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

By C.M. Swanson
Moose Lake Star-Gazette 

Finlayson resident focuses on federal level change


August 23, 2018

C.M. Swanson

From 2013 to 2017, Minnesotans aged 55 to 64 signing up for health insurance under the expanded version of the Affordable Care Act (ACA) through MNsure were sometimes met with an unwelcome surprise. If applicants met certain state income guidelines, they were routed, often unknowingly, to Medical Assistance (MA) resulting in the state placing a claim on the enrollee's personal estate for medical costs paid on their behalf. Upon the demise of the recipient, the claim became a lien with which surviving members of the recipient's family had to contend.

In the latter half of 2015, Finlayson Minnesota residents Rick and Rose Rayburn discovered a $30,000 claim against their estate under just those circumstances. It was an incensed Rick Rayburn, and a core group of people who found themselves in the same situation, who formed a grass roots coalition to change that cost recovery policy in Minnesota.

After a two-year battle, which included Rayburn and other members of the coalition testifying in Minnesota legislative sessions, in May 2017, Governor Mark Dayton (DFL) signed bill SF 216 into law, ending Minnesota's practice of placing estate claims on the estates of people receiving MA for general health care premiums and costs paid on their behalf.

Though it was a victory for the coalition on a state level, Rayburn learned the federal government retains the power to mandate present and past medical cost recovery in any of the United States, including Minnesota.

"The Department of Human Services was not able to give out any documents showing Minnesotan's estates were clear of recovery for these services," said Rayburn. "If Minnesota were to reenact the recovery law, it would go retroactive, and all of our estates would be at risk."

Another red flag popped up for Rayburn when he read the 2017 MNsure Application for Health Coverage and Help Paying Costs. On page 19, a bullet point above the signature line reads, "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."

Though Minnesota does not currently have a cost recovery policy, Rayburn is not confident the law will remain in effect.

"If you sign up for Medicaid," said Rayburn, "you better be aware and prepared to possibly pay back the amount they pay on your behalf. They don't even specify age on the application now. When you're signing that (application), it doesn't matter what the state is doing right now. You're giving them permission to recover costs at any time in the future."

Armed with this knowledge, Rayburn directed his focus to change the law at the federal level. He registered as a member of District 11 B Democratic Party and began to attend caucuses and conventions.

"I don't agree with everything the Democratic party does," said Rayburn, "but I realized in order to fix something you might have to get into the workings of it. I decided the Affordable Care Act was the key to this thing. I figure it should be fixed from within the Democratic party."

December 22, 2017, 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 to voice his concerns. Over the course of the next several months, during follow up calls, Rayburn learned a bill was being drafted to address the issue.

July 26, 2018, U.S. Representative Rick Nolan introduced bill H.R. 6549, the Medicaid Estate Recovery Fairness Act of 2018. The accompanying press release stated Nolan's bill would, "codify the Minnesota estate recovery model into federal law and is aimed at protecting the estates of some individuals who were newly eligible for Medicaid benefits under the Medicaid expansion provisions of the Affordable Care Act (Obama Care)."

The press release went on to say the law was intended to "effectively cancel any pending estate recovery claims for any previously enrolled newly eligible individuals."

"I give Nolan a lot of credit," said Rayburn. "When you're a Democrat and the Affordable Care Act is the source of the problem, coming forward and owning up to the problem and offering a solution, you can't do much better than that. So, hats off to Representative Nolan and his team."

The road to change at the federal level is long, but Rayburn said he intends to support Nolan's bill, even to the point of complying with the suggestion of contacting congressional representatives of other states to garner support for H.R. 6549.

"It's kind of a daunting task to call these congressmen, explain I'm from Minnesota, that I've made a presentation to Representative Nolan, that a bill has been introduced, and what is your position on this bill?" said Rayburn, "but I'm just going on with it until there is nowhere else to go."

Back in 2015, Rick Rayburn was perfectly content to enjoy a simplified life living in a house he built himself in rural Minnesota, choosing kerosene lanterns over electricity, a hand pump from a drilled well over indoor plumbing, a wood stove over a gas furnace, and traveling to Minneapolis every other week to drive truck so he could devote the other two weeks a month to planting, growing and harvesting crops, and maintaining his property. Since then, he has become a self-described, "citizen activist" who was not satisfied with changing a state law he felt unjust, but like David after Goliath, is willing to face his federal government to pursue a righteous cause.

"It's going to be a tough one to get this thing through," said Rayburn. "I think we've set a precedent in Minnesota. I think we have proven beyond a shadow of a doubt that this is a national issue that needs national attention.

"This bill is the canary in the coal mine for ethics because if this bill gets ignored, then I think it's going to show if Congress can get away with it, they will. If this bill gets addressed, I think we will be able to feel good about our representation in our government. That is what I truly believe. We'll see."


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