Medicaid expansion passes Senate, goes to Dayton

Minnesota is about to expand federal health care coverage to thousands of people living on the brink of poverty.

The Minnesota Senate voted 45-22 Thursday to take the federal government up on its offer to cover the multimillion-dollar cost of moving 35,000 people out of state-based health care and into Medicaid, known in Minnesota as Medical Assistance.

The legislation now moves to Gov. Mark Dayton, who is expected to sign it into law within days.

The expansion will affect childless adults earning less than $15,414 a year. The state also will move thousands more people out of the state-subsidized MinnesotaCare program into the federal health care program, which offers more generous benefits. In the end, the legislation will affect more than 80,000 people and save the state $129 million over the next two years and more in years to come.

Six Republicans joined with the entire DFL majority to support the bill.

Medicaid expansion is an optional provision of the Obama administration's health care reforms. For states that opt in, the federal government will fully fund the initial cost of moving low-income childless adults into subsidized federal health care coverage, then fund 90 percent of the coverage from then on.

Sen. Kathy Sheran, DFL-Mankato, called the expansion an opportunity to help those in need while taking advantage of federal funds. She and other supporters said the move provides health insurance to people who are ringing up costs anyway. When those uninsured people get sick now, they often head to hospital emergency rooms that can't turn away patients but have little chance of collecting payment.

But critics say that if federal funding dries up in the future, states would be left to cover the multimillion-dollar cost of the program. Said Senate Minority Leader David Hann during Thursday's floor debate: "There are some of us who are not in a trusting mood."

Most states with Democratic governors are moving toward Medicaid expansion and the millions in savings that go with it.

A number of Republican governors have signaled support for expansion, as well, including the governors of Arizona, Michigan, North Dakota and Ohio.

But earlier this week, Republican governors Scott Walker of Wisconsin and Mike Pence of Indiana rejected Medicaid expansion. Walker announced an alternative plan that would bring some childless adults into the state's Medicaid system while moving thousands of other low-income residents into the federal health insurance exchange program.

The new coverage in Minnesota would begin in January.