Health care guaranteed to be available and affordable for every Minnesotan; Minnesota Health Plan, Minnesota Health Board, Minnesota Health Fund, Office of Health Quality and Planning, ombudsman for patient advocacy, and auditor general for the Minnesota Health Plan established; Affordable Care Act 1332 waiver requested; and money appropriated.

2025-2026 Regular Session Introduced by Kaela Berg and 32 co-sponsors

Minnesota proposes single-payer health system replacing private insurance with state-administered coverage for all residents, requiring federal waiver approval.

Introduction and first reading, referred to Health Finance and Policy

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Legislative bill overview

HF 1812 proposes establishing a single-payer health care system in Minnesota called the Minnesota Health Plan, creating a new Minnesota Health Board to administer it, establishing a dedicated health fund, and setting up oversight mechanisms including a patient advocacy ombudsman and auditor general review. The bill requests a federal Affordable Care Act Section 1332 waiver to allow Minnesota to implement this alternative to the current multi-payer system.

Why is this important

This represents a fundamental restructuring of how health care is financed and delivered in Minnesota—shifting from the current mix of private insurance, Medicare, Medicaid, and uninsured populations to unified public coverage. The bill's success would determine whether approximately 5.7 million Minnesotans receive health care through a state-administered program rather than current insurance arrangements, potentially affecting premiums, provider networks, and tax obligations.

Potential points of contention

Federal waiver uncertainty: Section 1332 waivers are discretionary and politically sensitive; federal approval is not guaranteed and depends on administration priorities

Cost and funding mechanism: The bill appropriates money but doesn't specify total cost estimates or detailed revenue sources (likely involving significant tax increases), making fiscal impact analysis difficult

Provider and insurance industry opposition: Hospitals, pharmaceutical companies, and private insurers typically oppose single-payer models that reduce their role and negotiating power

Implementation complexity: Transitioning millions of people from existing coverage to a new system raises questions about timeline, provider participation, drug formularies, and potential service disruptions

State authority limits: Questions exist about whether Minnesota can effectively regulate health care pricing and delivery without federal coordination for cross-border care