By Bethany Helwig
Moose Lake Star-Gazette 

Medicaid revision at federal level at stand still

 

September 5, 2019



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), Minnesota’s version of Medicaid, 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.

Local residents Rick and Rose Rayburn, Scott and Ellen Killerud, Robert and Julie Gelle, along with others of their grassroots coalition, successfully helped bill SF 216 be signed into Minnesota law, ending the state’s practice of placing estate claims on estates of people receiving MA for general health care premiums and costs paid on their behalf.

Rayburn and the small group set their sights on the next challenge—changing the law at the federal level. After talks with legislators, Representative Rick Nolan (D-MN) eventually introduced bill H.R. 6549, the Medicaid Estate Recovery Fairness Act which was introduced on July 26, 2018. The bill was “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).”


However, after its introduction, the bill was apparently abandoned with no further action to promote or sponsor it.

Rayburn has attempted to keep the bill in motion, contacting Senator Amy Klobuchar and Representative Pete Stauber in attempts to have one of them reintroduce a similar bill. While Representative Stauber stated he would keep Rayburn’s thoughts in mind if someone else introduced the bill, Senator Klobuchar was waiting for someone in the House to introduce the bill first. In other words, they would act only if someone else would first.

While there is no movement currently at the federal level, the issue continues to concern and distress those the clawback affects. The Seven County Senior Federation recently had their annual meeting where they discussed the top 28 issues in Minnesota, and Medicaid estate recovery was rated as the number five top concern.

“I was recently asked to speak at a ladies senior group meeting, as several of the women in this group are facing the loss of their homes when they pass away due to Medicaid estate recovery,” said Rayburn.

Rayburn isn’t alone in his crusade to change the laws surrounding Medicaid. “I’m also in contact with a woman in Iowa and several people in Massachusetts that are trying to remove their Medicaid clawback laws.”

Another issue the group is hoping to address is the time limit for record retention of medical expense histories. Even with the most recent law passed concerning recovery in Minnesota, unless the change is made at the federal level as well, those records could still be used to reclaim from estates in the future. Removing those records from the equation could alleviate the worry of recovery down the road.

“With those histories gone, there will be nothing for the Department of Human Services to reclaim in the future,” said Rayburn. He spoke with Senator Jason Rarick about this concern and was notified that Senator Rarick and Representative Nathan Nelson were working on bill language to address it at the upcoming Minnesota legislative session.

“Resistance to the Medicaid estate recovery problem locally and nationwide still has a strong undercurrent and now as before needs public awareness and involvement for anything positive to happen,” said Rayburn.

 

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