County gears up for increase in Medical Assistance casesIncome Maintenance Supervisor Patti Hart told commissioners that her department is bracing for the onset of an anticipated 1,068 new Medical Assistance (MA) cases when the federal government’s Affordable Care Act (ACA) takes effect Jan. 1, 2014.
By: Wendy Johnson, Pine Journal
Obamacare is about to hit Carlton County in a big way.
In a report to the Carlton County Board on Monday, Income Maintenance Supervisor Patti Hart told commissioners that her department is bracing for the onset of an anticipated 1,068 new Medical Assistance (MA) cases when the federal government’s Affordable Care Act (ACA) takes effect Jan. 1, 2014.
At that time, everyone in the state must have health insurance, with only a few minor exceptions, a change that will increase Medicaid enrollment in Minnesota by an estimated 95,000 people. The reason for the dramatic increase is that ACA expands the eligibility criteria for health care enrollees to include a broader base of people.
The Affordable Care Act, commonly called “Obamacare,” was signed into law by President Obama on March 23, 2010. Its goal is to increase the rate of health insurance coverage for Americans and reduce the overall costs of health care.
Hart said some 25 percent of the prospective new intakes are expected to apply as early as October in anticipation of the Jan. 1 start date — a number that would effectively double the county’s average for a single month. At that rate, she said, the county is going to require additional people in the department to interview applicants, determine eligibility, process their paperwork and track the overall process.
MA, Minnesota’s Medicaid program, helps cover the cost of health care for low income people through state and federal funding. Though the program is overseen by the Minnesota Department of Human Services, eligibility is administered by offices at the county level.
In order to handle the potentially explosive increase in workload in Carlton County, Hart requested the board approve the hiring of two additional financial eligibility specialists and an additional office support worker.
“Even at that,” said Hart, “I am being really conservative,” pointing out that St. Louis County has already hired 16 new staff members to handle the expected upswing in cases, with an eye toward an eventual total of 29.
Hart said Carlton County currently averages 250 MA intakes per month, and the existing 15 staff members in her department are falling behind with the work they already have, due in large part to an ever expanding caseload over the past 10 years. She pointed out that contributing factors to the county’s growing case counts include the declining economy, inflation, lack of jobs, unemployment benefits running out and the elimination of an asset test for the food support program (food support cases in the county rose 70 percent over the past five years).
“We have been struggling for a long time but haven’t added any staff members,” she said.
Carlton County has high MA case counts compared to other counties of its size, Hart said, pointing out that Morrison County currently has 2,938 cases compared to Carlton County’s 3,837.
Though commissioners were somewhat concerned about the extra expense involved with the new hires, they concurred the move was necessary and approved Hart’s request. Hart said that if the expected number of intakes doesn’t pan out as anticipated, the department would adjust its staffing numbers at that time.
Carlton County Health and Human Services Director Dave Lee explained to commissioners the county is currently reimbursed for 50 percent of the salary expense for a financial eligibility specialist. The state of Minnesota is currently applying for enhanced reimbursement from the federal government for the next two to three years, however, as the transition to ACA takes place. He said Health and Human Services is prepared to cover the extra cost out of its own fund balance if necessary.
“It could take as long as March or June of 2015 before we can see what impact this really has,” Hart concluded.