Medical Assistance expansion will cost Minnesota countiesThe federal effort to expand Medicaid to more Americans will mean free medical care for an extra 11,127 St. Louis County residents starting next year, but it could cost the county an extra $1 million to manage.
By: John Myers, Associated Press
The federal effort to expand Medicaid to more Americans will mean free medical care for an extra 11,127 St. Louis County residents starting next year, but it could cost the county an extra $1 million to manage.
That was the assessment earlier this week by county Social Services officials who warned that they will have to hire many new case workers in the next few months to be ready for the expansion that begins Jan. 1, 2014.
The effort is part of the Affordable Care Act, often called Obamacare, intended to guarantee that everyone in the nation has some sort of health-care coverage.
Minnesota lawmakers passed the plan and Gov. Mark Dayton signed it into law on Feb. 19 as one of two major pieces of health-care legislation this year. The bill is a companion to the health-care exchange bill Dayton signed Thursday in adopting more provisions of the Affordable Care Act.
Under the changes, people newly covered by free Medical Assistance, which is Minnesota’s Medicaid program, include adults without dependent children with income up to 138 percent of the federal poverty guideline, up from 75 percent of poverty now; parents with incomes up to 138 percent of the guideline, up from 100 percent; and 19- and 20-year-olds to 138 percent of the poverty guidelines, up from 100 percent.
The 2013 federal poverty guideline is $11,490 for a single person and $23,550 for a family of four.
This year, some 31,618 St. Louis County residents are covered by Medical Assistance. Under the expanded program, the number of people covered will jump to 42,745 residents, about one of every five county residents.
While the actual medical coverage is 100 percent federally funded, the federal government will pay only 47 percent of the county’s costs to confirm eligibility and administer the program. Local county taxpayers have to foot the other 53 percent, said Anne Busche, director of St. Louis County’s Public Health and Human Services Department.
The county now has 82.5 caseworkers for Medical Assistance. Busche said they will need another 29 to 40 caseworkers this year to handle the increased workload. That cost could hit $1.34 million out of the county’s property tax levy. That’s about 1 percent of the county’s tax levy, and counties all over Minnesota face the same problem.
“We can’t wait around on this. We need to be ready by Jan. 1,” Busche told commissioners.
Several commissioners grumbled that the Medical Assistance expansion is yet another example of well-intentioned federal and state legislation that often leaves the county, and property taxpayers, footing at least part of the bill.
“This is going to help some families but it’s going to hurt the county’s budget,” said Mike Forsman, a county commissioner from Ely, during a County Board workshop that included the issue this week.
County officials said they are talking about the cost issue with state Rep. Tom Huntley, DFL-Duluth, chairman of the House Health and Human Services Finance Committee.