In Minnesota’s individual health insurance market, the numbers are quietly slipping in the wrong direction. About 135,000 people who buy their own coverage had selected plans through MNsure by the end of December, roughly 4% fewer than the approximately 141,000 enrolled at the same point last year. With higher premiums hitting mailboxes and enhanced federal tax credits gone, officials and health policy watchers warn that enrollments could shrink further in the weeks ahead as the reality of those first bills sinks in. Some shoppers are already moving into cheaper plans to cut monthly costs, and others may simply let coverage lapse once the invoices arrive.
Those 135,000 sign-ups are not the final tally. Open enrollment on MNsure ran through Jan. 15, and many renewals happen automatically, so the total is still inching upward. But state officials and insurers told reporters that some Minnesotans are deliberately waiting to pay their first premium, hoping Congress will step in with more financial relief. If those payments do not arrive by the end of the month, the coverage will be terminated. MNsure chief executive Libby Caulum warned that “some people feel they are priced out of the marketplace,” and insurers say cancellations could accelerate if higher bills stick, according to The Minnesota Star Tribune.
Subsidy Cliff and Sticker Shock
MNsure is also staring down a subsidy cliff that could reshape the market over the next few years. The agency projects that more than 19,000 Minnesotans will lose access to premium tax credits in 2026 and that roughly 70,000 others will see their subsidies shrink. It has also warned that about 90,000 Minnesotans will pay more for coverage next year, with an average increase of about $177 per month, according to MNsure.
Those shifts are tied to two big forces arriving at once: the enhanced pandemic-era tax credits expired on Dec. 31, and insurers raised premiums for 2025. Together, that one-two punch helps explain why some enrollees are stalling on their first payments while they wait to see what Congress does. At the national level, the expiration of the enhanced credits could more than double average marketplace premium payments in 2026, which would deepen the affordability squeeze for many consumers, according to the Kaiser Family Foundation.
More Shoppers Choosing Bronze Plans
Plenty of Minnesotans are responding to the sticker shock by trading richer benefits for lower monthly bills. As of Jan. 14, about 55% of MNsure enrollees had signed up for “bronze” plans, up from roughly 47% at a similar point last year. That shift trims premiums but increases out-of-pocket exposure when people actually use care.
MNsure estimates that the median monthly increase this year for people who qualified for a tax credit last year but will not in 2026 is $368.72, and across all households the average increase is about $240 per month. State regulators previously signed off on final premium changes across major carriers that range from about 13% to 31%, a jump that experts say raises the risk of churn in coverage and a sicker overall risk pool, according to The Minnesota Star Tribune.
Where Congress and Insurers Stand
On Capitol Hill, there is movement, but not the kind that lets anyone relax yet. The U.S. House voted in early January to extend enhanced premium tax credits for multiple years. The bill, however, faces uncertain prospects in the Senate and would not immediately undo the higher costs for people already getting 2025 bills.
Insurers report that some customers have been holding off on paying their first premium while they watch whether lawmakers restore the pandemic-era aid. That kind of wait-and-see strategy could easily turn into lost coverage once grace periods expire. The House action, and the political drama around what happens next, is being watched closely by hospitals, insurers and consumer advocates, according to reporting by the American Hospital Association.
What This Means and What to Do
Decades of research show that people without insurance often delay routine and preventive care and later require more intensive and more expensive treatment, a pattern documented by national health experts, according to the National Academies. That is one reason state officials are trying to keep Minnesotans from slipping through the cracks as premiums climb.
MNsure is urging consumers to double-check their eligibility, compare plan options and reach out to a MNsure-certified broker or navigator for help sorting through costs so they do not stumble into an unexpected coverage gap, according to MNsure.
