The State’s Supplemental Budget

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The legislature will probably have a very difficult time agreeing on the Supplemental Budget this year.  The House Supplemental Budget plan depends on an increase in gambling in the form of a ‘racino’ at Canterbury Park, which does not seem to have support in the Senate.  The Senate plan would raise the necessary money by eliminating the politically appointed assistant commissioners in state departments and closing tax ‘loopholes’, which is not supported by the House leadership or the Governor.  In order to lessen the impact of the Governor’s plan on persons with disabilities, some means of capturing additional money will have to be agreed upon.

First let’s look at some of what happened in the budget adopted in 2003: co-payments for prescription drugs and doctor visits; $500 limit on dental care services for adults on MA and GAMC; significant increases for parents with children on the MA-TEFRA Program; caps on CADI and TBI waivers; elimination of slots for the MR/RC waiver; premium increases for persons on the Medical Assistance for Employed Persons with Disabilities program; cuts in payments to counties, which affects services for persons with disabilities; cutting MFIP payments by $125 per month for a child receiving SSI; most providers of continuing care received a 1% rate cut.

The Governors Budget Proposals for Fiscal-Year 2005: many continuing care providers would be cut another 1 ½ %; CADI and TBI waiver caps would be extended to 2008, although the caps would be somewhat higher than those enacted in 2003; inpatient and outpatient hospital rates would be reduced by 5%; this plan would, however, restore mental health services and diabetic supplies for those on MinnesotaCare; no change from the 2003 change in co-pays, dental limits or parental fees.

The House Supplemental Budget: eliminates all dental care for adults in the MinnesotaCare limited benefit set and uses the money to buy back dental care in Medical Assistance; exempts persons in facilities, who have only a personal needs allowance from co-pays for prescription drugs and medical appointments; gives a ½ % increase to providers who had a 1% reduction in the 2003 legislation; caseload waiver caps would be continued; mental health services would continue to be cut out of the MinnesotaCare limited benefit set; The Prescription Drug Program would be repealed when the Medicare Part D program begins in 2006 (there are significant problems with the Part D program for persons with disabilities); $500,000 with a $500,000 matching of federal dollars would be used to reduce parental fees for families using the MA-TEFRA program.

The Senate Supplemental Budget (at the time of this writing the Senate has not yet passed these proposals of the Senate Finance Committee):  Repeal the co-pays for medications and medical care under MA and GAMC; eliminate the dental care limit of $500 for MA; parental fees under the MA-TEFRA program would be reduced; the MFIP grant reduction for families with a family member on SSI would end; the limited benefit set under MinnesotaCare for persons without children would revert back to the benefit set prior to the 2003 changes; the caseload caps on the CADI and TBI waivers would expire at the end of fiscal year 2005; does not include provider rate cuts; would prioritize future waver slots for persons who have been on the Consumer Directed Community Supports Program.

Although there is some agreement between the Senate and House on restoring some of the cuts made in 2003, it is still very questionable whether these restorations will take place.  The financing proposals are so diverse that it will be difficult to come to an agreement.  If there is no agreement at the end of the legislative session, programs will continue with the cuts made in 2003.  The Governor could not use unallotments, which could further hurt persons with disabilities because the deficit gap could be covered with budget reserves.

In this article we have just addressed health care issues for persons with disabilities.  There are cuts in many other areas as well, which affect the disability community.  The cumulative effect could be devastating.