When Minnesota launches its taxpayer-funded paid family and medical leave program on Jan. 1, it will be the 13th state to offer such benefits — and one of only a few that has built its system from the ground up in the past decade.

Greg Norfleet, the chief architect of the program at the Minnesota Department of Employment and Economic Development, has said he is confident that the new benefits system — one of the most significant new benefit programs in state history — will work as intended on “day one,” though ambitious new state systems have encountered problems as they’ve launched in the past.

Minnesota’s vehicle licensing and title system, MNLARS, was plagued by software issues when it started in 2018. MNsure, the state’s health insurance marketplace, had significant delays due to software issues when it opened for applications in 2013.

Minnesota’s new system appears on track to start on time, and it’s already accepting early applications for parental bonding leave. Though, it’s yet to be seen if claim projections will align with costs.

Other states have had successful paid leave launches, although some have had problems in recent years.

For instance, Maryland passed paid leave in 2022. Its 2025 launch date was delayed two years to 2027 due to issues with costs and organization. Taxes would start in 2027, and payments would be available beginning in 2028 under the current plan.

Washington program’s financial woes

Washington state’s paid leave program has been operating since 2020, but has been plagued by staffing shortages, benefit payment delays and financial troubles.

In September, a state actuarial report found the program could face a $346 million deficit by 2029 and a nearly $1 billion deficit by 2030 under the current tax rate limits.

That comes after the state transferred $200 million to the paid leave fund in 2023 when the account for the program risked running out of money. The extra cash stabilized things and allowed the state to lower the tax to fund it, but didn’t resolve long-term issues.

Currently, the tax rate for Washington’s program is 0.92%. It’ll increase to 1.13% at the start of next year, and is expected to grow until it reaches a maximum of 1.2% in 2027. Once it reaches that projected ceiling, the program will struggle to remain solvent without extra state funding as claims will outpace premiums, according to the report.

Minnesota’s program

Minnesota’s paid leave program will be funded by a new 0.88% payroll tax on most employers. It will be split between employers and employees.

Employers can choose to cover the entire cost of the benefit, but most can charge employees up to about half the amount: 0.44%.

Asked if Minnesota’s program might face a similar fate to Washington’s, Norfleet said Minnesota has the advantage of being the 13th to launch the benefit.

“We know a lot more about the demand for these types of programs than we did even five years ago,” said Norfleet, who developed a similar program for Massachusetts, the eighth state to do so. “We’re starting higher than some other states have started, which I think does give us more financial stability over the longer term.”

Claims outpaced premiums

When Washington started collecting taxes in 2019, a year ahead of its program launch, the premium rate was at 0.4%. That gave the state around $467 million to fund the program at the beginning. But paid leave proved popular and claims quickly outpaced taxpayer premiums.

Around 113,000 people claimed the Washington paid leave benefit in 2020, costing the state around $613 million. By 2023, the number of claims grew to more than 210,000, and the cost doubled to nearly $1.5 billion.

After the Washington Legislature provided the program additional funds, payments and premiums continued to grow. In the 2025 fiscal year, 240,000 claimed the benefit, costing the state around $2 billion — $300 million more than the previous year.

Growth is stabilizing in the program, according to the state’s Department of Employment Security, but deficits still loom. Washington had a population of 7.7 million in 2020 and 8.1 million in 2025. Minnesota, meanwhile, has a population of 5.8 million, up from 5.7 million in 2020.

Washington’s program has a staff of 318 as of 2025, according to a recent legislative report. Meanwhile, Minnesota hired around 300 earlier this year and plans to have a staff of around 400 new state employees for its program.

Why officials say Minnesota’s program will be different

Minnesota’s paid leave launch is different from Washington’s in a few ways. First, there was no payroll tax in the year before the 2026 launch. Instead, the program is seeded by $668 million from the historic $17.5 billion state budget surplus in 2023.

Secondly, the standard premium rate for Minnesota’s program is more than twice what Washington’s was in its earliest years. The starting rate in Minnesota will be a 0.88% payroll tax shared between employers and employees.

Minnesota officials estimate that nearly 132,000 people will apply for the benefit in the first year, and that the state will collect around $1.6 billion to fund it.

The initial estimated tax rate grew from the earlier projection of 0.7% when the Legislature passed the program in 2023. Last year, the House passed a bill boosting collections by about $312 million after a new actuarial analysis found 0.88% would be the most effective initial rate to fund paid leave.

