by Steve Timmer

May 23, 2017, 6:00 PM

Ok, Grandma, pack your things; here’s a shopping bag

And be sure to see the article in the 6/25/17 Strib.

The poor, the elderly, and the disabled in Minnesota are about to encounter a perfect storm. The first budget that has sprung fully formed from the forehead of President Trump proposes $800 billion (with a “B”) in Medicaid cuts over ten years. The effects, according to CNN, include:

The $800 billion reduction, confirmed to CNN Sunday evening by a senior administration official, assumes that the GOP health care bill that the House passed earlier this month would become law, that official said.

The House legislation to dismantle the Affordable Care Act — President Barack Obama’s landmark health care law also known as Obamacare — would significantly curtail federal support for Medicaid.Under that bill, in 2020, states that expanded the program would no longer receive enhanced funding to cover low-income adults, while states that did not expand previously would not be able to do so, starting immediately. Some 11 million adults have gained coverage under Medicaid expansion.

Also, the bill would reduce federal funding for the entire Medicaid program, which covers more than 70 million low-income children, adults, disabled Americans and the elderly. States would either receive a set amount of funding per enrollee, known as a per capita grant, or fixed funding in the form of a block grant.

But not to worry, right? Minnesota will take care of its people.

Well, worry.

The state’s budget deal announced just before midnight Monday night (5/22) was described this way, in a Pioneer Press story:

Bargaining over health and human services spending was the most difficult. Republicans said it was necessary to reduce spending there to protect the state from fast-rising costs, while Dayton argued cutting budgets in those areas would harm Minnesotans in need.

Let’s see, costs are rising, so we need to cut the budget?

I wouldn’t look to a Republican legislature to keep a roof over Grandma’s head when Medicaid gets the axe. When the economy turns (not if), and we’ve hamstrung a handful of budget cycles with transportation spending, instead of raising the gas tax, and the state’s budget goes back into deficit, things will be especially tough on the health and human services front. Especially in rural areas where the community hospital and nursing home are very important economic elements.

Rep. Erin Murphy talked about these things in her recent appearance at Drinking Liberally.

Update 5/24: Apparently, it’s even worse than reported by CNN. According to a Strib article that went up on the website last evening, while everyone was paying attention to the two-ring circus as the legislature:

The budget would cut $627 billion from Medicaid, which provides health insurance for the poor, on top of $839 billion in reductions from the Affordable Health Care Act, the GOP-backed bill that passed the House this month.

But wait, that’s not all! In addition to the general rogering that Trump’s budget visits on education generally, the Medicaid cuts will hurt special education, which school districts are required to provide:

So, special education funding has always been low. We have never met our federal commitment to school districts to fund special education. And about 30 years ago, the federal government decided that they would allow to start to bill Medicaid for some of the therapies in particular that are very costly to provide special education students.

And so school districts have been reliant on Medicaid to supplement some of the special education funding they receive for a very long time. It’s standard practice in many districts.

Further update 5/25: Sen. Melisa Franzen warns of a structural deficit, one scenario outlined above.

The tax bill is fiscally irresponsible. Price tag over $700m. #structuraldeficit #mnleg

— Melisa Franzen (@MelisaFranzen) May 24, 2017