Patching the holes in health care safety net

Don Heinzman
ECM Editorial Writer

In Minnesota there is a state safety net for an estimated 800,000 disabled, elderly, and families with children who need help paying for their health care.

During fiscal year 2010 and 2011, the Minnesota Department of Human Services spent $7.5 billion for health care with Medical Assistance (Medicaid) funds

Of that $7.5 billion, the federal government paid $4.5 billion, the state $2.9 billion and the counties $101 million.

Seventy percent of that money paid the health care for the elderly and the disabled, much of it for grandparents in care homes. Children, parents, pregnant women and adults with no children made up 74 percent of the enrollment.

Half of those receiving care in both Medical Assistance and Minnesota Care are children.

Those who qualify for medical assistance have incomes below the federal health care guideline, which is $11,170 a year for a single person.

Under the Affordable Health Care Act, just declared constitutional by the U.S. Supreme Court, this federal Medicaid assistance will continue.

In fact, under the law, more people will become eligible as the limits will be extended to 133 percent of poverty in 2014, enabling another estimated 120,000 to be eligible for Medical Assistance by 2016. The federal government will pay 100 percent of the tab for the first three years to care for the newly eligible.

The Supreme Court in its decision declaring the Affordable Health Care Act constitutional, said expansion of Medicaid is optional for the states.

Some governors say they will reject expanding Medicaid even though the plan calls for the federal government paying 100 percent of the cost the first three years starting in 2014.

Minnesota Gov. Mark Dayton is expected to welcome the expansion for another 120,000 people who won’t be able to pay for their health care in 2016.

Gov. Dayton and the Minnesota Legislature already have used the law to expand coverage for 80,200 adults who have no children in the home and incomes below 75 percent of poverty.

The Affordable Care Act also does away with the asset test. Now only income determines eligibility for Medical Assistance.

In other words, if you are poor your health care will be covered.

Another program called MinnesotaCare is a part of the safety net. It’s available to those who aren’t eligible for other state programs and can’t afford private health insurance.

Last year, 148,000 people enrolled in MinnesotaCare, costing the state, federal government and insurance consumers $737 million, according to the Department of Human Services. It is funded mainly by a tax on hospitals and health care providers.

There are critics who say the state and the country are on the road to socialized medicine, but it’s obvious that now without Medicaid, funded heavily by the federal government, many poor people today would be falling through the holes in the state’s health care safety net.

Don Heinzman is the former editor of the Elk River Star News and a member of the ECM Editorial Board.