The maximum rate allowed under current law will be 1.1% — down from the original 1.2% when paid leave was first passed in 2023. House Republicans were able to reduce the overall maximum rate by 0.1% as part of a budget deal with the DFL-controlled Senate and Gov. Tim Walz earlier this year.

Groups like the National Federation of Independent Business warned of growing premiums before the program was enacted two years ago.

An early test

One component of Minnesota’s paid leave program is already operating in a sort of “beta” test phase. DEED is currently taking applications for parental bonding leave with certain employers. That early benefit access could expand to a broader group in the coming weeks, according to state officials.

Part of the reason for this is to test a small part of the system before it goes live, but also to help alleviate a large number of parents applying for birth-related benefits at the beginning of the first year, something Norfleet said is referred to as the “baby bump” in paid leave circles.

That’s because if a parent had a child in 2025, they are eligible for benefits in 2026 up until the child’s first birthday. With early access to applications, Norfleet said he hopes DEED can process around 5,000 leave applications before the rest of the program goes live on Jan. 1.

Past the paid leave pilot testing, DEED has held more than 300 public engagement sessions with employers across the state to help them prepare.

Minnesota Chamber’s concerns

The Minnesota Chamber of Commerce has pointed to issues other states, such as Washington, have faced that may be warning signs for Minnesota’s program.

Lauryn Schothorst, who handles workplace issues for the group, said they’ve discussed problems like program rollout and call center staffing with the state.

“DEED is very well aware of our concerns based on experiences in other states like Oregon and Washington,” Schothorst said in a statement. “DEED has said loud and clear that they are also tracking these cautionary tales and have been preemptively working to prevent them. We’ll have to see.”

Their primary concern, however, is the effect new rules and regulations will have on businesses across the state. Schothorst said some of the biggest troubles for businesses will be revising benefits packages and employees on extended leave during workforce shortages.

How it works

Starting in 2026, most Minnesota employers will be required to offer employees 12 weeks of family leave and 12 weeks of medical leave. Annual time off will be capped at 20 weeks.

Events like having a child, a serious illness or caring for a sick family member are eligible for coverage. Supporting a family member called to active duty in the military, responding to personal safety issues and bonding with a child also qualify.

The amount of money workers will qualify for under paid leave will depend on their wages.

Someone who earns less than 50% of the state’s average weekly wage, according to the state Labor Department, would get 90% of their normal pay.

A worker earning more than 50% of the state’s average weekly wage would get 66%. Those earning double the weekly average pay would receive 55% of their regular wage.

A person earning Minnesota’s annual average salary of $71,300 would get $1,075.72 a week in payments from the leave program. DEED has calculators that provide estimates of premiums and weekly payments on its website.

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St. Paul PD’s first AI policy: How is it being used and what’s next?

Artificial intelligence is upon us, and just as other historical breakthrough technologies have proved, it is not a matter of how it will accommodate us but how we must accommodate it.

Education, finance, law, transportation and energy are all sectors that are being dramatically transformed by AI, and medicine will be no exception. What will the AI automation of health care mean for patients?

With more diagnostic power available to patients than ever before, they will have more agency than they could have imagined. The AI transformation of medicine likely will sharpen diagnoses, streamline treatments and improve patient outcomes. Convenience will be the coin of the realm; many doctors’ appointments and emergency room visits will become unnecessary. The long era of sitting quietly while the doctor pronounces what ails us and what to do about it is ending.

Unfortunately, the future may not be as promising for physicians. The machines will soon out-doctor the doctors: AI will diagnose better and more quickly, and robotics will perform procedures more efficiently (the next generation of robotic surgery will need minimal human supervision). Physicians, especially the less experienced, are likely to overrely on machine AI in the pursuit of efficiency and speed. Doctors could become drone workers to the queen bee of AI. If that happens, what point is there in training new physicians? It is a notoriously cost-inefficient process.

But it doesn’t mean physicians can be completely eliminated, if for no other reason than AI “hallucinations” — the misleading results that machine learning occasionally generates. The diagnosis or treatment that AI suggests could be completely wrong, and the machine will not realize its error. Amr Awadallah, chief executive of an AI startup, told The New York Times, “Despite our best efforts, (AI systems) will always hallucinate. That will never go away.” Infallible machines turn out to be fallible. So there will have to be a physician somewhere in the equation to monitor the process.

But the biggest risk of AI in medicine will be cybersecurity. Of course, you will be assured that your information is secure. But it won’t be, because there is no such thing as total security. Electronic medical records were once touted as secure, but whole hospital systems have been taken down and held for ransom by malefactors. Given the national interconnection of medical databases, an AI agent could in theory take down the medical systems of the entire country.

