Health and human services leaders from across Rice County warned that upcoming Medicaid restrictions could strain local hospitals, long-term care facilities, and disability services during a community forum hosted by the League of Women Voters and ISAIAH Minnesota.
Held Oct. 28 at St. John’s Lutheran Church Hall, the forum — titled “The Effects of Medicaid Changes on Our Community” — drew residents and local officials alike to discuss how federal policy changes could impact access to care for the community’s most vulnerable populations.
The panel featured Zander Abbott, President and CEO of Northfield Hospital + Clinics; Charlie Mandile, Executive Director of HealthFinders Collaborative; Sandi Gerdes ’83, Executive Director of Laura Baker Services Association; Tom Nielsen, President and CEO of Northfield Retirement Community; and Galen Malecha, Rice County Commissioner. Mike Johnston of Rice County Human Services also shared data on local program enrollment.
Panelists agreed the proposed Medicaid eligibility cuts and administrative changes included in the One Big Beautiful Bill Act — including new work requirements and more frequent re-enrollment — could have lasting effects across Rice County. With one in five county residents currently receiving medical assistance, the changes could leave thousands struggling to stay insured.
Johnston told attendees that across all its programs, the county manages more than 9,600 public assistance cases. The county currently has 35 financial workers who determine eligibility, 20 of whom work specifically on medical assistance. The average caseload for families, children, and adults is over 600 per worker. For more complex programs, such as those serving people with disabilities or the elderly, the average caseload is around 240 per worker.
With legislative changes to Medicaid introducing new limitations on eligibility, Johnston expressed concern about the increased “administrative complexity.” The legislation introduces six-month renewals in addition to annual renewals, and in some cases, reviews may be required on a quarterly or even monthly basis.
“This adds paperwork for both the people we serve and for our staff, creating administrative challenges in managing increased workloads,” Johnston said during the forum. “We face difficult decisions about whether to hire more staff, manage longer backlogs, or potentially reduce other county services.”
In addition to administrative costs, health care providers are preparing to take on monetary costs. Currently, around 11 percent of Northfield Hospital’s revenue comes from Medicaid. Abbott said the hospital anticipates a three to nine percent loss in annual revenue as a result of overlapping federal funding changes.
“We’re trying to understand how these reductions might affect the care we provide and the services our community depends on,” Abbott said during the forum.
In an interview with The Olaf Messenger after the event, Abbott said that community need is guiding the hospital’s strategy as they approach these reductions.
“I hear directly from people who live in Northfield saying it’s important to make sure we have primary care, rehabilitation care, and the whole number of services we provide,” Abbott said. “So [I am] working hard with our team to make sure that with fewer dollars coming in, we can still provide all those services or community.”
In the forum, Gerdes said that Laura Baker Services Association, which supports people with intellectual and developmental disabilities “to live the lives that they choose,” is in a particularly unstable position as changes continue to be implemented.
“We are part of a very fragile industry,” Gerdes said. “Medicaid is the primary source of funding for long-term care and medical treatments for people with IDD [Intellectual and Developmental Disabilities]. Yet, Medicaid policy reflects troubling societal values — values that suggest those who rely on it somehow deserve less.”
According to Gerdes, Medicaid is structured to only cover 40 to 60 percent of service costs, operating under the assumption that other payers will fill the gap. However, this system does not work when a person’s only source of income is Medicaid — which is now facing cutbacks.
“If Medicaid is removed or reduced, we don’t know what will happen to the people that we serve. There is no backup plan,” Gerdes said.
Bogdan Vizoli ’26, a nursing student who attended the event, said in an interview with The Olaf Messenger that these changes will hurt an already struggling healthcare system.
“Most people that are on … Medicaid in general, are the people that need medical care the most due to a lot of other detrimental factors in their life, like lack of good food options, lack of exercise, [and] poor working conditions,” Vizoli said. “These people that need their health care the most are getting [that] care taken away from them.”
In an interview with The Olaf Messenger, Gerdes said she believed the focus must remain on the people who rely on these services. “We always start with the person being at the center of everything that we do, and trying to figure out how we can maintain that in the world of the many changes that are happening in funding,” Gerdes said.
The League of Women Voters Northfield-Cannon Falls, a nonpartisan organization that sponsors educational events to inform the public on pressing civic issues, noted that the views expressed at the forum were those of the panelists, not the League.
