premium Tax Credits For Three Years. According to Politico, "House Democrats could move as soon as tomorrow to force a vote on extending the expired Obamacare subsidies for three years, Meredith Mast Hill reports. This measure follows last month’s major setback for Speaker Mike Johnson, when four House Republicans broke from the party to support a discharge petition backed by Minority Leader Hakeem Jeffries to hold a vote." [Politico, 1/6/26]
Finstad Was Not One Of The Republican Signers On A Discharge Petition Led By Rep. Brian Fitzpatrick.
[Clerk of the U.S. House of Representatives, Discharge Petition No. 12, 12/10/25]
- December 2025: Fitzpatrick Filed A Discharge Petition Aimed At Extending ACA Premium Tax Credits For Two Years. According to a press release from Rep. Brian Fitzpatrick, "Today, Congressman Brian Fitzpatrick (PA-1) released the following statement after filing a discharge petition to bring his Bipartisan Health Insurance Affordability Act directly to the House floor for a vote, ensuring Congress takes action to prevent devastating health insurance premium increases when current protections expire at the end of the year: ‘Congress cannot sit idle while American families face a preventable crisis. Our job is to protect the people we serve, and that responsibility demands immediate action. […] Key Provisions of the Bipartisan Health Insurance Affordability Act The legislation advances five reforms designed to protect affordability, strengthen accountability, and ensure taxpayer value: Prevents premium spikes: Extends enhanced premium tax credits through 2027, to protect families from abrupt monthly cost increases. Restores Consumer Control: Stops unauthorized plan and subsidy changes by requiring consent and prompt notification before any modifications take effect. Shines Light on Middlemen: Ends hidden spread pricing, severs PBM profits from drug prices, and requires full rebate pass-through to ensure savings reach patients. Gives Families New Tools to Manage Costs: Expands access to Health Savings Accounts and simplifies premium payments to reduce disruptions in coverage. Smart Stewardship of Taxpayer Dollars: Modernizes eligibility and introduces a reasonable minimum contribution to protect long-term affordability and responsible stewardship of federal dollars." [Press Release – Rep. Brian Fitzpatrick, 12/10/25]
Finstad Was Not One Of The Republican Signers On A Discharge Petition Led By Rep. Josh Gottheimer.
[Clerk of the U.S. House of Representatives, Discharge Petition No. 13, 12/10/25]
- December 2025: Gottheimer Filed A Discharge Petition Aimed At Extending ACA Premium Tax Credits For Two Years. According to a press release from Rep. Josh Gottheimer, "Today, December 11, 2025, U.S. Congressman Josh Gottheimer (NJ-5) released the following statement: ‘In less than three weeks, unless Congress acts now, Affordable Care Act tax credits will expire, and health insurance premiums will shoot up 175% — or $20,000 a year — for families in Jersey. This week, Congresswoman Jen Kiggans and I, with 36 of our Democratic and Republican colleagues, introduced new bipartisan legislation that includes a two-year extension of health insurance premium tax cuts for American families. It’s a commonsense proposal that will keep costs down and prevent families’ premiums from skyrocketing in January. But, the Speaker of the House is refusing to bring our legislation to the floor for a vote. So, our bipartisan group just launched a discharge petition to force an immediate vote in the House. We must get this done now. We must find common ground and lower health insurance premiums. Time is running out for families.’" [Press Release – Rep. Josh Gottheimer, 12/11/25]
¶ Finstad voted for a bill that would weaken protections for people with pre-existing conditions and failed to address premium spikes
¶ December 2025: Finstad Voted For The Lower Health Care Premiums For All Americans Act
2025: Finstad Voted For The Lower Health Care Premiums For All Americans Act That Allowed The ACA Tax Credits To Expire. In December 2025, Finstad voted for, according to Congressional Quarterly, “the bill that would expand the ability of small businesses to establish association health plans and bars states from preventing small businesses from obtaining stop-loss insurance for self-funded health insurance plans. It would codify and expand rules governing employer-funded health reimbursement arrangements and would allow employees in such arrangements to pay Affordable Care Act health insurance premiums through salary reductions. It would provide funding for ACA policy cost sharing reduction payments that reduce deductibles and copayments. It would prohibit plans from providing abortion-related care. It also would require pharmacy benefit managers to provide transparency regarding prescription drug costs and the drug rebates they receive.” The vote was on passage. The House passed the bill by a vote of 216 to 211. [House Vote 349, 12/17/25; Congressional Quarterly, 12/17/25; Congressional Actions, H.R. 6703]
