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Ramsey County continues to prepare for the potential impacts of federal budget cuts, grant cancellations, and policy shifts.
On May 22, the US House passed a budget reconciliation bill (HR 1) that includes provisions to limit access to Medicaid and SNAP (Supplemental Nutrition Assistance Program), both critical social safety net programs on which many Ramsey County residents depend. The bill imposes work requirements and new out-of-pocket costs for certain Medicaid enrollees, expands work requirements for certain SNAP enrollees, and increases state and county administrative cost shares. HR 1 now goes to the Senate, which will work through June to pass the bill according to its own reconciliation process by July 4. If they make changes to the bill, the bill must go back to the House for another vote.
In Minnesota, counties determine eligibility for SNAP and Medicaid. All increased eligibility requirements and verifications will fall administratively to counties. The state technology systems we are required to use to determine eligibility are antiquated. Because it is nearly impossible to update these systems to manage new eligibility requirements, we expect a significant increase in workloads, costing counties millions of dollars.
Ramsey County will not be able to absorb the combined costs of federal program cuts and heavy administrative mandates. These reductions would likely mean longer wait times for critical services and benefits, reduced or triaged services, and higher property taxes.
Medicaid Changes
The House Reconciliation Bill Overview
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Impacts on Minnesota and Ramsey County
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Imposes work requirements and new monthly premiums for able-bodied adults without dependents
Requires more frequent eligibility verification—every 6 months instead of annually.
Imposes a complex array of new barriers, including:
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Complex application processes.
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Increased documentation requirements.
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More frequent reporting obligations and stricter enforcement of existing rules.
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Administrative workload is doubled for counties who are already managing significant backlogs and caseloads.
Minnesota Management and Budget (MMB) has estimated that the administrative and paperwork burden of administering work requirements will cost MN counties about $160M per year.
Administrative costs rise as the state must verify work hours, citizenship and fee payments.
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Reduces Federal Medical Assistance Percentage (FMAP) by 10% for expansion states due to a federal level policy position that aims to block healthcare access for people who are undocumented. This 10% FMAP reduction applies to Minnesota because we are an expansion state that uses state funds to provide coverage to all people who call Minnesota home and meet state level residency requirements.
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MN DHS estimates loss of federal FMAP funds at $330M per year.
Significant increase in administrative burden of verification requirements.
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Reduces eligibility period for retroactive coverage to 1 month from 3 months.
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Increased medical debt for individuals and families earning around $20,000 annually.
Higher costs for uncompensated care for hospitals and other health care providers.
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How will this affect Ramsey County residents?
In 2023, 37% of Ramsey County residents received Medicaid (Medical Assistance or MA in MN) for at least one month of the year. There are currently 85,000 MA cases in Ramsey County.
Complex new requirements could cause:
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Eligible individuals to lose and/or not access coverage, disproportionately impacting vulnerable groups.
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“Enrollment churn” with enrollees losing coverage as soon as their eligibility is reverified.
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Longer waits for essential services, while the county completes required paperwork.
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Less time with county staff.
The Minnesota Department of Human Services (DHS) estimates that up to 253,000 Minnesotans could lose Medicaid coverage under these new requirements.
SNAP Changes
The House Reconciliation Bill Overview
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Impacts on Minnesota and Ramsey County
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Forces states to pay 5% of benefit cost in 2028, rising to 15-25% if a state’s error rate is high.
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Minnesota’s SNAP benefits were $1.4B in 2024; even a 5% state share would be about $70M/year, escalating sharply if error rates exceed 6%. (MN’s error rate is currently around 6%.)
Because counties are responsible for enrollment, the state would likely pass this cost to counties and property taxpayers.
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Hikes the state/county share of all administrative costs from 50% to 75%.
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In FY24, MN received $78.5M in federal reimbursements for administrative expenses. 79% of these reimbursements went to counties for administrative costs.
Reducing the federal share from 50% to 25% would cut the reimbursement in MN by half, a total impact of approximately $30M for counties based on the FY24 caseload.
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Imposes a work requirement on parents with children over the age of 6 and adults aged 55 to 64.
Tightens waivers for able-bodied adults without dependents.
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Thousands may lose access to benefits; state and county administrative costs rise as they must verify work hours.
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How will this affect Ramsey County residents?
Currently there are 35,000 SNAP cases in Ramsey County. A significant number of these cases could lose eligibility due to work requirements.
Increased administrative burden and longer wait times for people seeking an eligibility determination for benefits, less time with county staff, and greater frustration. This will disproportionately affect:
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Working families with children
In the 2022–2023 school year, 27.8% of Minnesota kindergarteners — more than 18,000 children — entered school with the support of SNAP. Children under the age of 18 are also the largest age group that benefits from the Supplemental Nutrition Assistance Program (SNAP) comprising 37% of the county's program participants. Adults 55 and older are the second-highest group after children, with 20% of SNAP program participants. As of 2023, 48% of the total black/African residents, 31% of all Asian residents, 71% of all American Indian residents and 8% of white residents are on SNAP. Any federal SNAP changes will disproportionately affect those receiving SNAP benefits, namely children, seniors, and our diverse racial and ethnic communities.
Ramsey County is engaging with state legislators and our congressional delegation to share the impact that these changes will have on Ramsey County residents. We will continue to analyze the potential impacts to the county budget and to assess not only direct, but indirect and collateral impacts. Not only does Ramsey County host community meetings for recipients of public benefits, but we will also be hosting several convenings of aligned partners, advocacy groups and other community organizations on a regular cadence to stay strategically engaged and leverage partnerships in response to changes that will affect our Ramsey County community.
We stand ready to partner with you in the fight against state and federal cuts to the social safety net. We see the potential for long-term damage to the community, impacting not only those who depend on these programs, but all residents, as a result of increased property taxes.
For more information:
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