Speed is key to 'unwinding' health coverage twist

Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.

•••

Minnesota lawmakers demonstrated their ability to sprint when it comes to policymaking this session by reaching agreement on budget targets this week long before closing time at the State Capitol.

They need to come out of the starting blocks swiftly once more to handle the latest twist in what was already a formidable health care challenge: "unwinding" COVID-19 emergency measures that kept people across the United States enrolled in publicly funded medical assistance programs throughout the pandemic.

The federal and state governments jointly fund medical assistance programs. Federal officials have issued new 'unwinding' requirements that states must follow to keep federal aid flowing even as continuous enrollment's sunset looms on March 31. Complying with the new guidance will require the Minnesota Legislature to grant additional authority and flexibility to the state Department of Human Services (DHS) and to provide funding to administer the unwinding at the state level.

If steps are not taken quickly, Minnesota could lose out on federal aid to offset medical assistance program costs. If DHS cannot submit and implement a federally approved plan by April 1, the state risks losing $117 million during the quarter ending June 30.

Passing a legislative package before the end of March would help prevent that and ensure Minnesota receives federal funding for future quarters. At stake: $290 million for the calendar year.

It's important to note that 44 other states are in a similar bind. DHS Commissioner Jodi Harpstead said in an interview this week that her peers nationwide are doing their best to understand and adjust to the new guidance.

While the ongoing changes exacerbate the unwinding's complexity, the feds' goal is a noble one — to mitigate coverage losses in the vulnerable populations served by medical assistance programs. In Minnesota, 1.5 million people — from struggling young families to elders needing long-term care — rely on medical assistance.

The Star Tribune Editorial Board has previously sounded the alarm about the complexities involved in unwinding the continuous enrollment policy, which centers on doing financial eligibility checks to ensure taxpayer assistance goes only to the genuinely needy.

Redetermining eligibility for this many people is a necessary but nevertheless massive undertaking. It's complicated by what remains a paper-based process, with responsibility shouldered by counties and the state. Both will need additional staff and will be hiring during historic labor shortages in Minnesota and elsewhere.

Thankfully, lawmakers have introduced and updated legislation (HF 2286/SF 2265) to address the new requirements and provide dollars for eligibility redetermination. The bill's funding breakdown: $58.6 million from the state's general fund in the 2024-25 biennium, and $10.3 million to the health care access fund, for a total of $68.8 million.

Passing the legislation quickly wouldn't just ensure compliance with the new federal requirements. Measures would also help the state and counties get a jump start on hiring additional staff. That's a significant added benefit.

This week's committee hearings clearly show that key legislators, particularly Rep. Mohamud Noor, DFL-Minneapolis, understand the urgency to move quickly. His colleagues should heed his concerns and get this legislation to a floor vote before the month's end.