Minnesota Republicans released their proposed cuts to health and human services this week. There’s much to not like in these bills, but one of the most damaging proposals is what my colleagues and I refer to as the “global waiver”. Minnesota would be required to seek a federal waiver that would allow the state to administer its Medicaid program as it wishes and without regard to pesky federal regulations. Specifically, lawmakers want to be free to increase cost-sharing, restrict services based on population or geographic region, establish stricter income and asset limits, and require individuals to purchase private health insurance. It would transform Minnesota’s Medicaid program into something much more limited in reach and scope.
Republicans attribute significant savings to this waiver, but that’s problematic. The waiver proposal is written so vaguely that it’s difficult for state officials to determine exactly how it would change the program and thus how much savings it would generate. Furthermore, the federal government is unlikely to approve such a waiver (even if the governor signs off on it, which is also doubtful). It’s budget balancing through wishful thinking. But wishful thinking is more palatable than cutting funds to nursing homes or services for people with disabilities, which is what Republicans may have to do if they are truly committed to balancing the budget without raising taxes.
