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Organizing Secures Key Wins for Rural Healthcare in 2023 Minnesota Legislative Session 

MinnesotaCare Public Option & Prescription Drug Affordability Board are Strong Steps Forward

By Paula Williams & Amanda Koehler
June 14, 2023

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The Land Stewardship Project began organizing around healthcare in 2008 after hearing over and over again from our members that one of the primary barriers to getting into farming, or staying in it, is lack of access to affordable and useful health insurance. Farmers and other self-employed people do not have employer-based healthcare coverage without off-the-farm or additional jobs. They also often have variable incomes, making it difficult to consistently qualify for programs like MinnesotaCare. Moreover, having insurance doesn’t necessarily mean care is affordable, accessible, or of high-quality. People often have to delay or skip necessary medical care because they can’t afford the high out-of-pocket expenses if coverage is denied or they have high deductibles or co-payments. In rural areas in particular, it is hard to find in-network services when and where they are needed.

After years of grassroots organizing for accessible, affordable, high-quality healthcare for all Minnesotans, regardless of income, age, zip code, or  immigration status, LSP celebrates two strong steps in the right direction during the recently adjourned session of the state Legislature with the passage of a MinnesotaCare Public Option and the Prescription Drug Affordability Board.

Originally called the MinnesotaCare Buy-In, the Public Option expands access to affordable health coverage for more Minnesotans by allowing those
without access to employer-based coverage the option of purchasing a plan from this well-tested public program, paying an affordable premium based on their income. Currently, MinnesotaCare is only available to working Minnesotans with an income below 200% of the federal poverty line or $55,000 per year for a family of four. This leaves many no other option but to buy insurance on the individual health insurance market, which is plagued by ever-rising deductibles and out of pocket maximums of as much as $7,000 to $20,000 a year.

Another key aspect of expanding MinnesotaCare this session was ending the ban on coverage for Minnesotans without citizen status. Currently, thousands of undocumented workers and families, many on the frontlines of our food and farming system, are left without healthcare when they need it most. The Minnesota Department of Health Services estimates that 300,000 Minnesotans are uninsured. A disproportionate number of uninsured Minnesotans are Black, Indigenous, and/or people of color and 17% are undocumented immigrants. As an organization committed to transforming the food and farming system, we have consistently advocated for a healthcare system that leaves no one behind.

Over $1 billion on the reinsurance program has not fixed the problems of Minnesota’s individual health insurance market or expanded coverage. Instead of continuing to spend enormous resources subsidizing a broken health insurance system, Minnesota can now direct our healthcare dollars toward a better quality, affordable public health insurance option. The MinnesotaCare Public Option will be paid for with state and federal funds, premiums, and cost-sharing. Now that the MinnesotaCare Public Option has passed, agencies can begin conducting an actuarial analysis to determine how many Minnesotans are likely to enroll, and determine the premium costs based on that information. Minnesota’s Department of Health Services will also start the process of applying for the federal waiver to redirect federal healthcare dollars to the public option.

The Prescription Drug Affordability Board (PDAB) will have the power to rein in skyrocketing medication prices that Minnesotans rely on to survive and thrive by carefully setting upper payment limits on high-cost drugs. For too long, pharmaceutical corporations have legally been allowed to price-gouge when it comes to medicine, driving up costs at the pharmacy and across our entire healthcare system. Our current system works well for the industry’s profit-generating stakeholders, but it’s certainly not working well for patients. Even if you aren’t on a high-cost drug, we all pay the price for drug companies’ greed through higher costs for premiums, deductibles, and other out-of-pocket costs. In the words of Minnesota Attorney General Keith Ellison, who was a strong advocate for this legislation, “No one should have to choose between affording their medications and affording to live.”

For 15 years, LSP member-leaders have worked to get the MinnesotaCare Public Option with immigrant inclusion and Prescription Drug Affordability Board across the finish line by:

  • Holding hundreds of constituent meetings with state legislators at LSP Family Farm Breakfasts, in-district meetings and events, coalition lobby days, and more.
  • Sharing our stories in dozens of legislative hearings and at rallies.
  • Publishing dozens of letters-to-the-editor in newspapers across the state.
  • Holding several Town Hall meetings with Attorney General Ellison and other key leaders.
  • Gathering thousands of petition signatures calling on state leaders to champion affordable, accessible, high-quality healthcare solutions.
  • Sending thousands of e-mails and making countless calls to our lawmakers, urging them to support the MinnesotaCare Public Option, and the Prescription Drug Affordability Board and Provider Tax, as well as oppose reinsurance and other false solutions.
  • And more. In the end, people power prevailed!

Expanded access to MinnesotaCare will help make lives more sustainable, reliable, and affordable for farmers and others without access to employer-based coverage in communities across our state, as well as young people who age off their parents’ insurance, and early retirees. This expanded public program will make Minnesota a place where culture, innovation, small businesses, and local economies can thrive and grow.

