New Medicaid rules set for 2027, affecting some Otter Tail residents

Some Otter Tail County adults on Medical Assistance will soon have to prove they are working, in school, in training or doing community service, and they will have to renew coverage every six months instead of once a year. Minnesota officials say the first changes from the federal law signed by President Donald Trump on July 4, 2025, will not start until fall 2026, but most of the new rules begin Jan. 1, 2027.

The requirements will apply to people ages 21 through 64 who do not have dependent children, are not pregnant, are not American Indian or Alaska Native and are not getting Medical Assistance because of a disability. KFF says the federal law conditions Medicaid eligibility for adults in the ACA expansion group on meeting work requirements starting Jan. 1, 2027, and the Center for Health Care Strategies says that can mean 80 hours a month of qualifying activity such as work, school, job training or community service.

That means many current enrollees in Otter Tail County will not be directly affected, including people covered because of disability, anyone 65 or older, children 20 and younger, pregnant people and American Indian or Alaska Native enrollees. Otter Tail County’s own health care page lists Medical Assistance for children under 21, parents or relative caretakers of dependent children, pregnant women, people 65 or older and people with disabilities. In a county with an estimated population of 61,041 and 26.6% of residents age 65 or older, the new rules would hit a narrower group, but the administrative strain could still ripple through families and county offices.

For people who do fall under the new requirements, the checklist is short but critical: keep your contact information current, watch for renewal mail and respond immediately when a notice arrives. Minnesota Department of Human Services says there is nothing different people need to do right now to keep coverage, but renewal notices will matter more once the changes begin. If a renewal form arrives after the deadline, families may face gaps in coverage; if DHS never receives the form, coverage ends on the current certification end date.

The stakes are bigger than one county. Minnesota says more than 1 million people, about 18% of the state, are covered by Medicaid, and children make up 44% of recipients. KFF estimates the work requirements will cut federal Medicaid spending by $326 billion over 10 years and push the number of uninsured people up by 10 million in 2034. Otter Tail County residents with questions can call Human Services at 218-998-8150, where staff oversee more than 27 programs from the Government Services Center in Fergus Falls.