Faced with sharply rising premiums and the loss of key tax credit that helped many afford the coverage, about 17,000 Minnesotans this year have dropped the MNsure health insurance coverage they had previously purchased through the state’s Affordable Care Act marketplace.
MNsure, Minnesota’s marketplace for Affordable Care Act insurance, announced recently that 125,700 Minnesotans were enrolled in one of its health insurance plans as of May 2026. That’s down 12 percent from the 142,977 people who were enrolled in May of last year. And MNsure officials say the trend of people dropping their insurance plans will likely continue.
MNsure provides health insurance plans for people who earn too much to qualify for Medicaid, but don’t have access to employer provided health insurance plans. The drop in enrollment comes at a time when insurance premiums are skyrocketing and after a valuable federal tax credit that helped offset the cost of the policies expired.
Denise Robertson of Health Access MN, a MNsure partner dedicating to helping Minnesotans enroll in and use the health plan, said that her team had been preparing for a mass departure like this ever since they found out the tax credit wouldn’t be extended.
“We were dreading the open enrollment season at the time, having to deliver the bad news that people who had been receiving a tax credit for the past several years wouldn't be able to again,” Robertson recalled. “A lot of those folks just simply couldn't afford to pay a full price policy, and so they're just going out without health insurance.”
The tax credit was adopted in 2021 to help offset the cost of insurance premiums and make the health care coverage more affordable, but Republicans in Congress ended that benefit for anyone who makes more than 400 percent of the federal poverty level, which is $63,840 per year for individuals, and $132,000 a year for a family of four. The tax credit was eliminated in the legislation President Donald Trump called his “One Big Beautiful Bill Act.”
Democrats in Congress tried but failed to extend the tax credits last fall. It was one of the issues in a budget stalemate that led to the longest federal government shutdown in history.
At the same time, insurance premiums for health care plans under the Affordable Care Act have continued to go up significantly. A report by health policy nonprofit KFF found that in 2026, monthly premium payments for enrollees in the U.S. increased on average by a whopping 58 percent, while health insurance plan deductibles increased by 37 percent, and now stands at a record high of $3,786 on average.
The jump in cost is particularly acute in southern Minnesota, partly because of Mayo Clinic’s dominance in the region. Robertson said in Rochester, for example, a person with MNsure who lost out on the tax credit this year could have seen their premiums nearly quadruple in the past year.
Robertson said fewer Minnesotans can afford to keep the health insurance they previously bought on the marketplace. And that’s true across the country. KFF reported that enrollment nationwide could fall by about five million people this year, to about 17.5 million people in 2026, and possibly to as low as 16.5 million. A year ago, 22.3 million were enrolled in ACA health insurance policies.
Robertson said some of her clients are forgoing health insurance all together, while others are staying on, but switching to a plan with a higher deductible, or they are looking for work to get coverage through an employer. She said that some people have cobbled together a mix of other options — like buying short-term policies with limited coverage or even joining subscription programs, in which people pay a monthly fee to a health care provider to get basic primary care services.
Robertson stressed that she’s concerned about the rising costs and drop off in enrollment from a moral perspective — as she considers health care to be a basic human right — but she also clarified the financial ramifications.
When people don’t have access to health insurance, emergency rooms become more crowded and the cost of uncompensated care keeps growing, and inevitably the cost of carrying for a sicker society falls to the taxpayers and leads to higher premiums.
“I wish people understood that this isn't just a problem for the people who have to forgo health insurance,” Robertson said. “It's not just their problem. It's the rest of ours because the rest of the healthcare system picks up the costs.”
