The federal Medicaid program provides flexibility to individual states to structure their programs in ways that they believe will best serve the needs of the population. The Minnesotan government offers Home and Community-Based Services (HCBS) waivers tailored to the specific needs of individuals with disabilities, which helps individuals afford access to care in a home or other community environment instead of within institutions such as nursing homes or intermediate care facilities. Now, they face disability waiver cuts.
Minnesota’s Medicaid waiver program has been regarded as among the most generous in the nation, due to the state’s broad slate of services (including four distinct disability waivers and two nonspecific Medicaid waivers for the elderly); significant investment in reimbursements, and a focus on services like daily living assistance enabling individuals with disabilities an opportunity to live with more independence. However, during the state’s most recent legislative session, lawmakers voted to cut down the increasing budget of the waivers program as well as funding for nursing homes in order to achieve a more balanced FY26 budget.
Minnesota Now, a production of Minnesota Public Radio, recently conducted an interview with Linda Wolford, government relations director for the Minnesota Council on Disability, to learn more about the budget cuts and how they may affect the thousands of Minnesota citizens who rely on waivers for health care assistance. She offered insights including her assessment that the Minnesota Department of Human Services (DHS) had produced a proposal designed to soften the impact upon the people receiving Medicaid services.
Key Points
- The Minnesota disability waiver program consists of four primary waivers: Developmental Disability (DD), Brain Injury (BI), Community Access for Disability Inclusion (CADI) and Community Alternative Care (CAC). There are also two waivers offered to citizens 65 and older, which are not specifically connected to disability.
- Over 70,000 Minnesotans utilized disability waivers in 2023. Prior to the recent budget cuts, the program was on track to grow from $5B to $8.5B.
- Changes in the program budget will include:
- a reduction in the cost-of-living increase for health care providers from 6% to 2-4%
- a reduction in the allowed number of rate exceptions for individuals in significant need of services
- a review of eligibility for waivers that may divert select applicants to lower-cost services
At the time of the interview, the “One Big Beautiful Bill” Act (OBBB) had just passed the United States Senate; Director Wolford noted that this enactment may lead to further unknown Medicaid cuts for Minnesotans.
Looking Ahead
Advocates have also noted positive changes for Minnesotans with disabilities in the waiver policy. They anticipate individuals receiving 10 hours or more of services within Personal Care Assistance (PCA) or Community First Services and Supports (CFSS) programs will see a 5% increase in their reimbursement rate. Service animal trainers will have fewer restrictions on socializing their animals in public settings which is said to develop more resilient aides. There will be a waiver reimbursement for children with autism under the age of 12 who receive adaptive swimming lessons – proposed in response to recent data indicating significant risk for drowning among young children with autism. The state is also celebrating the improvement in wheelchair accessibility to the state office building following a $9.5 million budget allocation to lower the steepness of the capital tunnel.
Source: Cuts to unique disability waiver program leave questions for disabled Minnesotans