Like many Minnesotans, Niraphanh Insomphou’s family came to the state looking for safety. Her parents fled Laos in the 1970s and built a life in Minnesota. Her siblings eventually became U.S. citizens. Insomphou, who has intellectual and developmental disabilities and cannot speak, did not.
For nearly 40 years, she has lived in group homes, with Medicaid helping cover the services she relies on every day. On October 1, that coverage ended. She is among more than 5,000 immigrants in Minnesota who lost Medicaid under new federal eligibility rules.
It is easy for a number like that to get lost in a much larger conversation about health care, immigration, and public spending. But for people who rely on Medicaid, losing coverage can change everyday life.
People often think Medicaid is just health insurance, something that pays for doctor’s appointments, hospital stays, or prescription medications. For many disabled people, however, Medicaid also helps pay for things like home healthcare, therapies, and specialized medical equipment.
More than 200 Minnesotans receiving Medicaid waiver services were losing coverage. These services can make it possible for someone to live in their community.
Another Minnesota family is already living with that uncertainty. An Afghan woman who suffered a brain injury in the bombing at the Kabul airport has lived in an assisted living facility in the Twin Cities for four years. She cannot walk or care for herself and needs assistance around the clock.
Her daughter learned through a letter from the Minnesota Department of Human Services that her mother would lose Medicaid. Having her mother live with her was not an option. Her apartment has no elevator, and she has to work.
The assisted living facility covered the cost for a few extra days but could not continue indefinitely. The alternatives the family found included a homeless shelter that could not meet the woman’s needs or a hospital.
Minnesota officials have said about 75% of those affected are expected to qualify for MinnesotaCare. But MinnesotaCare does not cover some services available through Medicaid waivers. For people who depend on those services, having health insurance does not necessarily mean having access to the care they need.
There is something about these stories that complicates the way we often talk about accessibility. We tend to picture the parts of access we can see: ramps, elevators, accessible parking spaces, and automatic doors. Those things matter, but they are only part of what makes a community accessible.
A building can have an accessible entrance and still be unreachable for someone who loses transportation. A workplace can be physically accessible while remaining out of reach for someone who no longer has the assistance that helps them get through the morning.
The same is true of independence. For many disabled people, independence does not mean doing everything alone. It can mean having the support to make choices about where to live, where to go, and how to spend the day.
Much of that support is easy to overlook if you have never had to think about it. Policy changes can make it visible at the moment families are discovering how difficult life becomes without it.
For people like Insomphou, losing Medicaid is about more than insurance. It raises a quieter question about whether the support that has made a life in the community possible will still be there. What happens to independence when it is not?
Sources:
Timar-Wilcox, Estelle. “Minnesota Family Stuck Without Care After Thousands of Immigrants Lose Medicaid Coverage.” MPR News, 2 Oct. 2026, https://www.mprnews.org/story/2026/10/02/after-medicaid-coverage-cuts-minnesota-immigrant-families-are-stuck-without-care.
Van Berkel, Jessie. “Refugees, Other Noncitizens Lose Medicaid Coverage Under Trump’s Hallmark Legislation.” StarTribune, The Minnesota Star Tribune, 29 Sept. 2026, https://www.startribune.com/refugees-noncitizens-lose-medicaid-big-beautiful-bill/601890008.