¶ The Lower Health Care Premiums For All Americans Act Did Nothing To Address The Expiration Of ACA Enhanced Premium Tax Credits And Would Weaken Protections For People With Pre-Existing Conditions
The December 2025 Republican Health Care Bill Failed To Prevent Imminent Premium Spikes For More Than 20 Million People Who Relied On ACA Marketplace Plans. According to the Center on Budget and Policy Priorities, "The health bill House Republicans are preparing to bring to the floor this week not only fails to prevent imminent premium spikes for more than 20 million people in marketplace plans, but would raise costs even higher for many marketplace enrollees and weaken pre-existing condition protections for individuals and small businesses." [Center on Budget and Policy Priorities, 12/16/25]
- HEADLINE: "House Republicans Pass Health Care Plan Without Re-Upping Insurance Subsidies" [Politico, 12/17/25]
- HEADLINE: "House Passes GOP Health Bill Without Subsidies" [Axios, 12/17/25]
- HEADLINE: "House Passes GOP Health Care Bill Without Obamacare Subsidy Extension" [The Hill, 12/17/25]
- HEADLINE: "House Passes GOP Health Care Bill Without ACA Extension" [CBS News, 12/17/25]
The December 2025 Republican Health Care Bill Would Expand Association Health Plans, Which Would Result In Higher Underlying Premiums For Individuals And Small Businesses That Remained In ACA-Regulated Markets. According to the Center on Budget and Policy Priorities, "It would expand association health plans (AHPs), a type of health plan that trade associations, professional groups, and other organizations may offer their members, to cover self-employed individuals and small businesses as if they were large employers. By allowing more people to enroll in coverage not subject to ACA standards and consumer protections, this would segment insurance risk pools: individuals who are younger and healthier, or small businesses with younger or healthier employees, could get plans with lower premiums because they would be priced separately from ACA-compliant coverage and wouldn’t have to meet ACA standards such as having to cover a set of essential health benefits. As a result, individuals and small businesses remaining in ACA-regulated markets would see higher underlying premiums." [Center on Budget and Policy Priorities, 12/16/25]
The December 2025 Republican Health Care Bill Would Likely Lead To Higher Premiums For Older And Sicker Small Groups And Self-Employed People, Thereby Undermining Protections For People With Pre-Existing Conditions. According to the Center on Budget and Policy Priorities, "In addition, the bill would undermine protections for people with pre-existing conditions. While it would bar AHPs from rejecting individuals or charging them more based on certain health factors, it would give them greater ability to base a small group’s or self-employed person’s costs on their health risk compared to individual or small-group coverage. This would likely lead to higher premiums for older and sicker small groups and self-employed individuals, making such arrangements more attractive to healthier individuals and groups." [Center on Budget and Policy Priorities, 12/16/25]
¶ Minnesotans faced higher premium costs as a result of ACA enhanced premium tax credits expiring
HEADLINE: "ACA Marketplace Health Insurance Premiums To Rise 21.5% On Average In Minnesota, Expert Says" [ABC 5, 11/4/25]
Minneapolis Star Tribune Reported People Across Minnesota Could See Average Prices Increases Of $3,400 As A Result Of ACA Premium Tax Credits Expiring. According to the Minneapolis Star Tribune, "While the Blue Earth County example might be an extreme case, health care advocates worry that if enhanced tax credits aren’t renewed, people across Minnesota will see price increases averaging about $3,400. Nearly 20,000 will lose all subsidies, and some likely will go without insurance. They could get sicker from delaying treatments or create stress on hospital budgets by seeking free or discounted care. ‘If you don’t have coverage, it doesn’t mean that you’re not going to get sick,’ said Lynn Blewett, a health policy professor at the University of Minnesota." [Minneapolis Star Tribune, 11/21/25]
70,000 Of The 89,000 Minnesotans Who Relied On ACA Tax Credits Were Expected To See Less Help If The Enhanced Tax Credits Expired. According to the Minneapolis Star Tribune, "Roughly 89,000 people across Minnesota receive ACA tax credits. About 70,000 will see less help next year if Congress doesn’t extend the enhancements, MNsure says, while 19,000 people will receive no financial help whatsoever." [Minneapolis Star Tribune, 11/21/25]
HEADLINE: "With Federal Subsidy Set To Expire, Some Minnesotans Face Eye-Popping Health Premium Increases" [MPR News, 11/7/25]
