Minnesota Gov. Tim Walz is set to join Kamala Harris on the ballot for the 2024 presidential election. Here's what we know about the Democratic vice presidential contender's actions and views on healthcare.
Ms. Harris announced her running mate selection Aug. 6. Mr. Walz, 60, has led Minnesota as a two-term governor, taking office in 2019. He was a member of the U.S. House of Representatives, representing Minnesota's 1st congressional district, from 2007 to 2019. The state is home to some healthcare heavyweights, including Mayo Clinic based in Rochester, UnitedHealth Group based in Minnetonka and Medtronic in Minneapolis.
1. Healthcare as a right. Mr. Walz believes healthcare is a human right, a belief he described as a "Minnesotan value" in his 2019 inaugural address as governor. "What Minnesotans want from their health care is simple. They don't want to get sick in the first place. But if they do, they want care at a price they can afford and at a location close to home," he said at the time, noting the need for improvements to healthcare delivery, affordability and outcomes.
2. Health insurance coverage. MNsure, Minnesota's official health insurance marketplace established in 2013, saw a record number of enrollments in 2024 with 146,445 people successfully signed up. The same year, the percentage of Minnesotans without health insurance fell to 3.8% compared to the national uninsured rate of 7.7%.
During his 2018 gubernatorial campaign, Mr. Walz supported the introduction of a public option in Minnesota. The plan, designed to complement MinnesotaCare for residents earning above 200% of the federal poverty level, has progressed slowly. MinnesotaCare provides coverage for low-income Minnesotans who lack affordable healthcare options, while Medical Assistance (MA) is the state's Medicaid program for individuals with very low income. Unlike MA, which has no monthly premium, MinnesotaCare may require a premium based on the household size and income of the enrollees.
In 2023, legislation was passed mandating a study and actuarial analysis of a public option, with findings due in early 2024. Based on these findings, the earliest start date for the public option would be 2027. The Minnesota Department of Commerce released the report earlier this year outlining two approaches to the public option, with estimates that the expansion could cost the state up to $364 million annually and increase enrollment by up to 151,000 people.
The Minnesota Hospital Association has opposed the concept of a public option to augment MinnesotaCare, testifying that "allowing a public option without some type of upper income threshold and recognition of the imbalance of reimbursement between public and private insurance was ill advised."
3. Health insurer restrictions. UnitedHealthcare was "deeply disappointed" in May 2024 when Minnesota lawmakers and Mr. Walz renewed restrictions preventing for-profit HMOs from securing managed care contracts in the state's Medicaid program. Minnesota had traditionally reserved its Medicaid program for nonprofit health plans until lifting the ban on for-profits in 2017. UnitedHealthcare, the nation's largest health insurer and the only for-profit HMO in Minnesota Medicaid, responded by filing a lawsuit on Aug. 5, challenging the new restriction set to take effect in 2025.
4. Healthcare funding challenges and dynamics. In the final days of Minnesota's 2023 legislative session, a healthcare fight and compromise emerged related to a bill on nurse-to-patient staffing ratios.
Initially introduced in February, Minnesota's Keeping Nurses at the Bedside Act faced strong opposition from the Minnesota Hospital Association, which claimed it would reduce hospital care capacity by 15% and threaten regular care access for 70,000 patients. The bill lost momentum after Mayo Clinic, warning it would reconsider billions in future Minnesota investments, secured an alternative pathway with lawmakers under the staffing proposal — an option the health system said was available to any hospital.
Last-minute compromises on provisions in the bill made by lawmakers with influence from Mr. Walz left the legislation so fundamentally changed that its title was adjusted from the Keeping Nurses at the Bedside Act to the Nurse and Patient Safety Act. The revised act focuses on workplace violence protections and benefits for nurses. Minnesota Nurses Association President Mary Turner criticized Mr. Walz for yielding to corporate pressure and "allowing corporate executives to dictate our public policy behind closed doors."
5. Medical debt regulation. Mr. Walz signed a bill into law in June 2024 that adds regulations to healthcare billing processes. The Minnesota Debt Fairness Act bans medical providers from withholding necessary care due to unpaid debt; prevents medical debt from impacting credit scores; eliminates automatic transfers of medical debt to spouses; establishes rules against unethical debt collection practices; requires providers to publish their debt collection practices, and creates a process for disputing medical coding and billing errors.
