Pretty much all the above. Blue Cross, the #1 health insurer in MN, quit the state and premiums are up 70% for the rest. The MNSure website still doesn't work. The turning of Cedar/Riverside into Little Mogadishu is also a sore point but nobody is willing to say so out loud because it is non-PC. Upstate in the Iron Range the economy is still terrible and they feel like they are being ignored.
And there was that m-uslim attack at the mall in St. Cloud. Plus I think Sanders won here.