These wins are great encouragement for the road ahead. Healthcare legislation and its implementation are complicated and there are many pieces to the complex puzzle. Undocumented workers should be able to start buying into the current MinnesotaCare program by 2025 and the MinnesotaCare Public Option should be rolling out in 2027.  This means, of course, that there’s more work to be done by people’s organizations like LSP and our partners at Minnesota Farmers Union, TakeAction, SEIU, UNIDOS, Minnesota Nurses Association, AARP, Springboard for the Arts, Mainstreet Alliance, ISAIAH, AFL-CIO, MN Budget Project, and others to ensure everyone has the healthcare they need.

Give it a Listen

In episode 310 of  LSP’s Ear to the Ground podcast, we discuss why working on healthcare reform is so important and provide more details on what was accomplished during the 2023 session of the Minnesota Legislature.

Paula Williams is a long-time LSP member-leader from Barnum, Minn., who recently led LSP’s healthcare organizing work in a short-term staff role. As her role as an LSP staff member has come to an end, she will be re-joining the LSP board of directors. For more information on LSP’s healthcare work, contact policy manager Amanda Koehler at akoehler@landstewardshipproject.org or 612-400-6355.

LSP members delivering a petition calling for healthcare reform to the office of Minnesota Governor Tim Walz.
Category: Blog
Tags: drug prices • farmworkers • healthcare • immigrant farmers • Minnesota Legislature • MinnesotaCare • Prescription Drug Affordability Board

Upcoming Events

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October 2025

Tuesday October 7

6:30 pm – 8:00 pm
Book Event: We Can Do Better: Collected Writings on Land, Conservation, and Public Policy
Tuesday October 7
6:30 pm – 8:00 pm
Book Event: We Can Do Better: Collected Writings on Land, Conservation, and Public Policy
The Landing Market, 211 College Dr, Decorah, IA 52101, USA

The Johnson Center for Land Stewardship Policy is excited to share that one of our its primary pillars of work — a published collection of Paul Johnson’s writings —  is set for release on Oct. 2.  The book features a brief biography and a discussion of Paul’s ideas within the historical and future contexts of private lands conservation. Details on the event are available here.

For details on We Can Do Better: Collected Writings on Land, Conservation, and Public Policy click here.

 

Friday October 10

8:30 am – 3:00 pm
Weaving a Wider Community: Seeing & Countering Racism in Our Backyard
Friday October 10
8:30 am – 3:00 pm
Weaving a Wider Community: Seeing & Countering Racism in Our Backyard
111 N 1st St, Montevideo, MN 56265, USA

Join LSP and CURE for a community event at the Land Stewardship Project office in Montevideo (111 N. First St.), from 8:30 a.m. to 2 p.m., on Friday, Oct. 10. This event includes lunch catered by El Mana; please register by Oct. 3 to be included in the food count.

You can RSVP here.

The Racial Equity Conference, organized by the Greater Minnesota Partnership of the Facilitating Racial Equity Collaborative, has been specifically designed to bring engaging content to local communities through a unique pairing of online speakers and in-person local sessions. The morning’s online content will include a conversation focused on seeing and countering racism in rural communities, moderated by Eryn Gee Killough, paired with two outstanding keynote speakers, Jenna Grey Eagle and Ron Ferguson, who have experience working in rural communities. 

This online content will be exclusively available to local community gatherings. Each gathering will gear their in-person activity to their specific community with the goal of extending the impact of the conference to others throughout the following year. Join LSP and CURE for this western Minnesota gathering, or if a different location works better for you, check out all the local gatherings on the FREC site,

If you have any questions, do not hesitate to reach out. LSP’s Nick Olson can be reached via e-mail at nicko@landstewardshipproject.org.

9:00 am – 3:00 pm
Intensive Small-Scale Market Gardening Bus Tour
Friday October 10
9:00 am – 3:00 pm
Intensive Small-Scale Market Gardening Bus Tour
Leatherdale Equine Center, 1801 Dudley Ave, St Paul, MN 55108, USA

Explore profitable small-scale farming (1–5 acres) and soil care. Visit a cooperative incubator farm and a thriving suburban market garden. Learn about cover crops, reduced tillage, high tunnel soil health, and support for growers.

This is the second tour in a three-part soil health bus tour series. Participants can sign up for just one, two, or all three tours. Register at https://z.umn.edu/vegetablebustours. The cost is $15 (flat fee, covers 1, 2, or 3 tours). There are more details in the attached flyer.