Between hallucinations and hacking, there will have to be a role for physicians. The brilliant family physician and medical blogger Dr. Buzz Hollander once described the importance of the physician in the era of AI, “The internet has been a godsend for medicine; it has democratized medical knowledge away from the medical center libraries and academic journals and put it in everyone’s hands, at a faster pace than ever before. However, there is no device capable of reasoning through complex medical problems less prone to hacking, malware and corruption than the brain of a physician. No large scale attacks can be made on this form of intelligence.”

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The government, insurers, the health care industry, Big Science and Big Pharma will welcome, and eventually demand, that medicine be turned over to AI. The speed, efficiency and, of course, the profits will be too hard to pass up, risks be damned. Everyone in charge of health care will come to the same conclusion — the tremendous upside of having AI in charge of health care is worth the foreseeable risks. But, of course, not all risks are foreseeable, and those that are will be borne primarily by patients.

The AI revolution will be of immense benefit, but at the same time, it also will demand that all of us — patients and physicians — be aware of its shortcomings and potential pitfalls. Patients are the nexus between responsible health care and a dangerous technologic tsunami. They must make their desires known, the sooner the better, especially if they want the human contact that physicians, nurses and therapists provide. High tech should be tempered with high touch.

The author Avi Jorisch, who wrote a treatise on technology, “Thou Shalt Innovate,” observed, “Like every true revolution, it will begin within us — with the ancient, ever-new realization that technology is a mirror. What it reflects depends entirely on who we choose to be.”

Dr. Cory Franklin is a retired intensive care physician and the author of“The COVID Diaries 2020-2024: Anatomy of a Contagion as It Happened.” He wrote this column for the Chicago Tribune.

Today is Sunday, Nov. 23, the 327th day of 2025. There are 38 days left in the year.

Today in history:

On Nov. 23,2005, Ellen Johnson Sirleaf was elected president of Liberia, becoming Africa’s first democratically elected female head of state. She guided her nation through recovery after its exit from a decade-long civil war.

Also on this date:

In 1863, thousands of Union soldiers under Gen. Ulysses S. Grant marched out of Chattanooga, Tennessee, and battled Confederate forces through Nov. 25, forcing their retreat into Georgia in a significant blow to the South in the American Civil War.

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In 1939, early in World War II, the British armed merchant cruiser HMS Rawalpindi was on patrol when it was shelled and sunk in an engagement with two German warships southeast of Iceland, leaving more than 200 dead aboard the Rawalpindi and only a few dozen survivors.

In 1963, President Lyndon B. Johnson proclaimed Nov. 25 a day of national mourning following the assassination of President John F. Kennedy.

In 1971, the People’s Republic of China was seated in the United Nations Security Council.

In 1980, an estimated 2,500 to 3,000 people were killed by a series of earthquakes that devastated southern Italy.

In 1984, Boston College quarterback Doug Flutie completed one of the most famous passes in college football history, connecting with Gerald Phelan for a 48-yard touchdown with no time left on the clock as Boston College defeated the Miami Hurricanes 47-45.

In 1996, a hijacked Ethiopian Airlines Boeing 767 ran out of fuel and crashed into the Indian Ocean near the Comoro Islands, killing 125 of the 175 people on board, including all three hijackers.

In 2006, former KGB spy Alexander Litvinenko (leet-vee-NYEN’-koh) died in London from radiation poisoning after making a deathbed statement blaming Russian President Vladimir Putin.

In 2008, the U.S. government unveiled a bold plan to rescue Citigroup, injecting a fresh $20 billion into the troubled firm as well as guaranteeing hundreds of billions of dollars in risky assets.

In 2011, Yemen’s authoritarian President Ali Abdullah Saleh (AH’-lee ahb-DUH’-luh sah-LEH’) agreed to step down amid a fierce uprising to oust him after 33 years in power. (After formally ceding power in February 2012, he was killed in 2017 by Houthi rebels who were once his allies.)

In 2024, Israeli airstrikes in central Beirut killed at least 20 people and wounded dozens more, the latest strikes in renewed fighting between Israel and Lebanon-based Hezbollah militants. (A U.S.-brokered cease-fire would be reached on Nov. 27, with sporadic violations of that truce for months afterward.)

Today’s Birthdays:

Actor Franco Nero (“Django”) is 84.
Singer Bruce Hornsby is 71.
TV journalist Robin Roberts (“Good Morning America”) is 65.
Composer Nicolas Bacri is 64.
Poet and author Jennifer Michael Hecht is 60.
Olympic gold medal sprinter Asafa Powell is 43.
Ice hockey player Nicklas Bäckström is 38.
Singer-actor Miley Cyrus is 33.

