These are troubling times for Minnesotans with disabilities and their allies. Mixed news on proposed health and human services budgets at the state capitol has many advocates wondering what more they can do to gain support. Although several programs are in line for funds, two efforts that haven’t yet gained budget traction are the Best Life Alliance’s campaign for a caregiver wage increase and the campaign to change the Medical Assistance spend-down limits.

Worries also continue at the federal level. Although efforts to repeal the Affordable Care Act fell short in March, there are still grave concerns about the future of the federal-state Medicaid program. The proposal set aside last month would have cut $880 billion over the next decade, with Minnesotans facing at least $2 million in cuts by 2020. The program still faces the possibility of major cuts.

Continued talk of cuts and per capita Medicaid caps for states doesn’t mean the threat of reduced funding goes away. At a March news conference in St. Paul, several disability community leaders said that by slashing Medicaid, the federal government may be setting itself and states up for higher expenditures later as people are forced to move into nursing homes and out of community-based settings.

Steve Larson, senior policy director of The Arc Minnesota, said “Medicaid is a lifeline for Minnesotans with disabilities.” He described the prospect of more people waiting longer for services; more unnecessary institutionalization and individuals and families having to pay more and possibly forego lifesaving and life-enhancing treatments, therapies, and medical care.

“A per capita cap on Medicaid will decimate the mental health system,” said Sue Abderholden, executive director of NAMI Minnesota and another one of the speakers. “We are still in the process of building that system, and capping funds would not allow needed expansion to address waiting lists for treatment.”

Medicaid is a critical source of health insurance coverage and community supports for people with disabilities. Minnesota’s Medicaid program enrolls more than 140,000 non-elderly adults and children with disabilities. In addition, more than 18,900 Minnesotans with intellectual and developmental disabilities receive Medicaid services that help them live independently in the community.

While eyeing what is happening in Washington, D.C., activists are also watching what happens in Minnesota. 2017 committee action deadlines have passed and budgets are in the works. Minnesota lawmakers are working toward a May 22 regular session end date.

As Access Press went to press, budget hearings had wrapped up and committees were hurrying to get budgets onto the House and Senate floors. Budgets are very fluid and likely to change before reaching Gov. Mark Dayton’s desk.

Although a number of disability initiative are recommended fur funding many programs had their asks cut. Best Life Alliance’s campaign for a caregiver wage increase and the Minnesota Consortium for Citizens with Disabilities’ efforts to change the spend-down limits weren’t included in either budget.

Advocates on those issues and many others are pressing forward with legislative meetings and events, Best Life Alliance’s southern Minnesota allies held a press conference in Rochester in late March to draw attention their concerns.

Another worry is the possibility of deep cuts to transit and paratransit funding, especially in the House budget. At a March 27 news conference, Metropolitan Council Chair Adam Duininck, transit advocates, business groups, and local officials urged the House leadership to withdraw their proposed legislation and pursue a sustainable fix to transit funding in the Twin Cities metro region.

Bus, light rail, and Metro Mobility services for the elderly and disabled in the Twin Cities will suffer significant service cutbacks and fare increases under legislation introduced by leaders in the Minnesota House. The House Transportation Omnibus Bill proposes to drastically cut funding for Metro Transit, the largest transit provider in the Twin Cities. After accounting for a proposed fare increase, HF 861 balloons Metro Transit’s budget deficit to more than $125 million over the next two-year finding cycle.

The proposed cuts would result in devastating reductions in local bus and rail service. “To make up a deficit of that size, we will be forced to cut service by 40 percent. The service cut will be bigger if we don’t pass a fare increase this year,” said Duininck. The House proposal cuts general fund appropriations to regional transit by $120 million, and completely eliminates state general fund contributions by 2021.

Funding for paratransit is a huge concern. About, 20,000 Minnesotans with disabilities use Metro Mobility. As the region’s population ages, ridership on Metro Mobility has grown by 5 to 8 percent a year, and there is no sign it will let up in the future. Federal and state law require that the service provide rides to eligible individuals, regardless of growth in demand or cost. Metro Mobility’s service area and hours of operation are minimally defined by law, although Metro Mobility currently provides more services than the legal minimum.

“The disability community was not consulted about this bill,” said Kjensmo Walker, who chairs the Metropolitan Council’s Transportation Accessibility Advisory Committee. “For many people with disabilities, transit is a lifeline, it’s how they get to work, school, doctor appointments and connect with the community. Whether it’s a service like Metro Mobility, or regular route bus service, transit is vital to our community.”