Medicaid expansion: more insured at state-budget savings

ACA advocates predict uninsured Blacks will drop from 20 to eight percent




By Charles Hallman

Staff Writer


The Greater United Way held a “community conversation” December 4 at the Wilder Foundation in St. Paul on the Affordable Care Act (ACA) and how it can help low-income uninsured Minnesotans. Minnesota Human Services Commissioner Lucinda Jesson and NorthPoint Health and Wellness Center CEO Stella Whitney-West, HealthPartners Government and Community Relations Vice President Donna Zimmerman and Jonathan Watson, Minnesota Association of Community Health Programs associate director spoke to an audience mainly composed of local health professionals.

Stella Whitney-West is CEO of
NorthPoint Health and Wellness Center

One-half of NorthPoint’s clientele are on Medicaid, the federal health program for low-income individuals and families. Thirty-seven percent are uninsured and 80 percent are from communities of color, Whitney-West pointed out.

“North Minneapolis always shows up in the highest percents for adult obesity, smoking rates, diabetes and for uninsured,” Whitney-West said.

Although nine percent of Minnesotans are uninsured, Watson stated that the percentages among Blacks and other people of color are nearly three times higher: 20.4 percent for Blacks, 25.4 percent for Latinos and 23.3 percent for Native Americans. With the ACA, the number of uninsured Blacks in the state will drop to eight percent, he predicts.

Having more people with health coverage is “the good news,” noted Jesson. She added that it will be easier for people “to get eligible and stay eligible. We will have a whole lot of people, and that’s a good thing.” The commissioner, however, expressed concerns about “the fiscal cliff” currently being debated in Washington and what impact that may have on the state.

After their presentations, Jamal Hassan of Hope Health Care asked the panelists how the Somali community and other communities of color can become better informed on the ACA.

“I don’t want to exclude anyone,” responded Jesson. “We know that we have greater gaps with our communities of color and have to do more targeted outreach to those communities. But we need to get the word out, make it easy to get people eligible for our programs.”

“Consumers will have tools available to access how to select healthcare [options], and that is a good thing,” said Whitney-West, “but I [also] see that as a challenge.”

The NorthPoint CEO told the MSR that “competition in our community” in providing health coverage for community residents is growing. For many years her organization has served the North Side as the main healthcare source, especially for uninsured residents.

Minnesota Human Services
Commissioner Lucinda Jesson
Photos by Charles Hallman

“There are now providers and organizations that traditionally were not looking at communities like North Minneapolis,” noted Whitney-West. “Some folk are now seeing it as an opportunity to come into the community to provide services. That puts us at a position where we are going to be competing for resources as well.

“On the other hand, it also challenges us as an organization…to be the provider of choice no matter who else moves into the community,” she continues. “The community should see us based on services, the quality, and the respect that they get that we become their health center of choice.”

A new Kaiser Family Foundation report says that some states, including Minnesota, could see budget savings from expanding Medicaid because of a key provision of the ACA. Medicaid provides health coverage for low-income individuals and families, and if a state chooses to participate, it receives federal funding if certain guidelines are met. Beginning next year, if states choose to offer more services, such as preventive services, the state will receive an increased federal medical assistance percentage for these services.

During a November 27 phone interview with the MSR, Jesson noted that the 2013 Minnesota Legislature has “two big questions” to address when it convenes next month. “One: Will they act [on] Medicaid expansion, which will [allow] more health care for people? And the second big question: Will the state authorize its own state health-based exchange or will it default to a federal exchange?” she said. “Those are questions every state will have to face.”

The Medicaid expansion “should be clear to most people — it is about more health care for more people at a budget saving to the State, because the federal government will pick up most of the cost,” Jesson explains. “I hope the legislature will address that quickly and in a straightforward fashion.”

Such discussions, she predicts, might be easier with a DFL majority legislature. “It should be a lot smoother today than it was before the [November 2012] election but it’s still a lot of hard questions the legislature has to answer,” she noted.

The commissioner also pointed out that expanding Medicaid “will more than cut in half” the number of uninsured Minnesotans. “Over a five-year period the Medicaid expansion will save the state of Minnesota over a billion dollars,” she surmised.

“I think it is going to take continuous, ongoing education” on the ACA and its benefits, admitted Whitney-West after the December 4 event. “I think all community-based organizations will have to do their part in making sure that they are educating the community about opportunities.

“I know a lot of people are not aware of” the ACA and its many benefits, said Whitney-West. “We have to continue to provide them with that information.” Using existing community-outreach workers will help as well, she believes.

“I think African Americans and [other] people of color should celebrate that this is major,” proclaimed Whitney-West on the ACA, President Barack Obama’s signature legislative measure from his first term. However, despite President Obama’s reelection, “It is not over. There’s clearly political backlash” over the healthcare law, she warned.

“When you look at the funding for the Affordable Care Act, there are some things we are still at risk for. When you talk about the budget at the federal level, there are some things that for sure NorthPoint and other community health centers can easily reduce significantly.

“This is going to be an ongoing battle, and people need to pay attention and be diligent.”


Charles Hallman welcomes reader responses to challman@spokesman-re