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Minnesota hospitals warn federal subsidy cuts and Medicaid changes could add hundreds of millions in uncompensated care and threaten rural services

5949379 · October 13, 2025
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Summary

Hospital association leaders and rural hospital executives testified the loss of premium tax credits and proposed Medicaid changes would raise charity care and revenue losses, placing many rural hospitals at risk of cutting services or closing.

Mary Krenke and Joe Schindler of the Minnesota Hospital Association presented a state-level estimate of the financial effects hospitals would face if federal marketplace subsidies end and HR 1’s Medicaid-related changes proceed.

Krenke said the association used a DHS estimate that roughly 60,000 Minnesotans could be priced out of marketplace coverage if enhanced premium tax credits are not extended. The association’s conservative estimate is that hospitals would see about $115 million annually in additional charity care and $161 million in lost payments tied directly to those 60,000 people — a combined roughly $276 million hit to hospitals statewide.

Joe Schindler, the association’s vice president of finance, walked the committee through the assumptions behind those numbers: the…

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