Affordable Care Act ripples to hit county

by Paul Rignell

Contributing writer

President Obama signed the Affordable Care Act three years ago, and Minnesota’s own legislators have worked on a state-level health insurance exchange bill this session in time for implementation next year, but the public ripples will not end in St. Paul.

The Sherburne County Board on March 12 heard from Ken Ebel, director of Health and Human Services, and Gina Anderson, financial assistance supervisor for the department’s Income Maintenance division, on what commissioners may want to consider in budgeting for 2014.

“At this point, it’s becoming clearer and clearer that counties are going to carry the burden,” Ebel said.

With the federal law that will require all persons to be on health insurance plans, counties will find more citizens qualifying for Medical Assistance next year. Anderson said that group could include an unnamed 30-year-old single male, for example, who would not be considered now.

Each new assistance client would mean an additional case file for the county, and Anderson shared an estimate that the county could see 2,200 new names for cases. More than half, or about 1,200, of those potential clients are now on MinnesotaCare and “almost certain” to join the county rolls, Anderson said. She and Ebel advised the County Board there could be a need to hire an additional seven to nine eligibility specialists when the changes are planned to happen next year, and such growth would more than double that unit of workers.

County Commissioner Felix Schmiesing said he figured each new position would carry an extra $60,000 to $70,000 in annual payroll costs, with benefits. Ebel replied that the impact would be slightly less per hire, for a total of $50,000 to $55,000 per position.

The county manages only around 1,500 cases now, with four eligibility specialists each tracking 275 clients. A fifth person, a telecommuter from whom more is required, follows 400 cases, Anderson explained.

Ebel said the federal government would begin by paying half of new associated costs, leaving counties to work the rest into their levies.

“The state should put in some money, but they do not,” he said.

Schmiesing offered a sentiment spoken by many since the bill was passed in Washington: “We were much better off before anyone read the bill,” he said.