MMLA's Project Care on the Effects of Medicaid "Unwinding"

In the latest issue of Minnesota Medicine, the frustration, fear, and anger resulting from “Medicaid unwinding” is discussed with Ralonda Mason, supervising attorney at the Saint Cloud office of Mid-Minnesota Legal Aid (MMLA). Along with others, Mason explains the complicated process of eligibility determinations and the toll on clients who were mistakenly denied coverage.

In response to the Covid-19 global pandemic, there was a massive increase in eligibility for the Medicaid program, which Mason explained was done for a very important reason. Many Americans would have otherwise lost healthcare coverage completely when employers needed to lay off staff or shut down completely and these people were suddenly eligible for Medicaid. “While we were struggling through an unprecedented health emergency in this country, having people lose coverage and access to healthcare would’ve been horrible for all of us.” Mason said.

But while experts in the field knew that eventually the expanded eligibility and coverage would end with the pandemic, many people benefitting from the program did not, and were taken by surprise when learning they could lose their coverage. It is estimated that between 100,000 and 280,000 Minnesotans could lose their Medicaid coverage in 2024. Mason notes that Minnesota has tried to be thoughtful about evaluating enrollee eligibility during the “unwinding” process while also recognizing the huge challenges inherent in reaching so many enrollees and communicating what needs to be understood and done.

MMLA’s Project Care (a free healthcare navigator service) provides assistance to help people apply for Medicaid coverage and take necessary steps to stay covered. Navigators work in the St. Cloud office, as well as in 14 different locations in the 12-county area. Bilingual navigators are stationed in public libraries, health clinics and social service agencies and navigators also meet with people on the phone and through virtual appointments. MMLA’s St. Cloud office is the only legal aid program in the state that provides this service to clients. “We’ve worked hard to make sure people know that we are providing these services. It is part of our job and our mission,” Mason said. On the subject of how complicated the process is, she noted, “You shouldn’t need to go to a lawyer to get to see your doctor.” Read more in “A tangled web: Minnesota’s post-COVID Medicaid ‘unwinding’ requires patience, compassion.”

Legal Services Advocacy Project Makes Gains for Clients in Active Legislative Session

The 2023 legislative session was historic. The well publicized “trifecta” produced perhaps the most momentous and transformative set of legislation in Minnesota’s history. Many major advancements for legal aid's clients, and all Minnesotans, that were enacted include paid family leave and earned sick and safe leave time; codification of reproductive freedoms; passage of significant gun safety laws; a 100% carbon-free energy requirement by 2040; and a massive affordable housing funding bill, which includes a permanent rental assistance fund. 

While these broader issues captured headlines, the Legal Services Advocacy Project (LSAP) worked to pass a wide range of bills across a variety of substantive areas that made significant inroads in advancing protections for legal aid clients.  

• Universal free breakfast and lunch for Minnesota students; 

• Ending school suspensions for children in grades K-3;  

• The first increase in General Assistance in 30 years; 

• Giving survivors of domestic violence a path to relief from “coerced debt”;  

• MFIP disregard for participants receiving RSDI; 

• Major MFIP sanction reform and MFIP drug testing repeal; 

• A massive Child Tax Credit;  

• Banning school seclusion for children through 3rd grade; 

• Funding to fully fund wage supports for persons with disabilities holding subminimum wage jobs;   

• Extending the period within which to file a UI appeal to 45 days;  

• Providing for an annual COLA to the housing assistance grant;

• Extending MNCare coverage to undocumented persons;

• Providing for recertifications once every 12 months for MA recipients;

• Removing asset limits for persons applying for MA-EPD; 

• Eliminating the requirement that tenants must pay back rent to assert a habitability defense;

• Making eviction filings nonpublic until the court issues a final judgment;

• Providing that the new 14-day pre-eviction notice is prima facie evidence of an "emergency" for purposes of emergency assistance eligibility;

• Payday lending reform; and 

• Eliminating the court-imposed bar to taking actions under the Consumer Fraud Act.

LSAP — which is comprised of staff attorneys Jessica Webster, Ellen Smart, and Ron Elwood — annually champions both discrete and systemic policy issues that fundamentally impact the lives of thousands of Minnesotans. They work with lawmakers, legislative staff, government agencies, legal aid staff, and dedicated partner advocacy groups to design, negotiate, and refine hundreds of new and existing laws, and always with legal aid’s clients and mission guiding their work.

LSAP Addresses Equity with New Self Storage Law

A new Minnesota storage law now allows any renter facing auction of property for non-payment to recover personal papers and health aids, like CPAP machines or wheelchairs, regardless of value. Self storage reform was one of several equity provisions adopted by the 2021 Minnesota Legislature.

Previously, self-storage facility owners could lock out renters for nonpayment of rental fees and ultimately auction off their property. Self storage facilities are sometimes utilized by people who have been evicted, foreclosed on, or are facing some other financial, housing, or domestic violence crisis and need a place to store their belongings.

The new law is an update to 1988 legislation not reviewed since 2014. The Legal Services Advocacy Project (LSAP) and the Minnesota Self Storage Association negotiated to approve language acceptable to both renter advocates and owners. In addition to the ability to recover personal papers and health aids when facing auction, renters can now recover other items if they are recipients of “relief based on need” or are survivors of domestic violence and sexual assault.

“Relief based on need” includes the Minnesota Family Investment Program, Medical Assistance, General Assistance, MinnesotaCare, the earned income tax credit and other government benefits programs for residents with lower incomes. Importantly, the new law does not create an eviction record for renters because it removes the process from landlord-tenant eviction law and places it in the section of law covering self-storage. Additionally, building owners must now provide more detailed notice before they can start an action to auction off property. The notice must say how much rent is owed, when access to the unit will end, and how the renter can dispute the claim of money owed.

Read “How reforming Minnesota’s law governing self-storage units became an equity issue” in MinnPost.

Changes to MFIP Could Benefit Families and Simplify Process

Annual cost-of-living increases to Minnesota Family Investment Program (MFIP) benefits, and simplified application requirements, if approved by the state, would reduce stress and provide some income stability for approximately 30,000 Minnesota families.

Currently, Minnesota MFIP recipients are required to submit an eight-page eligibility form every month showing income, assets and expenses. And Minnesota is the only state that still requires this cumbersome paperwork. Additionally, the MFIP program has seen only one other cost-of-living increase in 35 years.

Minnesota nonprofits, county social service agencies, and other advocacy groups support the proposals, and the governor’s proposed budget would enable MFIP recipients to lock in their benefits for six months. The budget also includes a one-time payment of $750 to help families who receive MFIP address critical needs.

"This is a game changer," said Jessica Webster, staff attorney with the Legal Services Advocacy Project. "After decades of eroding benefits, even a modest expansion of [MFIP] payments and easing of reporting requirements are a very big deal." Read the Star Tribune article.