Doors open for TEFRA

Many Minnesota families with disabled children are celebrating changes to a key state assistance program. Changes to the Tax Equity and […]

Healthcare professionals talking

Many Minnesota families with disabled children are celebrating changes to a key state assistance program. Changes to the Tax Equity and Fiscal Responsibility Act or TEFRA are among many key law gains taking effect this summer. These changes will make a significant and positive difference for Minnesotans with disabilities. 

The revisions, which have been discussed for years, were championed by many disability advocacy organizations. 

Medical Assistance (MA) under the TEFRA option allows MA eligibility for children with disabilities in families that have incomes too high to qualify for MA. TEFRA is the federal law that sets the rules for this option. 

TEFRA often covers costs private insurance providers don’t or won’t cover. It is a very beneficial program in some ways, families note. It covers many costs of equipment, home and transportation modifications, equipment, therapies, home and community-based waiver services and much more. But the fees created huge financial issues for many families. 

In the past these families have had to make tough choices about how their children are cared for. Those choices affect an entire family, including children who are not disabled. Families had to pay hundreds if not thousands of dollars per year in TEFRA fees, which strained entire family budgets. Families take out second mortgage or max out credit cards. 

Some families cut their incomes, with one spouse opting not to work, Others even considered out-of-home options for their children. 

TEFRA also has been criticized for having overly complex paperwork for families in the program. 

Since 1990, families who access this option had faced a sliding-scale fee that has dramatically increased over time. Some families pay parental fees for waivered services as well.  

The quest for changes to TEFRA has a long and complicated history. Families and advocacy groups have sought fee reductions and program changes for years. 

During the 2023 session, state lawmakers and advocates described the parental fees as a tax on disabled children. This session’s legislation had many champions in both the House and Senate. 

Rep. Heather Edelson (DFL – Edina) was one of the leaders in eliminating TEFRA fees. She worked closely with legislators including Rep. Mohamud Noor (DFL – Minneapolis) and Sen. John Hoffman (DFL – Champlin) to get the measure into the final budget bill. “I was proud to chief author this legislation and glad we were finally able to get it to the finish line!” she said in a social media post. 

KSTP-TV recently featured a family that will benefit from the change, the Wakefields of Lakeville. They have previously paid TEFRA frees of several thousand dollars a year to help with care for a daughter who has a rare chromosomal difference called ring 21 chromosome with q-deletions. 

The family has used TEFRA to modify a van and their home, including a special bed. TEFRA also helps pay for her food, therapies and classes. They say being able to continue using the assistance without the fee will make a big difference. 

Learn more the Wakefields at

Learn about TEFRA at 

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