MA TEFRA WHAT YOU NEED TO KNOW Prepared

MA - TEFRA: WHAT YOU NEED TO KNOW Prepared by Maren Christenson Hofer

WHAT IS IT? TEFRA stands for Tax Equity and Fiscal Responsibility Act TEFRA is not insurance, rather it is a pathway to Medicaid for those who do not qualify for Medicaid based on income requirements alone. It is based on disability certification. Any family with a child who is certified disabled by the state (SMRT) is eligible for TEFRA.

WHY IS IT IMPORTANT? It allows families of children with disabilities to access care that they cannot access through private health care insurance alone. Many private insurances do not cover many of therapies needed by children with disabilities. Or if they do, it is in limited amounts (e. g. ten OT visits per year, 50 hours of behavioral therapy per year). TEFRA provides a means to access those therapies. 10, 714 parents have accounts with Parental Fee Unit in FY 2018.

WHO IS ELIGIBLE FOR TEFRA? The child must live with a parent The child must be under age 19 The child must be certified disabled by the State Medical Review Team (SMRT) or the Social Security Administration (SSA)

WHAT DOES IT COST? Many families can access Medicaid for their children with disabilities based on meeting income guidelines. For those that families whose income is too high to meet Medicaid guidelines, TEFRA allows them access to the same services on a sliding fee scale that is based on income. This is known as the parental fee.

WHAT IS THE PROBLEM? WHY ARE FAMILIES SEEKING LEGISLATIVE CHANGE? The parental fees for TEFRA for some families are exorbitant. Many families paying parental fees are already under considerable financial strain. TEFRA fees operate as a disability tax, that families without disabilities do not have to pay. Many families cannot access therapeutic services available through TEFRA, because the costs are too high. As a result, children are not receiving the intensive therapies that could make a considerable difference in their long term outcomes.

WHAT EXACTLY ARE THE FEES? Parental fee calculator can be found at: http: //pfestimator. dhs. mn. gov

BARRIERS TO ACCESS Issues with MA-TEFRA enrollment and renewal also present barriers to families When families use MNsure, they don’t see information about the MA-TEFRA option Different counties and different financial workers have different processes for enrolling MA-TEFRA paperwork is complicated and complex, causing additional hardship and stress in the lives of Minnesota families.

HOW CAN WE SOLVE THESE ISSUES? Two bills: Lower parental fees Streamline enrollment/renewal Bill authors include: Senator Jerry Relph (R, 14) Representative Alice Mann (DFL, 56 B)

WHY SHOULD I SUPPORT THIS LEGISLATION? TEFRA helps families from every county, both urban and rural, middle and upper income. Both parties have put forth platforms of support for middle class families and members of the disability community. The current system poses undo hardship on families of children with disabilities.

HOW CAN I HELP? Join the Coalition to Lower Minnesota MA-TEFRA Parental Fees Facebook page. Find out who represents you in the Minnesota legislature. Share your story! Engage your elected officials at the Capitol and on social media.

SOCIAL MEDIA ACTION @[your legislator’s handle], I rely on MA-TEFRA to access services & supports for [child’s name], my child with a disability. Please support our effort to #lowerparentalfees and improve enrollment & renewal this session! #mnleg #my. MATEFRA