With 10 months left as governor, Tim Walz wants to pitch bold ideas whatever the political consequences.<\/p>\n
How else to explain a news conference Tuesday in which Walz proposed to completely reorder the state\u2019s Medicaid program that furnishes health care for disabled, elderly and low-income Minnesotans.<\/p>\n
It is a plan that would add hundreds of state government jobs, while leading to untold job losses in counties and among nonprofit health insurers. The proposal would also shift the day-to-day lives of people enrolled in Medicaid and health care providers.<\/p>\n
\u201cI think without the major structural changes you\u2019re going to find yourself chasing your tail on some of these things continuing forward,\u201d said the governor, who proceeded to compare the health care program for around 20% of Minnesotans to \u201ca bit of a Frankenstein\u2019s monster that you keep putting bolts onto the side of.\u201d<\/p>\n
But the Legislature may ignore Walz here.\u00a0<\/p>\n
Related: Old IT systems that determine Medicaid eligibility, among other things, may contribute to social services fraud<\/a><\/p>\n \u201cThis proposal as described by the governor has no future as far as I can tell in the Minnesota state legislature,\u201d said Paul Torkelson, R-Haska and co-chair of the House Ways and Means Committee.<\/p>\n As of Tuesday afternoon, no DFL lawmaker had gone on record to defend the governor\u2019s proposal.\u00a0<\/p>\n In fact, Sen. John Hoffman, DFL-Champlin and chair of the Senate Human Services Committee, stated that he was \u201cdisappointed to learn about this proposal just last night without a thorough conversation with the committee that has primary jurisdiction over Minnesota\u2019s human services system.\u201d<\/p>\n A rundown of the governor\u2019s proposal and how it fits into Medicaid fraud.\u00a0<\/p>\n What does Walz want?<\/p>\n Walz seeks to erase the nonprofit insurers known as managed care organizations that have ruled Minnesota Medicaid since the 1980s<\/a>.\u00a0<\/p>\n Currently, 80% of the state\u2019s Medicaid enrollees find health care providers via several different managed care organizations<\/a> like Blue Plus and Hennepin Health. Doctors and clinics bill these managed core groups, and these groups, in turn, get payments from the Minnesota Department of Human Services<\/p>\n Under the governor\u2019s plan, the Department of Human Services would directly reimburse providers who care for Medicaid patients.\u00a0<\/p>\n The governor repeatedly said that Minnesota should follow Connecticut, which got rid of its own version of managed care organizations in 2012.<\/p>\n Forty-two other states (including Minnesota) have some type of managed care groups, according to health policy research group KFF<\/a>.<\/p>\n Moreover, the governor wants Minnesota\u2019s 87 counties out of the business of determining who is eligible for Medicaid<\/a>. DHS would take on that roll as well.\u00a0<\/p>\n Minnesota is just one of 10 states that lets counties run eligibility.\u00a0<\/p>\n Related: Minnesota sues to block Trump administration\u2019s withholding of Medicaid funds<\/a><\/p>\n Counties have repeatedly lamented their burden in administering Medicaid. But the lion\u2019s share of their complaints concern outdated computer systems<\/a> used to determine eligibility, not performing the task itself.\u00a0<\/p>\n At the news conference, Walz repeatedly mentioned revamping Medicaid IT. But neither the governor nor the Legislature have a firm proposal on this subject.\u00a0<\/p>\n Julie Ring, executive director for the Association of Minnesota Counties, emailed Tuesday that she needs to learn more before opining too much on Walz\u2019s proposal.\u00a0<\/p>\n Ring said she did support Walz calling to \u201cdedicate funding for a study to provide future recommendations\u201d on how to administer human services programs.\u00a0<\/p>\n How is this a step to fighting fraud?<\/p>\n Thanks to fraud allegations, Medicaid went from a point of pride for Walz to (arguably) ending the governor\u2019s career in state politics<\/a>.\u00a0<\/p>\n But the nexus between fraud and this proposal is unclear.<\/p>\n Rep. Kristin Robbins, R-Maple Grove, noted that managed core organizations have their own internal auditors and that there would appear to be less fraud among these insurers compared with providers directly reimbursed by DHS.\u00a0<\/p>\n