2026: The Number Of Minnesotans Who Signed Up For ACA Marketplace Plans Dropped Eight Percent Compared To 2025. According to MinnPost, "When the enrollment period opened Nov. 1, MNsure officials warned that enrollees’ monthly premiums would soar 57% due to the expiration of a federal subsidy, among other cost factors. Enrollment closed Jan. 15, and, according to MNsure, 139,251 Minnesotans signed up, an 8% drop compared with 2025. Given the eye-popping increase in monthly premiums, this 8% dip seems modest. But the decline does not account for tens of thousands Minnesotans who signed up for a less encompassing plan. Plus, it is too early to know how many people will lose coverage for not making premium payments. ‘What I suspect and fear is that as we get further into the year, the number of Minnesotans who do not have coverage will climb,’ said Libby Caulum, CEO for MNsure." [MinnPost, 2/18/26]
- MinnPost: “The Decline Does Not Account For Tens Of Thousands Minnesotans Who Signed Up For A Less Encompassing Plan.” According to MinnPost, "When the enrollment period opened Nov. 1, MNsure officials warned that enrollees’ monthly premiums would soar 57% due to the expiration of a federal subsidy, among other cost factors. Enrollment closed Jan. 15, and, according to MNsure, 139,251 Minnesotans signed up, an 8% drop compared with 2025. Given the eye-popping increase in monthly premiums, this 8% dip seems modest. But the decline does not account for tens of thousands Minnesotans who signed up for a less encompassing plan. Plus, it is too early to know how many people will lose coverage for not making premium payments. ‘What I suspect and fear is that as we get further into the year, the number of Minnesotans who do not have coverage will climb,’ said Libby Caulum, CEO for MNsure." [MinnPost, 2/18/26]
¶ Finstad’s Inaction Created A Dramatic “Subsidy Cliff”
The Expiration Of Enhanced ACA Premium Tax Credits Created A “Subsidy Cliff” Whereby If Households Earned Even $1 More Than A Specific Income Threshold They Could Lose All Eligibility For Assistance. According to CNBC, "For the first time in years, many Americans enrolled in a health insurance plan via the Affordable Care Act marketplace will need to keep a careful accounting of their annual income — or risk a hefty federal tax bill. Enhanced ACA subsidies lapsed at the end of 2025, leaving millions of households on the hook for higher insurance premiums. The lapse also reintroduced the so-called subsidy cliff, whereby households that earn even $1 more than a specific income threshold will lose all eligibility for subsidies, also known as premium tax credits. That income cutoff, which varies by family size, is $62,600 for a single person, $84,600 for a two-person household and $128,600 for a family of four in 2026, for example." [CNBC, 1/6/26]
- More Than Two Million Americans Had Incomes Near A “Subsidy Cliff.” According to CNBC, "More than 2 million people enrolled in an ACA marketplace plan have an income near the subsidy cliff. ACA enrollees also tend to have relatively volatile incomes, making it hard to predict their annual earnings, experts said." [CNBC, 1/6/26]
Households That Went Over The Income Limit Would Have To Pay Back Any Federal Assistance They Received For Premiums, Which Could Cost Thousands Of Dollars, When They Filed Their Taxes. According to CNBC, "Households over the limit would have to pay back any federal subsidies they received for premiums — potentially worth thousands of dollars — when they file taxes next year for 2026." [CNBC, 1/6/26]
Republicans’ Big Beautiful Bill Exacerbated The Problem By Stripping Away Guardrails Capping The Amount Of Excess Subsidies Households Are Required To Repay. According to CNBC, "The potential financial impact is exacerbated by a multitrillion-dollar legislative package known as the ‘big beautiful bill’ that Republicans passed over the summer, which stripped away guardrails capping the amount of excess subsidies households must repay, experts said." [CNBC, 1/6/26]
¶ 22 Million Americans Relied On ACA Premium Tax Credits To Afford Health Insurance
Approximately 22 Million Americans Relied On ACA Premium Tax Credits To Afford Health Insurance. According to CNBC, "About 22 million Americans received premium subsidies, also known as premium tax credits, in 2025. Households can opt to receive the tax credit in one of two ways: As a lump sum during tax season or as an advanced payment. Under the latter option, by far the most popular, the federal government issues the tax credit directly to a consumer’s insurer, which then lowers the consumer’s out-of-pocket premium. Consumers receive those advanced ACA subsidies based on an estimated annual income they provide when signing up for insurance. They must reconcile those subsidies during tax season and repay any excess tax credits to the IRS." [CNBC, 1/6/26]