Letter to Secretary Burwell - Urging the Administration to Allow Minnesota to Continue to Use State's Medicaid Home and Community-based Services Policy

Letter

We respectfully request that you address an important issue in order to prevent Minnesotans with disabilities from losing access to Medicaid home and community-based services. Starting June 1, 2016, Minnesota will be forced to comply with federal spousal impoverishment requirements that are less favorable than the state's current policy. We urge the Department of Health and Human Services (HHS) to allow Minnesota to continue to use the state's long-established policy.

Spousal impoverishment rules are used to determine financial eligibility for married couples when one spouse is applying for coverage of Medicaid long-term-care services. These federal rules determine the amount of a married couple's assets that they may keep while enabling the spouse to receive Medicaid home and community-based services. Any assets in excess of this amount that are held by married couples must be spent prior to eligibility. Minnesota currently applies different spousal impoverishment rules for younger, working-age families who may have children at home but are affected by a catastrophic health event or a progressive, degenerative disease. These rules allow the individual with a disability to receive long-term care in their own home or community but enable the family to keep their assets so that they can save for their children's education and pay for their home.

Section 2404 of the Affordable Care Act (P.L. 111-148) sought to establish spousal impoverishment rules in states that did not have financial protections in place for people receiving home and community-based services. The financial eligibility criteria in Section 2404 is stricter than Minnesota's policy, and as a result, the Centers for Medicare and Medicaid Services is requiring that Minnesota impose a lower asset criteria for families receiving home and community-based services starting June 1. If Minnesota is forced to comply with these more restrictive requirements under Section 2404, the state estimates that up to 480 families of the total 2,800 affected, would be forced to choose between losing their Medicaid coverage, losing their hard-earned savings, or obtaining an unwanted divorce. No family should be forced to make these incredibly difficult choices, especially those who are already faced with a disabling medical condition.

Congress did not intend for Section 2404 to restrict existing access to vital health services for these families. In order to remedy this problem, last week, members of the Minnesota congressional delegation introduced the Protecting Families with Disabilities Act of 2016. The bill would enable Minnesota to continue providing services to working-age families under its existing spousal impoverishment requirements without imposing the stricter federal rules. While Congress considers the Protecting Families with Disabilities Act of 2016, we urge you to act to prevent Minnesotans from losing access to critical home health services.

Thank you for your attention and we look forward to working with you to resolve this important issue.