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

By C.M. Swanson
Moose Lake Star-Gazette 

Estate lien battle moves to federal level as grass roots coalition presses on


January 11, 2018

Left side of table: Will Mitchell, Legislative Director for U.S. Congressman Rick Nolan; head of table: Rick Rayburn, grass roots coalition member; right side of table: Rick Olseen, Congressional Aide to Rick Nolan; and base of table: Jeff Anderson, District Director.

In his ongoing focus of changing health care laws at the federal level, on December 22, 2017, Finlayson resident Rick Rayburn met in Duluth with Will Mitchell, Legislative Director for U.S. Representative Rick Nolan (D-MN); Jeff Anderson, District Director; and Rick Olseen, Congressional Aide.

Rayburn presented two scenarios at the meeting. The first is removal of the state option to recover Medicaid services costs through estate liens, other than for long-term care. This option comes with substantial cost, due to billions of dollars currently being recovered by states engaging in estate recovery for general health care costs. Until December 2016, Minnesota had been one of those states.

The other, less preferred, scenario Rayburn presented at the meeting is to prevent retroactive recovery for Medicaid services prior to the start date of any new recovery policy (since the federal government still allows states to pick up that option).

In Minnesota, that includes the group of people for whom Rayburn and the grass roots coalition successfully fought to protect. At issue is the fact that, even though (as of December 2016) the Minnesota Department of Human Services (DHS) is currently prevented from placing claims on estates of 55- to 65-year-olds to recover healthcare costs paid by the state on their behalf, Rayburn noted that DHS continues to keep records of previous estate claim amounts of people who had been routed to Medical Assistance (MA) when they signed up for health care insurance via MNsure.

Also raising questions is bullet point three above the signature line of the 2017 MNsure application for health care stating, "If anyone on this application is eligible for Medical Assistance, I have read and understand that the state may claim repayment for the cost of medical care, or the cost of the premiums paid for care, from my estate or my spouse's estate."

"Why does it say that?" said Rayburn in an interview after the meeting. "Sure, Minnesota's current law doesn't allow for estate recovery but what does that statement on the application form imply?"

The coalition contacted Sen. Tony Lourey (D) originator of the Minnesota bill signed by Gov. Dayton, to voice their concerns. Sen. Lourey responded by writing a letter to Seema Verma, Administrator for the Centers for Medicare & Medicaid Services (CMS), and to the Minnesota Congressional Delegation. Dated September 1, 2017, the letter in support of a federal level change reads in part, "The impact of estate liens was particularly burdensome on Minnesota's farming community, where liens on family farms puts the long term livelihood of rural America at significant risk. The great benefit this provides to our communities is unquestionable, allowing greater financial stability and removing barriers from health insurance coverage."

Rayburn is also gaining support for the federal law change from a growing number of individuals and non-profit organizations including the Seven County Senior Federation, the Land Stewardship Project, and the Greater Minnesota Health Care Coalition (GMHCC).

However, the road to congressional action is a long, arduous journey. After Rayburn's December meeting, Congressman Nolan's office issued the statement, "A likely course of action is a draft bill, but we have not yet received a response from Legislative Counsel regarding our request."

Nonetheless, the tenacious Minnesota resident, and others with him, are on the trail. Rayburn strongly believes in the power of the individual. He urges all Americans to make their voices heard. In a letter to the editor of the Echoes newsletter, a publication of the Seven County Senior Federations, Rayburn writes, "As this issue breaks into the realm of Congress it is imperative that our Congressional Delegates hear loud and clear, that the U.S. can do better than estate seizures in lieu of health care. Please contact our Congressional Delegates to voice your concerns in support of this effort."

He then lists contact information for Sen. Amy Klobuchar: (201) 224-3244; Sen. Tina Smith: (202) 224-5642; and Congressman Rick Nolan: (202) 225-6211. The active grass roots coalition member also puts out a sincere invitation to those willing to make phone calls but are unsure of what to say.

"Any questions, please call your fellow member Rick Rayburn at (218) 565-1122."

The actions of Rayburn and the grass roots health care coalition have proven making change at the state level is possible. Now, they are on their way to a federal level change.

"Our politicians are there to do what we say," said Rayburn. "It is our responsibility as American citizens to make it clear to them what we want."


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