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Access Press - Minnesota's Disability Community Newspaper

Medicaid a worry – Disability groups rallying for spend-down, among other issues

by // February 10th, 2017

As the 2017 Minnesota Legislature chugs toward the first bill deadline March 10, Minnesotans with disabilities are working to make sure their voices are heard. More than 600 bills had been introduced as February began. That crush of legislation makes it crucial to make the case for policy and funding changes.

Disability Matters Day at the Capitol Minnesota State Capitol is Tuesday, February 28. Check-in is at 10 a.m. in the L’etoile du Nord Room in the lowered level, with an 11:30 a.m. rally in the rotunda. Those interested in participating can preregister and set up times to meet with their legislators before or after the rally.

The rally’s focus is on funding and services to help people with disabilities live independently in the community. Event sponsors include Brain Injury Alliance of Minnesota, Get Up Stand Up to Cure Paralysis Foundation, Minnesota Consortium for Citizens with Disabilities (MNCCD) and The Arc Minnesota. Contact Mike Gude, mikeg@arcmn.org, 651-604-8066 or Erica Schmiel, ericas@braininjurymn.org, 612-877-7905 if there are questions.

House and Senate health and human services finance and policy committees are hearing bills, reviewing Gov. Mark Dayton’s budget and working on budgets of their own. A $1.4 billion surplus was announced in December 2016, so more good news on that front is likely.

But a second fiscal issue at the federal level is causing alarm. President Donald Trump and his advisors are proposing moving to move to a block grant system for Medicaid. That could mean much less money for states. For Minnesota $11 billion could be slashed to $5 billion.

Few details are available at this time, but the prospect of such a change and the likely fight for funding has Minnesota’s disability community very worried. The prospect of such a cut or funding cap has been discussed at MNCCD meetings. Consortium President Randall Bachman called it a “clear and present danger.”

“It affects everything,” he said. Medicaid programs are now regulated by the federal government but run by state in a matching grant program, with no caps. A block grant system would have caps and would give states more leeway to set regulations. The move to block grants is promoted as a way to cut waste, but disability advocates contend it could mean longer waits for waiver service and help from other programs people depend on for day-to-day living. MNCCD member groups are contacting Minnesota’s Congressional delegation about the threat to Medicaid.

The rush to defend Medicaid goes on while MCCD continues its “Advancing Independence and Promoting Choice” campaign. A large group gathered January 10 at the State Office Building and share its top legislative priorities for the disability community.

Changing Medical Assistance policy so people can keep more Social Security income and savings is a top priority for MNCCD, but it wasn’t funded in Dayton’s budget. At the news conference self-advocate Rik Seiler spoke to reporters. The former construction workers sustained a traumatic brain injury in 2014 after he was struck and injured by a motor vehicle. He had just rescued a young woman from an auto accident.

Seiler has gone from being a rescuer to someone who needs help. While he is pleased to have regained independence with the help of Medical Assistance Disability and home care services, Seiler must pay a spend-down on all medical bills until he just has $792 to live on.

“I live on about $1,000 per month from Social Security Disability Insurance, which I paid into for 25 years while working construction,” he said. “But because of the spend-down, I am expected to pay all my medical bills until I have just $792 per month left to live on,” said Seiler. “It feels like I am being penalized for working hard my whole life and paying into Social Security.”

The second priority is breaking down barriers to community supports to provide more choice. Consumer Directed Community Supports (CDCS) is an option that provides greater flexibility to persons with disabilities receiving public supports. The program allows individuals to direct their own care, choose cost-effective services that are specifically tailored to meet their own needs, and find creative solutions to staffing shortages that plague the industry. “Our legislation is a critical step in breaking down the current barriers that prevent thousands of individuals from accessing CDCS,” said Steve Larson, senior policy director from The Arc Minnesota.

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