Let's have a full debate on Medicaid costs, changes

  • Article by: EDITORIAL BOARD , Star Tribune
  • Updated: January 2, 2014 - 6:34 PM

Sensible delay on Medicaid changes should spur broader debate.

Gov. Mark Dayton made a compassionate and politically savvy decision this week when he asked state officials to delay for a year cost-saving changes that would have phased in reduced home and nursing care for about 3,300 Minnesotans in 2014.

Hitting pause on the rollout during this election year gives the state time to ensure that a new but not-quite-ready state program to deliver limited supports for those affected “has time to be fully automated and available statewide,’’ Department of Human Services Commissioner Lucinda Jesson said in a Dec. 31 memo. It also gives the 2014 Legislature time to reconsider the long-delayed changes — expected to save about $50 million over the next four years — that were passed with bipartisan support in 2009 as legislators and then-Gov. Tim Pawlenty grappled with sobering budget deficits and soaring Medicaid costs.

Medicaid covers care for the poor, the disabled and elderly, and it’s funded jointly by the state and federal governments. Substantial Medicaid spending covers long-term care for low-income seniors without resources.

The recent outcry over the changes from powerful advocates for seniors puts pressure on lawmakers to reverse them. But the debate needs to go beyond the argument that the changes are no longer necessary because the state is in better financial shape. Medicaid spending in Minnesota rose to $8.2 billion in 2012, up 74 percent from 2003. That’s not sustainable.

The care eligibility changes protect those most in need of assistance. Seniors generally must now show they need help with four or more activities vs. one. The state also developed and expanded the new limited community support program as a cushion. Derided by some as “cuts,” the changes in reality are an example of “reform.” If this isn’t doable, what reform will be?

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