Volume 37, Number 3
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More paperwork, less care: How 2027 Federal changes threaten Minnesotans with disabilities
MARCH 2026 IN THIS ISSUE
By Frank Murphy For decades, Medicaid—our Medical Assistance (MA) program—has been the engine that quietly keeps Minnesotans with disabilities housed, healthy, and in the community. That’s about to change in visible and painful ways. Starting January 1, 2027, a series of new provisions will reshape who qualifies for MA, what is covered, and how hard people with disabilities have to work just to stay enrolled.
The Financial Ripple Effect: Federal Reductions
The impact of Operation Metro Surge on MN Autism community Page 4
Federal legislation passed in 2025 will trigger hundreds of billions of dollars in national Medicaid reductions over several years, with Minnesota on the hook for hundreds of millions in disability-related services alone during the 2026–27 biennium. Some of that is straight-up loss of federal matching funds. The rest comes wrapped in new reporting rules, shorter timelines, and federal caps that limit how quickly spending can grow. On paper, these look like levers and percentages. In people’s lives, they look like fewer care hours and more chances to get tripped up by paperwork.
The Paperwork Barrier: Six-Month Renewals
The first major shock to the system hits on January 1, 2027, when Minnesota begins moving many adults on MA, including some with disabilities, from annual renewals to check-ins every six months. That means more mail, more forms, and more deadlines—each one an opportunity for something to go wrong. A notice arrives in English to a household where English isn’t the first language. A form shows up during a hospitalization or a mental health crisis. The rules don’t have to change at all for coverage to be lost; the process itself becomes the barrier.
Hundreds gather on harm caused by fraud mitigation Page 5 The fight to end seclusion in Minnesota schools Page 7 Freedom in the deep: Free-daptive Divers want you to join them Page 8
Shrinking Safety Nets: Reduced Retroactive Coverage
from a hospital billing office and a credit score taking a hit.
That same day, retroactive coverage shrinks. Today, MA can reach back up to three months before enrollment to cover eligible bills. After January 1, 2027, most non-disabled adults will get only one month of retroactive protection. People whose MA eligibility is based on blindness or disability, as well as older adults, will have a two month window—still shorter than today’s three. For a person who ends up in the hospital in July but can’t complete an application until September, that missing month isn’t a theoretical loss. It’s a demand
The Burden of Proof: Navigating New Work Requirements Also kicking in on January 1, 2027, are the new work reporting requirements for many adults on MA. (States are allowed to start them sooner.) On paper, people with disabilities are exempt. The law says that adults ages 21–64 without dependent children must document 80 hours a month of work, MEDICAID To page 5
CAN DO CANINES
Fetching Ball Gala to celebrate the impact of assistance dogs
Tiff and her mobility assist dog, Tucker
By Caren Hansen Transforming people's lives by creating mutually beneficial partnerships with specially trained dogs is the mission of Can Do Canines, and it’s one they take seriously. Can Do Canines is a nonprofit organization that has been raising and training assistance dogs since 1989. They provide dogs to adults and children who live with disabilities that involve mobility challenges, hearing loss or deafness, seizure disorders, diabetes complicated by hypoglycemia unawareness, or childhood autism. They also train facility dogs that are matched with places such as hospitals or with a community service provider. Each dog is provided free of charge and receives customized training tailored to each client’s individual needs. One example of this unique training is Mobility Assist Dog Tucker. Tucker was matched with Tiff, who has spastic quadriplegic cerebral palsy, which affects all of her limbs, her trunk, and her speech. “My muscles are always tightening involuntarily, causing my body to have big and jerky movements. I am unable to walk and complete daily tasks, [including
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eating, getting dressed, walking, cooking, and cleaning] independently. My speech is also impaired, which makes communicating difficult with those who don’t know me.” That communication impairment made it challenging to find the right dog for Tiff. But Tucker was just the dog for the job. Tucker’s trainer, Stacy, used an app on an iPad to act as a talker board for Tucker’s cues. For instance, when Stacy wanted Tucker to “heel” next to her while she was using a similar powerchair to Tiff’s, she would tap CAN DO CANINES To page 4
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