Most MA-EPD participants likely to see premiums increase

Premium increases for persons using Medical Assistance for Employed Persons with Disabilities (MA-EPD) will be one likely result of the […]

Premium increases for persons using Medical Assistance for Employed Persons with Disabilities (MA-EPD) will be one likely result of the 2001 legislative session.  Although the ink is not yet dry on the Health and Human Services Omnibus bill, both the House and the Senate passed nearly identical versions of a plan to increase premiums for over 4,000 working persons with disabilities who need Medical Assistance for health care coverage.

The new premium schedule is likely to take affect September 1, 2001, and will mean that approximately 4,000 persons using MA-EPD will soon receive a notice of a premium increase.   The first new premium payment will be due beginning in September 2001.  DHS will send a general notice of the new premium sliding scale schedule to each participant in July and hopefully that notice will contain a website address to use to determine individual premiums due in September.

The new premium schedules passed by both the House and Senate will require premium payments from individuals beginning with 1% of total gross income at 100% of the Federal Poverty Guidelines (FPG), currently $716 per month.  Payments will be capped at 7.5% of income when total gross income reaches 300% of FPG, or $2,148 per month.

The new schedule means that many more individuals will be paying a premium, ranging from $7 per month for those with monthly earnings of $716, and rising to $161 per month for those with monthly gross incomes of $2,148.  For those with gross incomes over $2,148 per month (which is 300% of FPG), the premium will be 7.5% of monthly gross income.  It is important to remember that the premium will be based upon both earned and unearned income before taxes
and any other deductions.

The new premium schedule was a compromise in order to change the Department of Human Services’ budget proposal.  That proposal would have re-instituted a spend-down for those with unearned income (for example, Social Security benefits) of more than 100% of FPG, or $716 per month.  The DHS proposal would have hurt persons who still receive Social Security Disability benefits, but would not have been a stable source of funds in the long run, since it is expected that a good number of MA-EPD participants will lose their Social Security benefits as their earnings increase over time.

Medical Assistance for Employed Persons with Disabilities will remain a strong work incentive for persons who need the health coverage provided by Medical Assistance (MA), but are able to work.  First of all, using MA-EPD, individuals will be relieved of having to spend their income down to the Medical Assistance income standard.  The MA “spend-down” is like a deductible which requires that the person spend any income above the MA income standard (currently$482 per month) for health care before MA will cover health care costs.

In addition, MA-EPD will continue to allow persons to save money up to $20,000, not including allowed retirement accounts, a home and a vehicle.  The regular MA asset limit is $3,000 for an individual.  Also, MA-EPD does not count a spouse’s income and assets when determining the person’s eligibility.

It is important to spread the word to the 5,500 Minnesotans with disabilities using MA-EPD that a premium increase is likely by September 1, 2001.  Each MA-EPD participant will receive a  notice from DHS about the premium schedule increase in July.  Watch for more details in future editions of Access Press and through disability advocacy organizations and the Consortium for Citizens with Disabilities Work Incentive Work Group.

Anne Henry is an attorney with the Minnesota Disability Law Center

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