The Governor’s budget proposal includes more than 80 changes to programs delivered by the Department of Human Services. Some of the more dramatic recommendations are to the state’s public health care programs. Last week, Maureen O’Connell with the Legal Services Advocacy Project gave an amazing presentation that finally made sense of many of the health care cuts. Appropriately, she titled her talk, “What’s Left?“.
If you are an adult with no children, you would be in big trouble. The Governor’s proposal eliminates all eligibility for any reasonably healthy childless adult – over 65,000 people would lose access to public health insurance. The only childless adults who would still be covered are the elderly, disabled, and those in extreme poverty (below 75% of federal poverty guidelines) who are also applying for disability, homeless, incarcerated, and a few similar special categories. For everyone else, the only option would be private market insurance. But good luck if you have any preexisting conditions!
If you are a parent, the options would shrink. The Governor’s proposal takes all parents off of MinnesotaCare, reduces asset limits for Medical Assistance making it more difficult for parents to qualify, and eliminates outreach efforts to get eligible parents enrolled on Medical Assistance. The result – close to 22,000 parents would lose access to public health insurance in FY 2011. What’s left? Medical Assistance is all that’s left, but you need to have income less than 100% of federal poverty guidelines, have a child under age 19 and have less than $3,000 in assets if you are a single parent ($6,000 if there are two of you). If you are one of the thousands of working parents living above the poverty line, but without access to employer-sponsored insurance…you are out of luck.
If you are a child, the barriers increase. The Governor does not target children currently on public programs, but his proposals would still result in more than 26,000 children not being eligible for public programs in the future. The Governor’s proposals to eliminate outreach programs, eliminate enrollment reforms and eliminate premium reductions would increase barriers to getting children insured. The Governor also proposes to repeal a reform that helps children transition seamlessly from Medical Assistance to MinnesotaCare as the family income increases, impacting more than 13,000 children. Another 7,000 children would drop from health care programs because their parents would no longer be eligible for MinnesotaCare – research shows parents are less likely to enroll their children if they lose access themselves.
If you are one of the lucky adults to stay eligible, you’ll still lose services. The Governor would eliminate coverage for the following services for adults – dental (except emergency), chiropractic, podiatry, occupational therapy, speech-language therapy, physical therapy and audiology services.
Of course, these are just some of the changes to health care programs…I’ll talk about some of the other major health and human services proposals on another day.