Medicaid disruptions are affecting healthcare providers and will disproportionately impact Black Minnesotans

Medicaid changes are hitting Minnesota, and providers have begun feeling their impact. Some have been disenrolled after a recent state evaluation, while others report billing issues due to internal login changes. As these disruptions occur, hundreds of patients will remain vulnerable without the services they need, severely impacting Black and brown Medicaid users.

A June press release from the Department of Human Services shared that more than 5,500 providers were re-evaluated by the state after fraud allegations. Providers were required to complete a five-month review to show they met heightened legal and eligibility standards required to serve vulnerable people. While around 2,000 of these providers will continue to provide care uninterrupted, 3,411 providers were notified they would be disenrolled by the end of May, with most disenrollments due to incomplete paperwork.

The state is working to help inform residents whose coverage may be disrupted, including through the creation of a website with more information. However, active providers are also reporting recent billing issues due to a new internal switch with DHS, Anna Cazban, executive director of Southside Community Health Services, said.

“DHS moved to a new program, but they didn’t update the clearing house where all the claims are processed,” Cazban said. “For the past two DHS payments we’ve seen a disruption in payments because of that change. When we got our payments and it was close to zero, we said, ‘Oh, what’s going on here?’ Something’s wrong because we didn’t have anything indicating on our end that there was a problem.”

Providers used to be able to view their claim information from DHS through its interface, MN-ITS. However, on June 13, DHS began requiring providers to access their accounts through LoginMN, described as “a wide-scale, all-Minnesota state agency effort to improve security,” through a new webpage. This change, Cazban said, did not automatically roll over all the active accounts, leading to a gap in payment for providers. 

“MN-ITS remains the Minnesota Department of Human Services’ secure billing and claims system. The recent update changed how providers sign in, by moving authentication to LoginMN,” Emily Zimmer, Strategic & External Communications Manager for Minnesota IT services, said.

“LoginMN gives individuals and businesses a single account to access participating state services while protecting their information with multi-factor authentication and enhanced identity fraud detection.”

The issue has since been resolved, and Cazban expects DHS billing to return to normal by its next payment cycle.

“​As to be expected with any large technology implementation, a small number of providers experienced account migration or access issues during the transition,” Zimmer said. “Minnesota IT Services (MNIT) worked closely with the Minnesota Department of Human Services to identify and resolve those issues as quickly as possible and minimize disruptions for providers. 

While residents across Minneapolis were not impacted by the brief login switch, some may be impacted both by the state’s re-evaluation and recent federal changes to Medicaid eligibility. The first changes will begin this October, altering eligibility for certain undocumented residents. Next year will introduce a six-month renewal process, as well as stricter work requirements.

“It’s just going to be much more burdensome, and then the fact that it has to be done every six months. I mean, Hennepin County is already overwhelmed by eligibility requests and there’s a delay. It would double the workload for the counties, and I don’t know how DHS is going to approach it,” Cazban said. “I don’t know exactly how that’s going to play out when the time comes. People have lives to live, and they’re busy trying to work and take care of their families, and this is just one more thing that people have to worry about.”

Minnesota’s Medicaid and MinnesotaCare programs served 1.2 million residents in 2024 alone, recent data shows, with 42% of those enrolled being children. While the majority of those on Medicaid are White Minnesotans, the disruptions will have a larger impact on Black or Indigenous residents.

“Individuals with low incomes and those whose eligibility must be periodically renewed are generally the most vulnerable to disruptions in coverage if paperwork is delayed, eligibility requirements change, or they are unaware that action is needed to maintain their benefits,” Jane Lieberman from Hennepin Healthcare’s public relations office said. “As Minnesota’s largest safety-net health system, we continue providing medically necessary care while helping patients reconnect with available coverage and financial assistance.”

Black Minnesotans make up 20% of those enrolled in Medicaid statewide, but in Hennepin County, they represent the largest share of monthly enrollees, making up 38.1% of all residents enrolled in 2024. 2019 data from the University of Minnesota’s State Health Access Data Assistance Center showed that around 44% of Black Minnesotans under age 65 rely on Medicaid, and that 64% of Black Minnesota children depend on Medicaid for health care.

For those experiencing coverage issues, clinics like Southside and Hennepin Healthcare continue to serve residents despite billing issues.

“Patients’ healthcare needs do not stop when insurance coverage changes or lapses,” Lieberman said. “Our teams work closely with patients to help them understand a range of public assistance programs, assisting with Medicaid applications and renewals when appropriate. We also partner with Hennepin County Human Services staff who assist residents in navigating Medicaid and other public support programs.”

Southside Clinic, now located at 1000 East Lake Street, has made it its mission to serve Black and brown Minneapolis residents who may not have access to health services since its founding in 1971. The clinic also offers a sliding fee discount program, which allows patients to pay what they can if they are uninsured.

“That’s what we were founded for. That’s why we exist,” Cazban said. “I think we focus a lot on insurance, which of course is better, but we just know that there are some people who fall through the cracks, and we need to be there as a safety net provider to make sure that people are getting at least their basic healthcare needs covered and taken care of.”

Izzy Canizares is a contributing writer for the Minnesota Spokesman-Recorder. He welcomes reader responses at isabellacani0102@gmail.com.