You probably have heard the statement that “elections have consequences.” The 2024 election set the stage for the passage of the “One Big Beautiful Bill Act” (H.R. 1) on July 4, 2025, on a strict party-line vote; without the support of a single Democrat. That act authorized the largest cut to government health care funding in U.S. history, depriving at least 10 million Americans of health insurance.
The 2024 election and H.R. 1 will indeed have consequences for the 1.5 million Minnesotans enrolled in Medicaid and the approximately 83,000 Minnesotans who have received premium subsidies through the Affordable Care Act. Most of the effects of H.R. 1 are delayed until 2027, after the 2026 midterm elections. As a result of H.R. 1, Minnesota is projected to lose up to $2 billion annually in funding for Medicaid, the largest single source of health insurance in our state. Forty-two percent of Minnesota Medicaid enrollees are children. Medicaid pays for 33 percent of all births in Minnesota. The health care funding cuts from H.R. 1 will increase the financial distress of Minnesota hospitals, particularly rural hospitals that are often the largest employers in their communities.
What can you do about the health care injustices inflicted on Americans by H.R. 1? You can become a health justice voter by supporting legislators and candidates for office who realize that illness is a universal human condition and who believe that health care is a basic human right. The website mnvotes.gov provides information you need about voting in Minnesota, including:
- Registering to vote: https://www.sos.mn.gov/elections-voting/register-to-vote/
- Election Day voting locations and hours: https://www.sos.mn.gov/elections-voting/election-day-voting/
- Absentee voting and tracking your ballot: https://www.sos.mn.gov/elections-voting/other-ways-to-vote/
- In-person early voting dates and locations: https://www.sos.mn.gov/elections-voting/other-ways-to-vote/
- Viewing your sample ballot before you vote: https://www.sos.mn.gov/elections-voting/whats-on-my-ballot/
Ballots for voting by mail became available on September 18 and can be returned by mail or delivered in person to an election worker at specified locations. You can cast your ballot directly into a ballot counter starting on October 16 by voting early in person at specified locations.
H.R. 1 is projected to result in 51,000 additional deaths in the United States annually – deaths that are preventable (https://ldi.upenn.edu/our-work/research-updates/trump-senate-bill-seen-causing-51000-preventable-deaths-annually/) and (https://ysph.yale.edu/news-article/proposed-federal-budget-could-lead-to-over-51000-preventable-deaths-researchers-warn-in-letter-to-senate-leaders/).
Please commit to being a health justice voter. Your vote is important and can help save lives!
Ken Engelhart, M.D.
Editor