Moose Lake Star Gazette - Serving Carlton and Pine Counties Since 1895

By C.M. Swanson
Moose Lake Star-Gazette 

No rest for health care coalition

Health care recovery via estate claims still active at federal level


November 16, 2017

C.M. Swanson

Grass roots coalition member Rick Rayburn amassed a multitude of research on the estate claim issue during his campaign to change Minnesota law. Having succeeded there, the coalition is now focused on change at the federal level.

Minnesota resident Rick Rayburn lives the creed "Power to the People." In early 2017, Rayburn and a grass roots coalition, formed to fight the state legislature, celebrated a victory for those 55 to 65 years old unknowingly shuttled to a state sponsored healthcare plan resulting in claims against their personal property for healthcare costs paid on their behalf.

In 2014, thousands of Minnesotans signed up for healthcare through the MNsure website, only to be surreptitiously routed to the Minnesota Department of Human Services' (DHS) Medical Assistance (MA) program. The state paid premiums and general healthcare costs on behalf of MA recipients, then placed claims on their estates to recover costs, an option made possible with the expansion of the Affordable Care Act.

For well over a year, Rayburn and a core group, including Scott and Ellen Killerud, Robert and Julie Gelle, and Claudia Foussard, disseminated information through newspapers, social media, word of mouth and even postings in a local laundromat resulting in formation of a grass roots coalition that successfully lobbied for change through the Minnesota State Legislature.

In the spring of 2016, Sen.Tony Lourey (DFL) responded to the coalition's campaign by authoring a bill to discontinue the state's cost recovery policy for the targeted age group. Representatives Jason Rarick (R) and Matt Dean (R) authored a similar bill in the House. The bill passed the House and Senate, was placed in an Omnibus Supplemental Budget Bill and signed into law by Gov. Mark Dayton (DFL) on June 1, 2016, contingent upon federal approval by CMS, which occurred in December of that year.

However, victory did not lie easy on some members of the coalition. Having experienced the congressional paperwork shuffle for over 13 months, the core group said they would not rest easy until each had a legal document stating their estate claims were expunged from the records.

Rayburn has since discovered no such document will be forthcoming as the federal government still provides the option for individual states to engage in estate recovery programs to cover costs of healthcare paid by that state on behalf of recipients.

"The fact is, all the claim amounts that have been placed against everyone who was on Medicaid can be reinstated in the future," said Rayburn. "No one will give us a clean slate. We talked to the Department of Human Services and were told if Minnesota did pick up the lien clause again, which the federal option allows, that, yes, in fact, our claims would be reactivated. No questions about it. That was kind of disappointing."

"I feel it is a travesty, the way healthcare has become," said coalition member Foussard. "The working poor across America are pulling the weight for the country in estate liens."

Other core members of the coalition expressed similar thoughts.

"Yes, it's a win," said Julie Gelle of the victory in Minnesota, "but good isn't good enough anymore. We have to pursue the removal of the estate claim at the federal level."

With the coalition's backing, Rayburn continued his communication with Sen. Lourey, which resulted in a letter from Sen. Lourey and Sen. Scott Jensen (R) to Sen. Amy Klobuchar, Sen.Al Franken, the eight representatives of the Minnesota Congressional Delegation, and CMS Administrator Seema Verma.

The letter reads, in part, "As state legislators we are writing to share Minnesota's experience regarding Medicaid estate recovery and encourage federal action to eliminate estate recovery in most circumstances. In 2016 the Minnesota State Legislature amended Minnesota Statutes, section 256B.15 to change the law regarding Medicaid estate recovery and liens and the Center for Medicare & Medicaid Services (CMS) approved the corresponding state amendment ... The great benefit this provides to our communities is unquestionable, allowing greater financial stability and removing barriers from health insurance coverage."

Minnesota is not the only state to voice objections to Medicaid's estate recovery program. In an October 26 article entitled "Trump health official Seema Verma has a plan to slash Medical rolls" (, Casey Ross, National Hospitals Correspondent, states, "[CMS Administrator Seema] Verma's belief that the expansion of Medicaid under the Affordable Care Act was a disastrous move that extended coverage to millions of low-income people who shouldn't be getting insurance from the government."

"Look," said Rayburn. "I'm not trying to make a bad time for anybody. I just think this is not the way this country is supposed to run. If you want to take care of people's health, then give people the opportunity to pay a reasonable rate for insurance."

Among the many challenges in how to deliver healthcare at reasonable costs is the sheer number of people and organizations involved. Blame continually shifts between patients, medical staff, hospital administrators, insurance providers, HMOs, pharmaceutical companies, medical device manufacturers and entities in state and federal government.

"To me, it's pretty simple," said Rayburn. "Some kind of single payer system would be much better. This is the fix. You reign in these unbridled profits for all the healthcare industry, everything. People deserve to get paid for what they are doing, but what is reasonable profit? That is what you have to ask yourself."

The coalition thinks the power of change is in the hands of individuals. However, that takes getting involved.

"As of July 1, 2017, because of what the people in Minnesota did by voicing their displeasure, they have saved Minnesotans, in this one year, $2.45 million dollars in recoveries that would have occurred to unsuspecting people," said Rayburn. "That's what this accomplished. I think people need to understand that their voices will make a difference, but they have to speak up."

Coalition member Julie Gelle also encourages individuals to fight the healthcare cost recovery through estate claim's process at a federal level.

"No experience needed," said Gelle. "We welcome you to voice your anger, fears and concerns if you want to help make a difference in the lives of people who were so wronged and make it right."


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