This year the Upper Midwest Chapter continued its work at the State Capitols in our chapter states on issues that impact those living with MS. By the end of May, State Legislatures in Iowa, Minnesota and South Dakota had adjourned for 2016. The North Dakota Legislature was not in session this year.
 
Due to tight state budgets and short legislative calendars, we saw minimal positive policy changes for people living with MS. Here are some highlights of issues the chapter supported in 2016.
 

Iowa

Medicaid Privatization Oversight

The State transferred its Medicaid program to privately managed care organizations in April. To ensure health care access is maintained for Medicaid enrollees during this transition, the chapter supported several measures that ensure program oversight. This included multiple reporting requirements on consumer protection, outcome achievement and program integrity, as well as the implentation of a legislative health policy oversight committee, a managed care ombudsman for assistance and advocacy services, and a medical assistance advisory council with emphasis on public members. These provisions were a part of the Health and Human Services Budget bill and were signed in to law by the Governor this year.

Home Modification Assistance

The chapter continued to support funding to create a home modification assistance program for elderly Iowans or those living with a disability who wish to modify their homes to increase accessibility and safety. Although we were successful in getting the program included in a Senate Budget bill this session, it was unfortunately not a part of the final bill that passed the legislature. We will continue to support this issue in 2017 in order to secure funding for this important program.

Expanding Access to Medical Cannabis

This year the chapter supported the efforts of the Iowans 4 Medical Cannabis coalition to broaden the current medical cannabis law in Iowa. The current law only allows those living with intractable epilepsy to possess medical cannabis. This year’s initiative would expand the law to include additional conditions (including MS) and to allow in-state manufacturing and dispensing of cannabis medicine. A bill including this language passed the Senate last year and passed a House committee this year, but unfortunately did not progress any further.
 

Minnesota

Mitigate Medicaid Rule Change for Married Minnesotans

Recently there has been a change to the eligibility requirements for those who are married and access home and community based services (HCBS) through a Medicaid waiver. Historically, Minnesota has only counted the assets of the person seeking a waiver in determining eligibility. By March 1, 2017, the Federal Government is requiring Minnesota to use the combined assets of a married couple to determine eligibility, similar to other states. Enforcement of these new rules will have a significant impact on Minnesota families using a Medicaid waiver and some may need to lower or separate their assets to maintain eligibility.
 
This year we supported two provisions at the State Capitol to mitigate the impact of this change — increasing the spousal asset limit to $119,000 and to provide protection to retirement and college savings accounts. Both of these provisions were part of the final supplemental budget bill that was signed in to law by the Governor. Although this will provide greater protection of assets, it will not completely reverse the impact of these new rules. Minnesota residents who may be impacted should seek legal advice in order to make financial arrangements to maintain eligibility for their HCBS waiver.

Medical Assistance Eligibility Reform

The chapter continues to support efforts to reform the eligibility standards for Minnesotans living with a disability who access Medical Assistance, Minnesota’s Medicaid program. Last year, we were part of a coalition that successfully raised the program’s spenddown requirement from 75 percent of Federal Poverty to 80 percent, which took effect this July. This year we attempted to raise this value to 100 percent of poverty, but unfortunately the increase was not part of the final supplemental budget bill which was signed in to law this year.

Home Modification Assistance

The chapter continues to work on a bill to create a home modification assistance grant program that would assist homeowners with costs for home renovations that increase accessibility, similar to the program we support in Iowa. Unfortunately, the bill to create this program stalled in committee and we will continue to work with state agencies to create a program in 2017.
 

South Dakota

Medicaid Expansion

Expanding eligibility to Medicaid is a national priority for the National MS Society, South Dakota is the last of our chapter states to not expand eligibility to those who earn up to 138 percent of the Federal Poverty Level. By expanding, approximately 55,000 South Dakotans will gain access to health care they currently lack. During this year’s legislative session, the Governor supported expansion and began working on a plan to earn Federal and State approval. The plan was accepted by the Centers for Medicare and Medicaid Services, but there was not enough time to pass the plan through the legislature before the mandated adjournment date. The Governor intends to bring this plan to the legislature for approval in 2017.

• If you have any questions about these issues or other policy issues which impact you, please contact Dan at dan.endreson@nmss.org.