The American Health Care Act would have "dire consequences" for 100,000 Minnesotans, the state's human services commissioner has warned. A key affected population would be those on MinnesotaCare's subsidized health plans, which assist low-income residents.
The controversial healthcare bill that passed the U.S. House last week features significant cuts to U.S. Medicaid programs after 2020. The government would implement a cap on federal funding, giving states set amounts based on their populations.
This potentially means the end of funding for Basic Health Programs set up through the Affordable Care Act, which sees federal cash used to subsidize the cost of health insurance for people on low incomes who don't quite qualify for Medicaid.
Just two states have these Basic Health Programs: New York and Minnesota. Here it's known as MinnesotaCare.
Minnesota Department of Human Services Commissioner Emily Piper was frank about the impact the cuts could have.
Piper told GoMN that the bill "would take us backward by removing protections for consumers and by cutting health care to seniors, children, and people with disabilities, in addition to cutting federal funding to our state by over $2.5 billion in the first 18 months of the bill becoming law."
She continued: "This bill, should it become law, would have dire consequences to Minnesotans, our health and our state budget."
How would MinnesotaCare be affected?
Now bear with us here because this is kind of confusing.
Prior to the Affordable Care Act (aka Obamacare), MinnesotaCare helped pay for health coverage for those earning too much to qualify for Medicaid, but not enough to afford private health insurance.
The Medicaid waiver program was 50 percent funded by the federal government, and the rest by patient premiums and a tax on healthcare providers.
Obamacare established Basic Health Programs – utilized in Minnesota and New York – to allow states to continue and expand the services through this coverage, and MinnesotaCare was absorbed into that program.
A reported 85-95 percent of MinnesotaCare funding comes from the federal government, enabling the state to lower premiums and improve coverage for eligible low-income residents.
The DHS says the AHCA bill voted on last week does not provide a mechanism for the federal funding for Basic Health Programs like MinnesotaCare to continue, although it does not contain an outright repeal of the programs like the earlier version that never made it to a vote.
If the bill were to pass in its current form, funding for MinnesotaCare would disappear, with Minnesota having to find $500 million to continue it.
The DHS says this would be extremely difficult, considering another AHCA provision: "drastic cuts" to Medicaid, which it expects will reduce by $2.5 billion in just 18 months from 2020.
"This bill cap would, as of Jan. 1, 2020, leave Minnesota with no federal resources to support coverage for the more than 100,000 individuals on MinnesotaCare," Piper's office told GoMN.
That said, while the AHCA bill has passed the House it has not passed the U.S. Senate. Senators are expected to make significant changes to the plan before putting it to a vote.
How does MinnesotaCare work?
To qualify for MinnesotaCare, you need to have an income between 133 and 200 percent of the federal poverty level, which is currently $16,039-$23,760 for a household of one and $32,718-$48,600 for a family of four.
For under-21s and pregnant women, MinnesotaCare covers a wide range of medical services, including doctor and clinic visits, ER care, immunizations, mental health care, outpatient surgery, maternity care and rehabilitative therapy.
For parents, caretakers, and adults without children, the coverage is the mostly the same except they have copays and deductibles. Some things aren't covered, such as dental care, non-emergency medical transportation, nursing home care and orthodontic services.