New report recommends actions to move needle on racial equity in Minnesota's Medicaid program

A new report calls for specific changes in Minnesota’s Medicaid program to improve racial equity and health outcomes in the state, particularly for Black Minnesotans born in this country.

The report from the Minnesota Department of Human Services, “Building Racial Equity into the Walls of Minnesota Medicaid: A Focus on U.S.-born Black Minnesotans,” recommends three areas for action: Making it easier to enroll and renew coverage, expanding access to culturally relevant care, and engaging the community in the process of creating policy for Medicaid, also known as Medical Assistance in Minnesota.

Medicaid has a significant impact on access to care for Black Minnesotans. More than 40% of Black Minnesotans, including almost two-thirds of Black children, get their health care coverage through the federal-state program. The report hones in on the U.S.-born Black community, which experiences some of the state’s starkest health disparities. Compared to Black Minnesotans born outside the country, Black Minnesotans born in the United States have three times the rate of asthma, depression, and heart failure and heart conditions leading to hospitalization.

“This groundbreaking report was co-created with members of the U.S.-born Black community in Minnesota,” said Human Services Commissioner Jodi Harpstead. “It lays out real and actionable steps we can take to build equity into our Medicaid program. These changes will lead to improvements not only for the Black community, but also for other communities that experience health disparities.”

Dr. Nathan Chomilo, Medicaid medical director, was the report’s lead author. “It is an indisputable fact that Minnesota has a staggering racial health equity problem, and ignoring the stain of institutional racism has not made it go away,” Chomilo said. “This report aims to continue the evolution of how policy within DHS is designed, proposed and considered with communities at the center as well as model what accountability can look like as we aim to rebuild trust and ensure that Minnesota lives up to its commitment to equity.”

Governor Tim Walz’s budget for the legislative session includes several proposals that align with the report’s recommendations:

• Simplified enrollment and renewal processes in Medical Assistance and MinnesotaCare will result in more consistent coverage and fewer gaps in care.

• Offering continuous, stable Medicaid coverage to children for 12 months at a time will bring Minnesota in line with most other states, while improving children’s access to well-child visits, immunizations and other care.

• Funding community engagement conversations will support efforts to make public health care programs more responsive to the communities who make up the state of Minnesota.

• Making it easier to access culturally relevant care, including doulas.

• Support for navigator organizations that play a critical role helping Minnesotans access health care coverage.

U.S.-born Black Minnesotans who are enrolled in Medicaid and those working to advance racial equity in health care are invited to two upcoming online community conversations to learn more about the report’s findings, its calls to action and next steps. Register by visiting mn.gov/dhs/public-participation. The community conversations will be held:

• Tuesday, April 19 from 6 p.m. to 7:30 p.m.

• Monday, May 9, from 6 p.m. to 7:30 p.m.