September 15, 2026–The health insurance marketplace for Minnesotans without a government plan or employer sponsored coverage has been a decade long roller coaster ride. And tickets for the ride are really expensive.
Rates for 2027 will be released near the end of the month and will no doubt be a hot button issue in the upcoming mid-term elections. But before the ballots have been cast, it’s worth examining where we’ve been and where we need to be, if we are going to make health care more affordable for the farmers, day care providers, independent contractors and many others who rely on this market to cover themselves and their families.
Why do rates continue to rise? Here are the facts:
- Health care prices – which are already high – continue to increase.
- Enhanced premium subsidies, which helped lower premiums over the past several years, were not extended by congress.
- Enrollment is down nearly 100,000 from its peak in 2015.
- Only six health insurance companies have offered plans for 2027, down from a high of twelve.
There is some good news. Thankfully, in 2025, state lawmakers voted to extend the reinsurance program through 2027. The program was set to expire along with the enhanced federal subsidies. This would have caused unprecedented premium hikes, putting coverage out of reach for thousands of families. The Minnesota Council of Health Plans spent years warning policymakers about this looming double whammy. However, because reinsurance was only extended for two years, the 2027 legislature will need to extend the program once again early in session. It is time to make the program permanent.
What is Reinsurance
So what is reinsurance? It’s a good question, because this highly regulated program is often misunderstood.
The bottom line is that Minnesota’s reinsurance program pays for a portion of high-cost medical care for people with complex conditions like cancer, asthma, arthritis, heart disorders and autoimmune diseases. The Minnesota Comprehensive Health Association administers the program and uses an independent actuarial consultant firm to collect and track program data. For example, detailed reports indicate in 2024 there were 608 enrollees with metastatic cancer that had a portion of their provider charges paid for by the reinsurance program. By removing these costs, health plans proportionately lower monthly premiums by as much as 47%. This means thousands of Minnesotans who would otherwise be uninsured have coverage. In fact, a recent study concluded the reinsurance program enabled more than 88,000 Minnesotans to have coverage.
Extending reinsurance is a crucial step to supporting affordability, growing enrollment and supporting consumer choice in Minnesota.