Brick-and-mortar projects and a bevy of programs and service important to the disability community hang in the balance as the 2017 Minnesota Legislature nears its May 22 adjournment date. Gov. Mark Dayton and leaders in the House and Senate were meeting on budget issues as Access Press went to press. Dayton and Republican leaders of both legislative bodies are working to avoid a special session or the worst-case scenario of a government shutdown.
The state talks became more urgent as they took place against a backdrop of what is happening in Congress, with possible cuts to Medicaid and sweeping changes in health care coverage. On a razor-thin 217-213 margin May 4 the House passed legislation that dismantles the Affordable Care Act and replaces it with programs that would make obtaining health insurance and care more challenging to Minnesotans with disabilities. One huge concern is what indexing care to a person’s age would mean. Another is the impact on Medicaid.
The House plan would dramatically change Medicaid. Under the ACA states could choose to expand Medicaid by offering the program to people with incomes up to 138 percent of federal poverty level. The plan passed May 4 freezes Medicaid expansion in 2020. After that individuals who qualified for the program in its current form could stay on the rolls. But if they leave the program, they wouldn’t be allowed back in.
The House also proposed changing the formula used to determine how much money the federal government contributes to the program and creating per-capita spending caps per Medicaid enrollees starting in 2020. That would save the federal government $880 billion over the next decade but reduce access to services. The bill also state that Medicaid, or Medical Assistance in Minnesota, could become a block grant rather than a dedicated revenue stream. States could see large reductions in funding.
A wide range of other services, including special education, would be impacted by the House proposal. It now goes to the Senate.
Back in Minnesota, many issues are still in play. About $1 billion separates the different spending plans put forward by Dayton and House and Senate leadership, with differences in almost every state agency and department. Health and human services spending, the bonding bill and transportation funding are three of the flash points for Minnesotans with disabilities and their allies.
In health and human services the Minnesota Consortium for Citizens with Disabilities (MNCCD), Best Life Alliance and other groups are continuing to push for measures that didn’t get into the health and human services omnibus bill. That includes the push to change spend-down limits for people on Medical Assistance and the quest for higher wages for caregivers. There is also a continued push for a variety of programs for children and families, and for adequate funding for mental health programs. The levels of funding for state facilities, including St. Peter State Hospital, is a huge worry.
Bonding is also a concern as not all requests for state hospitals, treatment facilities and the state’s academies, which provide education for students with disabilities, have been met. No bonding bill was passed in 2016 so this year’s capital fund packaging has an air of urgency.
Transportation is a battleground as Metropolitan Council has estimated that it could see a $35 million deficit, forcing deep cuts to regular and paratransit services in the Twin Cities region. A 10 percent cut in route service and increase in fares would be likely. Paratransit would be cut and even eliminated in some areas. Transit and paratransit supports plan to rally at the capitol May 16.
MNCCD has announced its end-of-session wrap-up, at 9-11 a.m. Tuesday, May 23 at the Minnesota Department of Transportation Building cafeteria, 395 John Ireland Blvd, St. Paul. Breakfast will be provided with vouchers between 9-10 a.m. A wrap-up and All-Star Advocates awards event starts at 10 a.m.
