For the first time in a few years, Washington County is hiring.
But not everyone is jumping with joy.
The county board recently approved a request from the community services department for nine new full-time employees to handle the rollout of the federal Affordable Care Act, which expands eligibility for government assistance, and the state’s new health insurance exchange.
Though the initial push to get the program up and running might cause some headaches, officials say it will bring efficiencies in the long run.
The new hires will cost Washington County close to $250,000 annually, after a 50 percent federal match. More federal funding has been promised, but the final tally is still being worked out.
“We’ve coined it the ‘Unaffordable Care Act’ because counties can’t afford to keep it staffed,” county Commissioner Autumn Lehrke said at a board meeting last month. “It’s another example of an unfunded mandate.”
Washington County, like others, has put hiring on hold in recent years because of recession-related budget constraints.
The first year and a half of county funding for the new employees will come from existing sources. Many of the new employees will be hired on temporary two-year contracts, since the bulk of the extra work will come in 2014 and 2015.
The new staff are needed to handle an increase in the number of people applying for assistance programs and will help transfer existing cases to a new electronic case-management system.
Counties across the nation are in a similar situation, because the programs affected by the new health care law are implemented at the county level.
The Affordable Care Act, also known as “Obamacare,” was signed into law by President Barack Obama in March 2010, and its impact on counties will be felt beginning next year. The law is supposed to expand access to quality health care to lower-income Americans. Enrollment begins this fall; Minnesota applicants will use MNsure, the state’s new online health insurance marketplace, to determine eligibility.
The Minnesota Department of Human Services estimates that more than 151,000 new individuals will be eligible for Medical Assistance and more than 63,000 people currently eligible will see changes that will make it easier for them to stay on Medical Assistance.
More than 80,000 of those new individuals and more than 37,000 of the existing enrollees will be in Anoka, Dakota, Hennepin, Ramsey and Washington counties.
County officials are bracing for the initial push, unsure exactly what to expect.
“It’s going to be a lot more work. And the work is difficult because of the speed with which this thing is moving,” said Jerry Vitzthum, director of Anoka County’s economic-assistance department. “It’s very hard to plan for something where you have that much uncertainty. There are lots of questions still unanswered.”
There are questions about changes in food-support and child-support cases, about employee training and overtime, about the exchange program and the new system’s complexity, Vitzthum said.
Counties were also recently notified that many of the employee positions will be eligible for greater federal funding, or an “enhanced” federal match — up to 75 percent — that will lessen the hit to county coffers. Details are still being ironed out, so county officials don’t know yet how much of the spending will come from their own budgets.
The state Department of Human Services estimates the federal matching funds could be $40 million for Minnesota counties.
Though the new online exchange and management system are expected to create efficiencies in the long run, it could be several years before the state’s two-decade-old management system is updated and merged with MNsure.
“Until that occurs, this will require our staff to work in multiple systems,” said Linda Bixby, economic support division manager in Washington County. “There will be efficiency gains, I have no doubt. At what point we will have them is really the question. We have no idea what MNsure will look like as of January 2014.”
There is a bright side to the coming change, including job creation, improved case management and wider access to health care, Bixby said.
“Another way to look at this is, when more people have access to insurance, we have healthier communities,” Bixby said. “We have people who, because they’re getting their medical needs met and getting treated earlier, may be more able to contribute to the tax base. … That can also help as the economy improves and employers are looking for healthy, able-bodied employees. It is a potential positive for our state.”
Elizabeth Mohr can be reached at 651-228-5162. Follow her at twitter.com/LizMohr.
ONLINE
For more information on MNsure, visit www.mn.gov/hix/.