Saturday October 11

11:00 am – 2:00 pm
LSP-COPAL Visita a la Granja | Farm Tour
Saturday October 11
11:00 am – 2:00 pm
LSP-COPAL Visita a la Granja | Farm Tour
36919 County 57 Blvd, Dennison, MN 55018, USA

Building off the success of last year’s farm event with COPAL in Austin, Minn., this year Land Stewardship Project and COPAL members and supporters will gather at the Young-Walser Family Farm in Dennison, Minn. for a festive and delicious farm tour on Saturday, Oct. 11, from 11 a.m. to 2 p.m. We invite you to come and meet new folks, learn new skills, and try new food! 
 
This year’s COPAL-LSP farm event offers a little something for everyone: 
 
🍯 Honey sampling and the opportunity to purchase from Homestead Honey Farm. 
 
🍎 Apple cider pressing and tasting. (BTW, we’re still looking for an apple press if you or a farmer friend have one nearby we could borrow for this event!) 
 
🌽 Nixtamalization workshop and fresh, homemade tortillas, made with corn grown by LSP and COPAL members at the Young-Walser Family Farm! 
 
🍅 Salsa making and cricket-eating competitions! Yes, you heard that right —we’ll have the opportunity to sample crickets, a delectable crispy and savory snack commonly enjoyed throughout Mexico and Central America. Stay tuned for details on how to enter either competition. 
 
🥾 A tour of the Young-Walser farm, nestled in the beautiful Sogn Valley not far from Cannon Falls, Minn. Enjoy a tromp through the corn and squash fields and hike in the nearby woods. 
 
🌮 A shared meal and opportunity to hear from LSP and COPAL organizers about our participation in the Immigrant Defense Network. 

Let us know you can make it to ensure we order enough food and supplies! Carpools from Minneapolis and Rochester will be available to all attendees. 

________________________________________________

¡Únete a LSP + COPAL para nuestro recorrido anual comunitario en la granja!
Un espacio divertido para tod@s donde exploraremos la agricultura, aprenderemos sobre el campo y participaremos en actividades prácticas. ¡Uno de los momentos más especiales será hacer tortillas frescas junt@s!

Compartiremos un delicioso almuerzo comunitario, preparando tacos en estilo potluck (tipo convivio). Te invitamos a traer un platillo o acompañamiento para compartir.

También estás invitado@ a llegar temprano (desde las 9 AM) para ayudar a cosechar calabazas que sembramos. Puedes llevarte algunas a casa, y el resto se donará a un banco de alimentos local.

El Land Stewardship Project (LSP) es una organización aliada de COPAL que trabaja por sistemas alimentarios y agrícolas más sostenibles y justos. LSP y COPAL están unidas en su lucha por instituciones democráticas sólidas, comunidades saludables y acogedoras, y una ética de cuidado hacia la tierra y las personas que nos alimentan.

Tuesday October 14

11:00 am – 12:00 pm
Birds as Pest Control Allies on the Farm
Tuesday October 14
11:00 am – 12:00 pm
Birds as Pest Control Allies on the Farm
Online

This 10-lesson Wild Farm Alliance virtual course teaches agricultural professionals and farmers how to support beneficial birds and manage pest birds on farms. By learning how to assess the farm’s avian needs and opportunities, farms can be designed to provide for a diversity of beneficial birds. 

If pest birds are a problem, they can be discouraged with specific practices during the shorter periods when they cause damage. The sessions cover the latest research, tools and resources, and are given by experts in avian pest control, entomology, ornithology and conservation. While many topics and species are specific to the Midwest, most of the principles discussed are applicable across regions. 

Continuing Education Credits have been requested and are expected to be approved from American Society of Agronomy.

For details and to register, click here. 

The Course Schedule:

LESSON 1

Why Birds Belong on the Farm: Biodiversity, Pest Control & A Thriving Landscape

Tuesday, September 23, 2 p.m. CT


LESSON 2

Birds as Pest Control Allies on the Farm

Tuesday, October 14, 11 a.m. CT


LESSON 3

Birds in the Balance: Pest Control Services Across Crop Types

Tuesday, November 4, 11 a.m. CT


LESSON 4

Integrating Habitat into Croplands: Prairie Strips and Bird Conservation

Tuesday, December 2, 11 a.m. CT


LESSON 5

Birds on the Farm: Balancing Biodiversity and Food Safety

Tuesday, January 13, 11 a.m. CT


LESSON 6

Beyond the Crop: Birds, Biodiversity, and the Power of Edge Habitat

Tuesday, February 3, 11 a.m. CT


LESSON 7

Bridging Forestry, Farming, and Habitat

Tuesday, February 24, 11 a.m. CT


LESSON 8

Perennial Pathways: Agroforestry for Birds and Biodiversity on Farms

Tuesday, March 17, 11 a.m. CT


LESSON 9

Birds on the Range: How Grazing Practices Shape Habitat for Grassland Species

Tuesday, April 7, 11 a.m. CT


LESSON 10

Birds at Risk: How Pesticides Shape Safety on Agricultural Lands

Tuesday, April 28, 11 a.m. CT

View Full Calendar

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