"Credit card debt to buy a television is one thing," Mr. Walz told the Star Tribune in February before the law's passage. "Debt because you have a heart attack or get hit by a car or have an illness is an entirely different thing. And the idea that we are charging massive interest on that or reporting it to a credit bureau and we're destroying lives over it makes absolutely no sense."
The Minnesota Hospital Association opposed the legislation, expressing concerns that the provisions were not "appropriately balanced" and warning of an increased risk of bad debt at a time when hospitals are financially fragile.
The legislation followed a billing and collection policy at Minneapolis-based Allina Health that drew national attention and an investigation by the Minnesota attorney general in 2023. A New York Times article, citing internal documents and interviews, revealed that Allina Health restricted care for patients with certain levels of debt, with some patients not allowed to return unless their debt was paid in full. In response to the scrutiny, the health system first paused then announced the end of the policy in question.
6. Drug costs. In 2020, the governor signed the bipartisan Minnesota Prescription Drug Price Transparency Act, which was expanded in 2023. The law requires drugmakers to report significant price increases for prescription drugs to the state health department and provide detailed information on factors contributing to the price increases. In June, the state published its first list of 364 drugs from 76 manufacturers that are subject to reporting from drug manufacturers, pharmacy benefit managers, wholesalers and pharmacies.
In 2020, the governor also signed the Alec Smith Insulin Affordability Act to help people with diabetes who cannot afford essential medicine. The act was named after a Minnesota man who died in 2017 at age 26 after rationing insulin because he could not afford to buy more.
Under the law, eligible individuals in urgent need of insulin can go to their pharmacy once in a 12-month period and receive a one-time, 30-day supply of insulin for a $35 co-pay. The long-term program requires manufacturers to provide insulin to eligible individuals for up to one year, available in 90-day increments for a co-pay of no more than $50. Manufacturers must reimburse pharmacies for the insulin they dispense or send them replacement insulin at no cost.
In 2024, Minnesota secured settlements with Eli Lilly and Sanofi, stemming from a 2018 lawsuit against three major drugmakers over alleged price gouging on insulin. Under the terms of the settlement, all Minnesotans, regardless of insurance status, can purchase Eli Lilly and Sanofi's insulin products for $35 per month for the next five years. The settlements aligns with the U.S. Inflation Reduction Act of 2022, which capped out-of-pocket insulin costs for seniors on Medicare at $35 per monthly prescription. The state's litigation against Novo Nordisk continues.
7. Mental health. As a veteran himself, Mr. Walz prioritized veteran suicide prevention during his tenure in the U.S. House of Representatives and the House Committee on Veterans' Affairs.
Mr. Walz sponsored the Clay Hunt Suicide Prevention for American Veterans Act, which then-President Barack Obama signed into law in 2015. The law requires annual third-party evaluations of the VA's mental healthcare and suicide prevention programs, the creation of a centralized website with mental health resources for veterans, and collaboration between the VA and non-profit mental health organizations on suicide prevention efforts. It was named after Clay Hunt, a Marine veteran who died by suicide in 2011 after struggling with post-traumatic stress disorder and depression.
In 2022, Mr. Walz signed a $92.7 million omnibus mental health bill into law. The legislation aims to address critical needs in mental healthcare by increasing hospital bed capacity, attracting new mental healthcare professionals through grants and loan forgiveness programs, and expanding the use of mobile crisis units.
"Everyone deserves access to the mental health care that fits their needs, when they need it," said Mr. Walz, noting he saw the bill as a good step with "more work to be done to ensure children and adults have access to the mental health services they need."
8. Abortion and reproductive health. Mr. Walz is firmly pro-choice and took significant steps to protect reproductive rights in Minnesota. In 2023, with a Democrat-controlled House and Senate, he signed legislation that enshrined the right to abortion and other reproductive healthcare into state law. This action was a direct response to the 2022 Supreme Court decision to overturn Roe v. Wade.
"To Minnesotans, know that your access to reproductive health, and your right to make your own health care decisions, are preserved and protected," Mr. Walz said, according to the Associated Press. "And because of this law, that won't change with the political winds and the makeup of the Supreme Court."