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MA-EPD

MA-EPD. MEDICAL ASSISTANCE FOR EMPLOYED PERSONS WITH DISABILITIES MINNESOTA’S MEDICAID BUY-IN. CHIEF AUTHORS . Senator Linda Berglin, Democrat Minneapolis, Minnesota (651) 296-4261 sen.linda.berglin@leg.state.mn.us Representative Kevin Goodno, Republican Moorhead, Minnesota

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MA-EPD

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  1. MA-EPD MEDICAL ASSISTANCE FOR EMPLOYED PERSONS WITH DISABILITIES MINNESOTA’S MEDICAID BUY-IN

  2. CHIEF AUTHORS Senator Linda Berglin, Democrat Minneapolis, Minnesota (651) 296-4261 sen.linda.berglin@leg.state.mn.us Representative Kevin Goodno, Republican Moorhead, Minnesota (651) 296-5515 rep.kevin.goodno@leg.state.mn.us

  3. POLICY OBJECTIVE To support the well-being and economic self-sufficiency of persons with disabilities by assuring continued access to Medicaid for necessary health care services when they work.

  4. PROGRAM INTENT MA-EPD is intended to encourage persons with disabilities to work and enjoy the financial benefits of being employed. It also allows more people with disabilities to become taxpayers and reduce their dependence on a variety of government programs.

  5. ELIGIBILITY • Employed • Have a disability • Ages 16 to 64

  6. DEFINITION OF EMPLOYED • May work either part-time or full-time • May be self-employed • Must have some income from employment every 30 days

  7. DEFINITION OF DISABILITY • Receive Social Security benefits due to a disability Or • Certified by State Medical Review Team

  8. ASSETS • Up to $20,000 in assets • Any amount in a retirement account or medical expense account • Usual MA exclusions – home, vehicle, personal belongings

  9. HOWEVER… • If you stop working, regular MA asset rules would again apply ($3,000, including any money in retirement accounts)

  10. PREMIUM • No cost for MA-EPD if combined earned and unearned income is less than 200% of federal poverty guidelines • Premium of 10% of income above 200% of federal poverty guidelines

  11. 200% FPG Family Size Monthly Standard 1 $1,392 2 $1,875 3 $2,359 4 $2,842 5 $3,325 Additional $484

  12. OTHER HEALTH INSURANCE • MA pays the premium for other health insurance if determined cost effective. (Individual only pays MA-EPD premium.)

  13. MARRIAGE • Spouse’s income or assets are not counted. • If you stop working and need to return to regular MA, spouse’s income and assets would be counted in most cases. • If spouse receives SSI, their SSI benefits are affected by your work.

  14. REMEMBER... • No other rules have changed • If you go to work or begin working more, you need to consider how that will affect other benefits you receive such as Social Security, Food Stamps, subsidized housing, etc.

  15. For More Information… Contact: Karen Gibson, Health Care Consultant MN Dept. of Human Services (651) 296-1281 karen.gibson@state.mn.us

  16. QUESTIONS & ANSWERS Why is the Medicaid Buy-in important to you and your State?

  17. Q.1. Priorities & Concerns • Allow people with disabilities to become employed without fear of losing comprehensive, affordable health coverage. • Justify savings & costs for the program. • Fairness: SSI 1619(b) vs. SSDI

  18. Q.2. How Would Cost Estimates Have Been Done Differently • Should have anticipated higher enrollment. • Estimate of additional MA enrollees was accurate. • Must allow program time to realize savings.

  19. Q.3. Theory vs. Reality • Enrollment beyond expectations. • Difficult to define “Employment”

  20. Q.4. What would we have done differently • Freeze assets if people have to stop working so they don’t lose what they have saved while working.

  21. Q.5. How did we involve PWD in design of program? • Survey of Health Care Barriers to Employment • Allowed PWD to testify about previous disincentives. • PWD closely worked with Dept. of Human Services and Legislature.

  22. Q.6. Integrated with other State programs? • Vocational Rehabilitation integrated with One-Stop WorkForce Centers. • Minnesota Work Incentives Connection – Benefits, Planning, Assistance and Outreach

  23. Q.7. Who Conducts Outreach • Minnesota Dept. of Human Services • Minnesota Work Incentives Connection • Disability Advocates

  24. Q.8. Evaluation • MN Dept. of Human Services • Monthly enrollment statistics • Demographics • Premium breakouts • Gross monthly earnings • Recognize that more evaluation is needed to determine true impact…

  25. Q.9. Infrastructure Grants • Comprehensive study on cost savings. - Increased employment levels - Reduced health care costs - Reduced dependency on other programs i.e., Social Security, Food Stamps, Subsidized Housing - Increased access to third party coverage - Increased tax payments (Federal & State) • Added support to link PWD to necessary resources to ensure successful employment.

  26. Q.10. Advice to other States • Allow time before drawing conclusions. • Involve all stakeholders. • Invest in a comprehensive evaluation to thoroughly analyze all cost savings.

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