St. Louis County Board debates Affordable Care Act caseworkersA battle brews over hiring new employees to administer the Affordable Care Act.
By: John Myers, Duluth News Tribune
St. Louis County commissioners are expected to battle today over how many new caseworkers to hire in coming months to handle the rush of thousands of new county residents covered by the federal Affordable Care Act.
County officials in recent months said they’d need as many as 40 new positions to handle an influx of more than 11,000 additional county residents entering the system starting in January.
But county officials have pared that down to a request for 17 new hires, and county commissioners are slated to vote on that request today during their regular board meeting in Duluth.
Amendments are expected however, that would reduce that number to just nine new workers, a move some commissioners say would gut the effort.
And some commissioners would rather see the whole Affordable Care Act program go away entirely, hinting that the county could make a philosophical stand against the federal government and national health care.
“We’re seeing the results of having a top-down solution forced upon us. … I think you’re going to see a lot of counties push back when they see the price tag on this,” said County Board Chairman Chris Dahlberg of Duluth. “We could do so much better with a local solution.”
Dahlberg, who opposes the federal health-care effort, said county taxpayers shouldn’t be forced to implement the program.
“Maybe this is the time we take a stand against Washington,” Dahlberg said, although he added he may still vote for some new hires after the board’s likely heated debate winds down.
Commissioner Frank Jewell of Duluth said opponents to Obamacare are using the county’s administrative role as a soapbox for political statements against Obama and Democrats. Instead, Jewell said, if an adequate number of new positions aren’t hired, it will be St. Louis County citizens in need of health care who will suffer.
“I think some commissioners who oppose Obama and who politically oppose expanding health-care coverage think they can defeat it by strangling the system. They think they can try to make it fail by providing terrible service to our customers at the county level,” said Commissioner Frank Jewell of Duluth. “But, hey folks, this is the law. It passed in Washington and Minnesota. We need to administer it properly.”
Commissioner Pete Stauber of Hermantown, head of the County Board committee that oversees health and human services, said Monday that county officials were still “working on the numbers” for the new positions for today’s vote.
The Affordable Care Act, known as Obamacare, was signed into law in 2010 intending to guarantee that everyone in the nation has some sort of health-care coverage. Minnesota lawmakers passed the state’s part of the plan this year and Gov. Mark Dayton signed it into law on Feb. 19.
The county predicted the administrative situation last year and set aside leftover general fund money in 2012 to help soften the blow in 2013 and 2014. Still, the scope of the increase in new enrollees caught some by surprise.
In March, officials realized the federal effort to expand Medicaid to more Americans will mean free medical care for an extra 11,127 St. Louis County residents starting in 2014.
Under the changes, people newly covered by free Medical Assistance, which is Minnesota’s Medicaid program, include:
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, more than one of every five county residents.
The county now has about 82 caseworkers for Medical Assistance. In March, county Public Health and Homan Services Director Ann Busche said the department would need another 29 to 40 caseworkers by the end of this year to handle the increased workload. That could have cost the county $1.3 million annually if the feds didn’t help out.
Since then the federal government has clarified its role, saying it will pay for 75 percent of administrative costs. County officials also cut their request for new workers in half. That cost for the 17 requested positions will be more like $350,000 for the first year, county officials now note, or less than 0.4 percent of the county’s overall levy.