Initial Medicaid Implementation: Prior to the implementation of the Medicaid program, Minnesota ran a Kerr-Mills program that together with 4 other states took nearly 2/3rds of the funds for the nationwide program. The program unlike many other states provided comprehensive medical benefits. Minnesota initially began its Medicaid program in January of 1966, the first opportunity that the state had to implement Medicaid. When the program began it was estimated that 5% of the population was eligible for Medicaid. Again, the benefits offered were comprehensive with Minnesota being one of five states to offer all services to which the federal government would reimburse.
Key Medicaid Political Issues: Minnesota has made several efforts to integrate delivery system reforms and efforts to integrate social determinants of health into their Medicaid program. In 1983 the state began a program named PMAP that provided payments to HMOs particularly for rural areas. These nonprofit HMOs provided health care services to low-income residents at higher eligibility rates than the national average under the Medicaid program prior to the expansion of coverage. Today, approximately 750,000 Minnesota residents receive services through the PMAP program. Minnesota has generous optional benefits available to all residents including coverage of doula services and vision and dental benefits that are more generously available.
Medicaid Expansion Implementation: Minnesota expanded Medicaid with coverage beginning on January 1st, 2014 and enrollment beginning in October of 2013. Minnesota ran their own exchange which made integration with their Medicaid program more seamless than states that used the federal infrastructure. The state runs a Basic Health Program which provides an insurance option to people making under 200% FPL. The Governor proposed a plan that would add a Medicaid Buy In program to the state’s Medicaid expansion and basic health programs. The program did not gain traction in the legislature. In 2018 members of the Minnesota legislature proposed adding work requirements for the expansion population, however that proposal did not gain traction in the legislature.
General facts about Minnesota Medicaid:
Medicaid program name: Medical Assistance (Medicaid)
CHIP Program name: MinnesotaCare
Separate or combined CHIP: Combination
Medicaid Enrollment: 1.07 million
Total Medicaid Spending: $11.5 billion (FY2017 estimate)
Share of total population covered by Medicaid: 14%
Share of Children covered by Medicaid: 25% (estimate)
Share of Medicaid that is Children and Adults: 80%
Share of Spending on Elderly and people with disabilities: 58%
Share of Nursing Facility Residents covered by Medicaid: 50%
Expansion state: Yes
Number of people in expansion: 223,000 (2018)
Work Requirement: No