Governor-elect Amy Klobuchar now faces a clear test from her own party’s left wing on many fronts, but certainly a contender for House File One (considered the top priority) would be the current House File 1812, the Minnesota Health Plan (also called “MNCare for All” or MHP). MHP would outlaw private health insurance and replace it with a single statewide system covering every resident (here legally or otherwise) for medical, dental, vision, hearing, mental health, long-term care, and more.
Klobuchar ran on fixes to Medicare Advantage and all private health insurance, while more progressive DFLers like Peggy Flanagan ran on a complete takeover within MHP that outlaws all private health insurance, including employer-provided health insurance, Medicare Advantage, and union-provided health care.
The Minnesota Health Plan proposal has been around for several years and has survived by never having to become real. Proponents are typically the Bernie Sanders type, and in Minnesota that means Senator John Marty. Marty has carried the bill for years and is considered by many to be an earnest and good fellow, but not someone you would want to run the Mayo Clinic. Republicans and moderate Democrats have patted this idea on the head for a decade or more and kind of gotten used to having it around without causing fuss.
Except now it is getting real. The bill attracted coauthors who likely will be running the legislature soon. Thirty-five House members signed on (the maximum number), including the current and former chair of the health care committee.
With Democrats holding majorities in both chambers, progressive sponsors—more than 40 co-authors—will push it again, and they are dead serious. Klobuchar campaigned on a different approach: targeted state tax credits if federal ACA subsidies stay lapsed, expanded bulk drug purchasing, strengthened reinsurance, rural hospital support, and a crackdown on fraud. She rejected new tax increases and said she was not interested in moving Minnesota left or right. Her incremental proposals assume a competitive private market continues. HF 1812 would simply outlaw traditional health insurance.
From each according to his “ability” to each according to his “need”
Under MHP, premiums would be set by ability to pay, and eligibility would extend to all residents regardless of immigration status. The bill creates a new Minnesota Health Board, Health Fund, ombudsman, and auditor general, plus a request for a federal waiver. It stalled earlier amid budget realities and the 2025 decision to end MinnesotaCare coverage for undocumented adults.
An unelected board with taxing authority and the sole and uncontestable ability to set health care benefits is on its face unconstitutional. It would have the ability to take taxing authority away from the legislature—where our constitution demands it must stay—and somehow determine a benefit set and pricing for every person (whether documented or not) who calls Minnesota home (or decides to move here).
Under the bill, taxes would not have to be raised by the legislature; rather, “premiums” would be assessed to corporations and individuals based on the cost to deliver the “necessary” care. This would cost in the billions of dollars.
But being unconstitutional is a matter for judges to decide. If you think cooler heads might prevail before such a bill is signed, think again. The Democrats ascendant believe they lost the last trifecta by not going far enough. Many point to Walz caving on free health care for the undocumented as the low point of their careers.
DFL Floor Leader Jamie Long said of the compromise removing adult undocumented aliens from MNCare, “This bill is cruel. It is inhumane. And it will cost real human, Minnesotan lives.” When the deal was announced in the Capitol’s reception room, outraged DFL members literally banged on the doors chanting “Don’t kill immigrants!” and “Don’t kill our neighbors.”
The cost of MHP is unknown. The 2023 legislature commissioned a $3 million cost estimate that was to be released nine months ago but has yet to see the light of day. You can imagine why. The trillions such a plan would incur nationally has prevented other states from moving ahead on their own. Such a plan would not only cost billions for Minnesota, it would require the Trump administration to approve it. Hopefully no such approval would come, but it would present the administration with a tantalizing “watch out what you ask for” opportunity for Minnesota.
If MHP costs too much, or creates problems with the cash flow, perhaps HF2 will smooth over the rough patches. With DFL majorities restored in both chambers after the November 3, 2026 election—ending two years of split or tied House control—a new fifth-tier income tax is far more viable in the 2027 session. HF 4845, would set a new fifth-tier 10.85% top rate. While Gov.-elect Amy Klobuchar has not proposed broad new tax increases, DFL legislative control makes a targeted fifth-tier proposal substantially more likely than in 2026.
Klobuchar’s Obamacare vote a prologue?
In her early years in the Senate, Klobuchar was unwilling to push hard against the liberal wing of her party even when it meant sour impacts at home. While others held their vote for Obamacare until sweeteners were added or provisions removed, Klobuchar voted yes and then worked to lessen the harmful effects of her vote at home.
After seeing the election results of last night, DFL legislators who are DSA, POCI caucus, and even most rank-and-file Democrats may find no resistance from Klobuchar should they want to enact even the most radical legislation. A new 5th top tier of 14% would be higher than any other state in the country and would go a long way in paying for MHP, or a growing DFL wish list. It would pass in a heartbeat.
For Additional Information, please see: