May 27, 2016

Net-zero HHS agreement invests in some vulnerable Minnesotans; misses opportunity to help many more

Sunday morning, the Supplemental Budget Conference Committee approved House File 2749, which spells out the near future of Minnesota’s Health and Human Services (HHS) budget.

The bill provides important resources that will protect vulnerable young Minnesotans and provide for the treatment of Minnesotans with mental illnesses. However, the agreement missed an important opportunity to invest our state surplus in supports for Minnesotans who are struggling to make ends meet. It doesn’t include provisions to increase economic stability for our most financially vulnerable neighbors or expand access to affordable child and health care. On the other hand, the bill also left out harmful proposals that would have made affordable health care more difficult to come by for Minnesotans with lower incomes.

The supplemental bill increases overall HHS spending by $79 million in FY 2016-17 and $154 million in FY 2018-19. The increased funding doesn’t come from the state’s general fund surplus. Instead, it is made possible by a $74 million transfer from the Health Care Access Fund, which updates an existing transfer for payments intended to cover services provided by health insurers and providers; the transfer amount was frozen in 2005.

The supplemental budget bill includes many of the limited areas of agreement between the House and Senate’s HHS budget bills, and also contains some of Governor Mark Dayton’s priorities. The bill includes:

$63 million in FY 2016-17 and $71 million in FY 2018-19 dedicated to the hospitals and other facilities that provide care, treatment and support for Minnesotans with mental illnesses and sex offenders;

$4.8 million in FY 2017 and $28 million in FY 2018-19 to allow a spouse to preserve their family’s assets when their partner needs home- or community-based services provided through Medical Assistance;

$2.8 million in FY 2017 and $3.8 million in FY 2018-19 to tribal governments to support their efforts to provide culturally-responsive human services;

$2.5 million in FY 2016 and $4.8 million in FY 2018-19 to prevent liens from being placed on older Minnesotans’ estates when they enroll in Medical Assistance;

$20 million in FY 2018-19 for a 15 percent increase in payment rates to foster parents;

$188,000 in FY 2017 and $8.4 million in FY 2018-19 to be invested in certified community behavioral health clinics, a proposal that may be matched with an additional $15 million in federal dollars; and

$8.8 million in FY 2018-19 to support vulnerable youth through the Homeless Youth Act, school-linked mental health services and Safe Harbor for Sexually Exploited Youth.

The bill did not include any of the proposals to seek approval from the federal government to change the way Minnesota manages our state’s options for affordable public health insurance. Negative proposals left out would have:

Re-instituted asset testing for MinnesotaCare, placing an unnecessary, inefficient bureaucratic wall between more than 100,000 Minnesotans and affordable health insurance.

Provided working Minnesotans eligible for MinnesotaCare with options for health plans that come with higher premiums and cost-sharing than MinnesotaCare.

Constructive waiver proposals would have:

Re-established eligibility for Minnesotans earning 200 to 275 percent of the federal poverty guidelines, or $24,000 to $33,000 for a single adult. Minnesotans in this income range are nearly three times more likely to lack health insurance as Minnesotans with higher earnings. The cost of providing MinnesotaCare to these Minnesotans would likely be covered considerably or entirely by federal funding.

Allowed access to MinnesotaCare for people earning more than 275 percent of federal poverty guidelines.

Simplified health insurance enrollment processes for families with children eligible for Medical Assistance.

It is disappointing that proposals that would have helped more Minnesota families reach economic security failed to make the final cut. The list of new investments skipped the Child Care Assistance Program (CCAP), leaving 7,300 families on the waiting list and failing to expand the shrinking set of child care provider options for families who use CCAP by updating rates paid to providers. It also does not contain Dayton’s plan to update cash assistance offered by the Minnesota Family Investment Program, a crucial but cruelly out-of-date support for Minnesota families who fall on hard times.

The bill received final approval on the floor of the House and Senate on Sunday; it now awaits the governor’s signature before becoming law.

-Ben Horowitz