Proposed new reporting requirements for medical assistance recipients could come at a big cost to the county.
Last week, Sherburne County CHS Administrator Amanda Larson updated the county board on proposed legislation that would add work requirement reporting for a percentage of individuals receiving Medical Assistance (MA).
Larson said the bill, HF3722/SF3611 targets the Medicaid expansion population - adults without children who meet the poverty guideline ($16,644 a year).
“In Minnesota, 85% of these individuals are in a family with somebody who is working, and 73% are working themselves,” said Larson. “So this really is the working poor.”
Larson said they make up about 15% of MA spending. The Federal Government pays 90% of the cost, so if the state doesn’t cover the population, Minnesota could lose up to $1.5 billion in federal funding.
One of the biggest issues for the county’s Health & Human Services (HHS) Department is reporting and tracking. Under the proposed legislation, individuals who are able to work must report every 30 days regarding work requirements. There are 10 exclusions and verifications as part of those requirements.
Since the METS system, formerly MNsure, doesn’t have the capability to do monthly tracking, all of the reporting must be done manually at the county.
“If someone doesn’t provide the necessary verifications for those 30 days, they’ll be dropped from the program because METS doesn’t have the ability to suspend anybody,” said Larson.
“And if they want to reinstate, it takes about 45 minutes for county workers to manually add in someone to the system. And that’s only if they have all the information they need from that person.”
Proponents of the legislation say it will save the state money by eliminating benefits for those who should be working.
But Larson said the bill comes with its own cost - about $9.9 million to the state over the next two years, when the Dept. of Human Services will need an additional 65.5 full-time employees to administer the program.
An estimate shows about 161,000 clients would need to be screened initially, with 91,000 clients ongoing after the initial screening.
Based on the county’s current Medicaid expansion population of 2,191, Sherburne County would need to add more staff to do the work, anywhere between two and 10 people depending on the individual’s programs and services.
“Those estimates are based just on (client) numbers, not on workload,” said Larson.
It could create an entire new department with its own supervisor, said Larson.
Administrator Steve Taylor said he estimated the county’s cost at between $700,000 and $750,000.
“That’s on the high end,” he said.
Larson said estimates show Hennepin County may need another 300 staff for the program. Dakota County’s estimate is 40 new staff.
Opponents of the legislations say the implications are more far-reaching for clients and healthcare providers because those people dropped from MA will still have medical issues.
In a letter to state lawmakers, Michael Scandrett, executive director of the Minnesota Health Care Safety Net Coalition, wrote:
“Medical needs do not disappear when health coverage does. Instead, the costs of treatment of uninsured Minnesotans are shifted to county governments, community hospitals and safety net providers who have an obligation and responsibility for providing health care to uninsured patients.”
Commissioner Felix Schmiesing said it’s another case of good intentions without all the facts.
“That’s real simple. Able-bodied people should work. But the devil, as always, is in the details,” he said. “So much of what happens to us in the county comes out of a thought like that, which on the surface seems to make sense.
But they give us the charge to do it and they don’t think of what it costs. It’s not the first time something like this is put on us. The point is, all of this stuff is good, but who’s going to pay for it?”
Larson said she would continue to track the legislation.
