'We can't take it anymore': Vulnerable Minnesotans left without options after companies drop Medicaid rides
Minnesota nonemergency medical transportation providers pulled some Medicaid ride options after taking significant losses from state reimbursements. They said gas, labor and insurance costs jumped while their state reimbursement rates lagged.
GOLDEN VALLEY, Minn. — Dozens of patients and family members call LaTonia Jackson each day as they try to find a way to get themselves or their loved ones to medical appointments, dialysis treatments or other meetings.
They plead with the corporate manager at Driving Miss Daisy Inc. to help their parents or children get a safe ride. For many, it's their only option because they can't drive them and other options are financially out of reach.
Recently, Jackson has had to say no to more of them as the company, along with other nonemergency medical transportation providers around the state, stopped taking some clients on Medical Assistance.
When it gets to be too much for her, Jackson puts her head in her hands and cries.
"It's just very, very heartbreaking to hear the members and their families, you know, breaking down that they don't know what to do," Jackson said. "It is ridiculous that we're at this point. It's ridiculous that people can't get to their appointments."
Last week, companies around the state that offer non-emergency medical transportation announced that they would no longer offer fee-for-service rides for Minnesotans on Medical Assistance, the state's Medicaid program.
That means about 260,000 low-income Minnesotans who are eligible for state support could lose access to their service for getting to and from medical appointments.
Transportation company leaders earlier this year pleaded with Minnesota lawmakers to boost state reimbursement rates for the ride services. The rates have remained flat for a decade while costs ballooned, they said.
But after the Legislature closed out last month without approving a change, the company leaders said they couldn't continue to offer the rides as they also tried to navigate costs for gas, workers, insurance coverage and vehicle repairs.
"Our family's paying out of pocket, we can't take it anymore," Tarek Menesi, Driving Miss Daisy's financial officer, said.
"So I'm not calling it a strike, as a strike is when someone is unwilling to do something and that's not the case," he continued. "We are unable to subsidize the state of Minnesota anymore."
Menesi said his Golden Valley-based company used to provide about 20 fee for service rides for Medical Assistance clients each day. And this year, the company is set to take on $100,000 in losses because the reimbursement rate falls short of the real cost of providing those services.
Pine City-based Lifts Transportation & Abacus Transportation turns down between 50 and 80 ride requests daily because it can't recruit and retain enough drivers to meet the demand in Greater Minnesota, the group's president Scott Isaacson said.
"I feel helpless because I've been part of some of these councils in Saint Paul that have tried to come up with solutions. As much as we shine a light on this, nothing is done," Isaacson said. "And because somebody can't get access to the care that they need now it could affect them for the rest of their lives."
The state is responsible for making sure that Minnesotans on Medical Assistance can access the rides to and from their appointments. In a statement, Department of Human Services Assistant Commissioner Cynthia MacDonald said the state was "tracking the situation while coordinating with counties to assist with finding transportation providers and exploring telehealth options if appropriate.”
The department can't change the reimbursement rates, she said, and so unless or until lawmakers step in, the state and counties would have to attempt to find alternatives.
A "small number" of counties reported problems with getting rides for Medical Assistance recipients last week, MacDonald said.
But more could report issues in days and weeks ahead as additional transportation companies phase out their services.
"This is something that will have an impact, potentially, all across the state," said Matt Freeman, Minnesota Association of County Social Service Administrators executive director. "But it's difficult to predict the scope."
At the Capitol, lawmakers this week were expected to resume negotiations over supplemental budget bills that couldn't get buttoned up in May. If leaders in the divided Statehouse can agree, Gov. Tim Walz said he would call a special session to have them take up around $4 billion in new funding for state programs.
Members of the conference committee writing a $1 billion health and human services bill considered a rate reimbursement increase for the non-emergency medical transportation providers. But they couldn't compromise on that provision and several others before their May 23 deadline.
"It's been chronically underfunded and discussed for years and no one should be surprised that push came to shove and the operators couldn't afford the losses. No one goes into business to lose money," Sen. Jim Abeler, R-Anoka, said. Abeler is a chair on the Health and Human Services conference committee.
"There've been warnings, even in prior years about how rickety the system is," Abeler continued.
The idea picked up bipartisan support in the Senate and House lawmakers brought forward a lower-level rate increase before the Legislature adjourned.
With more than $7 billion in budget surplus funds still sitting in state coffers, Menesi, with Driving Miss Daisy, said the problem should be easy for lawmakers to fix.
"We're supposed to be the wealthiest country in the world with good infrastructure, and it's just rotting at its core," he said. "That money is just floating there because of politics, and they can't come to an agreement. It's just so ridiculous. I can't wrap my head around it."