The disabled face special challenges under new Medicaid rules

I have retinitis pigmentosa. I can’t see anything above eye level. I’m also Deaf, so when I call an agency, I use a video relay interpreter. I have a master’s degree and have spent much of my career figuring out how bureaucracies work. I can still lose an afternoon to a phone tree. So when I hear that disabled people are exempt from Medicaid’s new work requirements, I have a question: How am I supposed to tell you I’m exempt if I can’t use the method you’re asking me to use to tell you? Starting Jan. 1, Minnesota estimates that about 243,000 people on Medical Assistance will have to report 80 hours a month of work, school, volunteering or participation in a work program, or show they qualify for an exemption. They’ll also have to renew their coverage every six months. Related: Minnesota’s most vulnerable citizens are collateral damage in federal crackdown on Medicaid program If you got Medical Assistance on the basis of disability, you’re exempt. Federal law also exempts people who are considered medically frail, which can include people who are blind or disabled. But plenty of disabled people got their coverage through the adult expansion group. Maybe you have a serious mental illness or a chronic condition. Maybe you’ve never been through the process of getting your disability formally certified. Now you have to figure out how to show you qualify, while dealing with whatever made that paperwork hard to do in the first place. We’ve seen what happens when people have to report to keep their coverage. In Arkansas, about 18,000 people lost Medicaid within months of the state putting work requirements in place in 2018. Researchers found no measurable increase in employment. Most of the people subject to the rule were already working or should have qualified for an exemption. Minnesota DHS got an early start with an online tool that helps people check whether the rules apply to them. I’m glad it’s there. I also want DHS to think about the person who gets a printed notice they can’t read. How are they supposed to know there’s a tool, let alone that there’s a deadline? By the time someone reads them the letter, how much time do they have left? Here’s what I want Minnesota to do before people start getting those notices. Related: Inside the state’s miserable task of re-vetting Medicaid providers If the state already has records that establish someone qualifies for an exemption, use them. If you already know I qualify, spare me the afternoon on the phone. Make notices available in large print, braille, plain language and American Sign Language video from the start. Getting the information in a format you can use is part of getting the notice. It shouldn’t take a second request. Before cutting someone’s coverage for missing a reporting deadline, have a person try to reach them in a format they can use. And when the Legislature convenes, fund disability-led navigators who can sit down with people and help them get through the process. Attorney General Keith Ellison and three other states sued on Nov. 6 over the federal government’s threat to withhold Medicaid funding. The lawsuit could affect the timeline. Minnesota can get to work on accessible notices and outreach now. I keep thinking about the person who finds out they’ve lost coverage when they go to pick up a prescription. Somewhere in the state’s records, there may be a notice that went out on time. I want someone to be able to say that person could read it and had a fair chance to respond. Heather M. Grizzle is a DeafBlind resident of Elk River and the founder of Novara Consulting Group , which advises public agencies on accessibility and sign language AI. Related