FARGO, N.D. — The suspense for the North Dakota State football team was not on the field Saturday afternoon, not after 665 yards of total offense. It was a foregone conclusion that the University of St. Thomas was an undermanned Division I non-scholarship Pioneer Football League team that came to Gate City Bank Field at the Fargodome a banged-up outfit.

No, the biggest mystery will be unraveled at 11 a.m. Sunday when the 24-team FCS playoff field will be revealed on ESPNU. The Bison, 12-0, are certain to be the No. 1 seed after their 62-7 victory before 15,278 fans.

“It will be exciting. (I) think we did a good shutting the door and handling our business,” Bison cornerback Anthony Chideme-Alfaro said. “Excited to see who we’re facing, so ready to get onto the next week and get ready.”

The rest of the seedings, and where NDSU stands in the bracket, will be the questions to be answered. But this is something the Bison have been part of for the past 15 seasons. They know the drill: Seeds 9 through 16 will host first-round games against the last eight at-large entrants.

NDSU will get a first-round bye and will have home-field advantage as long as it continues to advance.

“We shut the door today,” said NDSU defensive tackle Jaxon Duttenhefer. “I don’t think there’s any doubt for us or the nation where we’re supposed to be. I think there will be a little more interest to see who will be on our side of the bracket.”

The Bison beat St. Thomas with an offensive onslaught that for a while threatened to break the school record for total offense, 756 yards set in 1988 against Morningside College.

It was the fourth-most in the Division I era with the leader in that statistic being 700 yards against the University of South Dakota in 2019. That was with quarterback Trey Lance.

“Really good job coming out ready to go, regardless of the opponent it’s hard to do,” head coach Tim Polasek said. “The first-half performance, thought defensively we were flying around.”

This was accomplished with Trey’s younger brother Bryce Lance, who had three receptions for 106 yards and two touchdowns.

The Bison starters were sharp early against the Tommies, taking a quick 21-0 lead. NDSU had 320 yards of total offense in the first quarter alone, and with the difference in team speed, UST had no answer to any deep passes the Bison had to offer. Scoring passes in the first half covered 81, 47 and 43 yards.

Already an underdog, Tommies had to play without starting quarterback Andy Peters, out because of a concussion suffered against Presbyterian College (S.C.) last Saturday. That left the job to senior Amari Powell, who came in with 33 passing attempts on the season. St. Thomas also was missing a few other starters because of injuries.

NDSU found out during warmups.

“Whenever you don’t have a major starter, there’s always a lot of question marks because you’re not prepping for that player,” Duttenhefer said. “I think not having (Peters) in changed their mentality of what they were going to do a little bit.”

The Tommies, in their first year of being eligible for the FCS playoffs, had those hopes dashed last week in a loss to Presbyterian, which eliminated them from earning the Pioneer League’s automatic bid.

It didn’t take Bison running back Barika Kpeenu long to record a career-long touchdown run. On second-and-2, on NDSU’s second play of the game, Kpeenu took a handoff to the left side, saw little room, cut to the right and bolted 74 yards down the sideline for a quick 7-0 Bison lead.

Kpeenu’s previous long this season was 42 yards, and the stage was already set for the expected outcome.

A 40-yard pass to Chris Harris on NDSU’s next possession set up Kpeenu for a four-yard TD run, making it 14-0 before the game was six minutes old.

“They were playing some soft coverage, and we were still getting behind them,” Polasek said. “Really happy how many balls (were) getting pushed downfield.”

Interceptions on consecutive possessions by NDSU safeties Darius Givance and Taylen Eady halted St. Thomas drives, the last that resulting in an 81-yard pass from quarterback Cole Payton to Lance that made it 21-0. That was a career long on two fronts: the longest TD reception by Lance and the longest TD throw by Payton.

It was another showcase moment for Lance.

“That’s been the case 10 of the 12 weeks,” Polasek said. “Overall this year, Bryce continues to get open. He’s a pretty good player.”

It was also the ninth-longest touchdown passing play in NDSU school history. The Bison didn’t let up with the passing attack, either, and Kpeenu was the recipient this time. Payton found him wide open for a 47-yard touchdown play and it was 28-0.

It was 45-0 at halftime.

Kpeenu finished with 107 yards on 10 carries. Payton was 9 of 12 passing for 279 yards and three touchdowns.

“We were just ready to play,” Kpeenu said. “We came out right away willing to play for our brothers.”