MA - TEFRA: What you Need to know

1. MA - TEFRA: What you Need to know Prepared by Maren Christenson Hofer

2. 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.

3. 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 the 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 parentshave accounts with Parental Fee Unitin FY 2018.

4. 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)

5. 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.

6. 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 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.

7. What exactly are the fees? • Parental fee calculator can be found at: http://pfestimator.dhs.mn.gov

8. 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.

9. 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, 56B)

10. WHY should I support this legislation? • TEFRA helpsfamilies 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.

11. 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.

12. 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 #myMATEFRA