Two bills are making their way through the legislature that could have a negative impact on people’s ability to access mental health care. HF 3722 (Fenton) /SF 3611 (Johnson).
The bills would require the Department of Human Services to apply for a federal waiver in order to impose work reporting requirements for “able bodied” people on Medicaid – or Medical Assistance (MA) as it is called in Minnesota. People will be required to work, volunteer or job-seek at least 80 hours a month and provide monthly verification to a county worker they met the 80 hours or that they met the exemption criteria.
The exemptions are limited and not precise. “Able bodied” is a loose term. Children 18 years of age and under, adults over the age of 60, people certified by the Social Security Administration (SSA) as having a disability, caregivers, people who are medically fragile, part-time students, and people receiving a certain level of substance use disorder treatment are exempt from these requirements.
So are people determined by a health professional to be “physically or mentally unfit” for work according to criteria that has yet to be established. However, it is unclear if that would include someone who is experiencing a health issue or the beginning symptoms of a serious mental illness. You can be sick but not disabled. Think of a young person experiencing their first psychotic episode – they will be eligible for MA for three months before being required to work – not enough time to see a psychiatrist (at least a three month wait) and not enough time to recover and get back to school or work.
The costs – human and fiscal – will be great. There will be costs to the counties and state to hire people to implement this program – checking paperwork – not helping people find or keep a job. There are bound to be errors and missing paperwork and people will not qualify for an exemption who should and others will lose their health insurance and thus access to treatment. There will be uncompensated care at our hospitals and community mental health centers.
While employment is a laudable goal, this bill will actually lead to people losing health insurance – MA – which covers the treatment that helps them work or people will try to become certified as disabled – stating that they cannot work.
We know what happens when people with a mental illness don’t get treatment; they end up in hospital emergency rooms, in jail, or on the streets with worse long-term outcomes and at greater cost. Imposing work requirements will take Minnesota backwards and undercut the progress we have made building our mental health system.
Sue Abderholden is executive director of NAMI Minnnesota (National Alliance on Mental Illness), a non-profit organization working to improve the lives of children and adults with mental illnesses and their families through education, support and advocacy.