Medicaid Q & A

Medicaid/MA/Medical Assistance FAQ

For those of us who are somewhat confused about Medicaid/Medical Assistance, could you explain the basics of this program?

Medicaid is the single most important federal funding source for persons with disabilities.

Medicaid, called Medical Assistance in Minnesota, is a federal/state partnership in which federal funds match state spending, dollar for dollar. The state and federal government each pay 50 percent of the total state Medicaid costs. This makes it possible for Minnesota to improve services offered and to increase the number of persons covered. Our state has 96,000 persons with disabilities now eligible for Medicaid.

What kind of services does Medicaid cover?

The Medicaid program funds health care services such as doctor, hospital and clinic visits, as well as long-term or continuing care services such as the home and community based waivers.

Recent news reports suggest the Medicaid program as we know it might be in trouble. Why is that?

Medicaid has been under fire in Congress and at the state level due to the federal and state budget crises in recent years. In February 2006, President Bush signed into law the Deficit Reduction Act (DRA). The bill will fundamentally alter many aspects of the Medicaid program.

What changes could be in store for Minnesota?

The DRA eliminated federal protections, which prohibited states from charging premiums and co-payments beyond a nominal amount for Medicaid. States can decide to charge those above 100 percent of the poverty level up to limits set in the DRA. Minnesotans with disabilities have already experienced significant problems with co-payments and any increased cost sharing would only serve to limit needed medical care.

Could my current Medicaid/MA benefits change?

States can change the Medicaid benefit set (the list of health services covered) to several different benefit sets for different groups. The new “slimmed down” benefit set option does not apply to persons eligible for Medicaid due to a disability. However, many people, especially low-income children, do not qualify as a disabled, yet need specialty care for their conditions in order to maximize their functioning and avoid deterioration. Such children with disabilities could be forced to apply for another benefit set (under another federal provision, Early Periodic Screening Diagnostic and Treatment or EPSDT) and lose precious treatment time or get lost in the bureaucratic process. In essence, children with disabilities and special health care needs will have to traverse two systems of health care, making it more difficult to access medically-necessary services and further fragmenting health services for children with disabilities.

Could Congress cut funding to Medicaid again in the future?

Yes. Medicaid could again this year face cuts in Congress due to continuing significant federal budget problems, which again, could impact Minnesota.

Why is it important to learn more about this issue?

Medicaid is the main source of funding for health care and community supports for persons with disabilities. To participate in our state’s decisions on the DRA options, it is crucial to understand the facts in order to explain its importance and to garner support for funding the program.

There are many challenges and decisions ahead for Medicaid at both the state and federal levels. Involvement of those affected to educate elected officials is essential for the future of this most significant program.