In Minnesota's 1st District, Medicaid pays for the care of 140,000 people, close to a fifth of everyone who lives there, most of them children, older residents or people with disabilities. Brad Finstad voted to take money out of that program twice: on May 22, 2025, the House approved the One Big Beautiful Bill Act with 215 votes, his among them, against 214, and on July 3 he voted for the version that became law, which by KFF's math removes $19.1 billion in federal Medicaid funds from Minnesota over a decade.
Earlier that spring, Finstad supplied deciding votes in February and again in April 2025 for a budget resolution setting a savings target of at least $880 billion for the Energy and Commerce Committee, which oversees Medicaid. The final law he voted for limits the provider taxes states use to fund their share of Medicaid, and KFF expects the state's hospital tax to get smaller.
Brad Finstad's Votes to Cut Medicaid and Health Coverage
- Care for Minnesota's Medicaid Patients Loses $19.1 Billion Under the Law Finstad Voted For in July 2025. Without Brad Finstad's yes on May 22, 2025, H.R. 1 would have fallen short: the House tally was 215 to 214, with one member recorded present. Finstad was a yes again on July 3, 2025, and the final bill passed 218 to 214. Over ten years, federal Medicaid spending drops by $911 billion under the law, and the uninsured rolls grow by 10 million Americans in 2034, both Congressional Budget Office estimates. In KFF's division of that cut among the states, Minnesota's portion is $19.1 billion, 15% of the federal Medicaid funding it was due, with a range running from $14.3 billion up to $23.9 billion.
- Minnesota's Hospital Tax Is Expected to Shrink Under Medicaid Cuts That Began With the 2025 Budget Plan Finstad Voted For. Twice in 2025 the budget resolution, H.Con.Res. 14, hung on a two-vote margin with Finstad voting yes: 217 to 215 on February 25, and 216 to 214 on April 10, when the House took up the Senate's version. Had he flipped, either tally would have tied, and ties defeat resolutions. Its instruction to the Energy and Commerce Committee, home of Medicaid, was to "reduce the deficit by not less than $880,000,000,000". Finstad then voted in May 2025 for the rule setting the terms of the H.R. 1 debate. The Medicaid cuts themselves came in the law Finstad voted for in July. A cap on the provider taxes states charge to fund their share of Medicaid takes $191 billion in federal money out of the program over ten years, according to the Congressional Budget Office, and nationally, tighter limits on state-directed hospital payments mean "payment rates for hospital services will decrease in at least 37 states" from 2028, KFF found. Minnesota's hospital tax is on KFF's list of state provider taxes expected to fall.
Who Loses Coverage and Care in Minnesota and Its 1st District Under the Medicaid Cuts Brad Finstad Voted For
- 60,700 children and 12,100 people with disabilities in Finstad's district get their care through the Medicaid program the law cuts. Of the 140,000 people on Medicaid in Minnesota's 1st District in 2025, 19% of residents, 60,700 were children, 12,100 had disabilities, 11,400 were seniors, 22,800 were expansion adults and 33,000 were other adults, according to KFF's district data, and their prescriptions, checkups and hospital bills are paid partly with the federal dollars the law takes away.
- 170,000 Minnesotans will join the uninsured by 2034 because of the law. By 2034, KFF projects, the law on its own leaves 170,000 more Minnesotans without insurance (KFF's range runs from 130,000 to 210,000), and Minnesota's uninsured rate climbs 3 points, which puts a doctor's visit or a refill on the family's own tab.
- Minnesota adults dropped under the work rule take $200 million a year in federal funding with them. Statewide, health officials expect 140,000 Minnesotans to lose coverage under the law, and by the Minnesota Department of Human Services' estimate the work-reporting rule alone would cost the state $200 million a year in federal funding as fewer people stay enrolled, plus a possible $165 million in new administrative costs for the state, counties and tribes, MPR News reported in April 2026.
- Rural Minnesota patients lose $4.3 billion in federal Medicaid funding over ten years. Rural Minnesota's federal Medicaid spending shrinks $4.3 billion across ten years, KFF estimates, money that small-town hospitals and clinics with many Medicaid patients count on to keep beds staffed.
- Seven Minnesota hospitals that lean on Medicaid and run negative margins are flagged as at risk under the law. Seven Minnesota hospitals are flagged as at risk in Public Citizen's data on the law, marked for high Medicaid shares and negative margins, a progressive watchdog's warning that for patients could mean longer trips to emergency and inpatient care.
Frequently Asked Questions About Brad Finstad on Health Care
What is Brad Finstad's record on health care under Trump?
Brad Finstad's yes was needed for the One Big Beautiful Bill Act's 215-to-214 House passage in May 2025, and in July he voted for the final law, whose Medicaid reduction the Congressional Budget Office puts at $911 billion over a decade. Of that, Minnesota loses $19.1 billion by KFF's allocation. He also cast the deciding votes on both 2025 budget resolutions, the plan that set a savings target of $880 billion or more for the House panel in charge of Medicaid.
Who in southern Minnesota's 1st District has to meet work requirements because of Brad Finstad's vote?
Brad Finstad voted for the law that will make Medicaid expansion adults, 22,800 of them in Minnesota's 1st District by KFF's 2025 count, prove they work, volunteer, train or attend school for 80 hours a month. Because Minnesota adopted the expansion, the rule will reach them, and states must begin enforcing it "no later than January 1, 2027." Those same adults will also face an eligibility review "once every 6 months."
Did immigrants in Minnesota lose Medicaid under the law Brad Finstad voted for?
Yes. The law Brad Finstad voted for cut off Medicaid for many lawfully present immigrants who lack green cards, refugees and people seeking asylum among them, and more than 5,000 immigrants in Minnesota were set to lose federally funded Medical Assistance starting October 1, 2026, MPR News reported.
Last updated: 2026-10-27