Minnesota just released its 2027 premium rates for health insurance on the individual and small group markets, and the news isn’t good. Average premiums are rising by 9.9% to 21.1% for the roughly 203,000 Minnesotans who buy coverage on the individual market and by 10.6% to 21.4% for the roughly 184,000 covered through the small group market, which includes businesses with two to 50 full-time employees.
It’s not just people buying coverage on the marketplace who are feeling the squeeze. Nationally, annual employer health plan costs are expected to rise by an average of 11% in 2027, the sharpest increase in more than two decades.
Several factors are driving these increases, including rising pharmaceutical prices and a large jump in the number of people without insurance. In 2025, 116,000 Minnesotans lost their health coverage, pushing the state’s uninsured rate from a historic low in 2023 to its highest level in six years. Making matters worse, the federal government allowed enhanced subsidies that helped make coverage affordable to expire at the end of 2025. For some Minnesotans, that meant premium increases of up to 250% in 2026, leading many to drop their coverage altogether.
Unfortunately, this is set to get worse, not better. Historically large cuts to Medicaid by the Trump administration, passed to help pay for tax cuts for billionaires, will begin taking effect at the end of 2026 and the start of 2027. These cuts are expected to cause up to 180,000 Minnesotans to lose health coverage and drive $1 billion annually in uncompensated care for Minnesota hospitals.
The result is that fewer Minnesotans will have access to health care, and it will be significantly more expensive for those who do. Without policy action, Minnesotans should expect price increases like these to continue in the years ahead.
What Minnesota Can Do
Many of these problems require federal action, but that seems unlikely with this Republican Congress and White Hous. But there are real steps the state can take.
First, Minnesota could strengthen its rate review process to bring down the premium increases insurers request. Vermont offers a strong example: in 2026, its regulators cut a requested 23.5% premium increase down to 9.6%. Vermont’s final premiums were 59% lower than the proposed premiums after their rate review process. By contrast, the final increases in Minnesota were 16% HIGHER than those proposed, when taking the average across all plans.
Second, Minnesota should move toward universal primary care for all residents. Guaranteeing access to basic care would help ensure that Medicaid cuts don’t push more people into relying on expensive, uncompensated care in emergency rooms.
Third, the state can crack down on the already significant consolidation in Minnesota’s health care market. Research shows consolidation drives up prices and reduces access to care, especially in rural areas. As part of this effort, the state should take a hard look at acquisitions by billionaire-backed private equity firms, which often jack up prices to pad their profits.
Finally, the state should be wary of reforms that try to lower costs by subsidizing insurance companies. This has been a particular problem with Minnesota’s reinsurance program, which not only spends more than most states’ programs but is also a national outlier because it’s funded by taxpayer dollars rather than fees on insurers.
The Bottom Line
Minnesotans are already paying more for health care, and they’re facing a future of less access and higher costs. The Trump administration and Minnesota’s Republican members of Congress are responsible for this situation, and we know they’re unlikely to offer solutions. In their absence, we need bold leadership at the state level to pass policies that protect Minnesotans from this dangerous future.
