Governor Mark Dayton’s budget proposal for health and human services would improve access to vital services for some of Minnesota’s most vulnerable populations, including children, people with mental illness or disabilities, and the elderly. His proposal includes a net increase of $185 million over forecasted general fund expenditures for FY 2016-17.
MinnesotaCare. One problematic component of Dayton’s budget would increase the cost of health care for working Minnesotans getting health insurance through MinnesotaCare. The administration proposes increasing premiums and out-of-pocket costs to reduce MinnesotaCare expenditures by $65 million in FY 2016-17 and $87 million in FY 2018-19. These increased costs to the already-tight budgets of working families could force them to avoid needed care entirely. Given that the recent February forecast predicts a positive balance in the Health Care Access Fund, which funds MinnesotaCare, we urge the governor to drop this provision when he releases his updated budget proposal next week.
Mental Health. People dealing with mental illness are also at a higher risk for problems with physical health, homelessness and chemical dependency. Dayton’s budget has several initiatives that recognize the interconnected nature of these issues. Most emblematic of this approach may be an investment in behavioral health homes. Behavioral health homes provide comprehensive care to improve patients’ overall health outcomes while also reducing their use of more expensive services, like emergency rooms. Dayton targets $6.9 million in FY 2016-17 and $24 million in FY 2018-19 to behavioral health homes. Dayton also proposes $2.8 million in FY 2016 and $4.3 million annually starting in FY 2017 to increase access to housing and supportive services for families dealing with mental illnesses — some of which is in Dayton’s housing budget.
Some of Dayton’s other mental health proposals are more controversial. For example, Dayton’s budget would devote $26 million in FY 2016-17 and $38 million in FY 2018-19 to boost provider reimbursement rates and contract with private hospitals to increase the availability of services for chemical dependency and highly aggressive children. However, the funding increases are paired with proposals to shut down and cap services at state-run treatment sites. During hearings on the governor’s budget, advocates cited concerns that the expanded private sector services will not completely fill the gap left by the reduced public sites. This could mean that some Minnesotans would be left without the help they need.
Dental Care. Low-income Minnesota children are about three times as likely to have their tooth decay go untreated compared to other kids. Visits to the emergency room for non-traumatic dental work cost the state $148 million over a three-year period. Dayton’s budget would spend $10 million in FY 2016-17 and $17 million in FY 2018-19 to address these issues by increasing Medical Assistance dental rates, thereby increasing access to dental services for low-income Minnesota families.
Not all dental providers would be paid more under this plan. Currently, providers operating in areas where there aren’t many dental professionals receive a “critical access bonus” when they serve low-income patients. While Dayton’s proposal increases the base rate for dental services overall, it also decreases the critical access bonuses for Medical Assistance patients and community health clinics, and eliminates the bonus entirely for MinnesotaCare patients.
MNsure. Dayton’s budget includes $12 million in FY 2016-17 and $13 million in FY 2018-19 for continued improvements and maintenance for the MNsure information technology system. This will help Minnesota improve the technology that connects consumers, insurance providers and the public sector in the health insurance marketplace.
Food Assistance. The Minnesota Food Assistance Program helps low-income people over 50 who are ineligible for federal nutritional assistance pay for food. Dayton proposes increased funding of $246,000 in FY 2015, $1.1 million in FY 2016-17, and $1.9 million in FY 2018-19 to meet the administration’s projections for increased demand.
Housing and Supportive Services for People with Disabilities. Dayton’s budget includes $3.1 million in FY 2016-17 and $22 million in FY 2018-19 to better address the housing needs of Minnesotans with disabilities. The administration is also changing some of their supportive housing guidelines, aiming to continue providing access to group residential homes while also increasing the ability for people with disabilities to live in more affordable, community-based supportive housing.
When a family hits a rough patch due to illness, economic hardship, or just plain bad luck, public services can provide critical support. Dayton’s proposals recognize the complexity of the hurdles many of these families face.