Senator John Hoffman: Reducing the Cost of Programs for Children with Disabilities

Minnesota is a leader in providing care for children with disabilities. The TEFRA program was created so that parents who earn too much to qualify for Medical Assistance could still receive services covered by public insurance. Only the child’s income is counted under the TEFRA option, and parents must pay a fee based on a sliding income scale.

What started off as a great idea to serve more families, has become a financial burden for many households due to the thousands of dollars in growing fees associated with the program. It is unconscionable that children in our state are unable to receive the health care and therapies they need to help them live more independently in the community because rising costs of parental fees have become so unaffordable. This issue significantly impacts middle class families who often struggle to pay the fees out of their modest incomes. For that reason, we are exploring ways to address these high costs that are keeping families out of this program.

This year, I am co-authoring a bipartisan bill to direct the Commissioner of Human Services (DHS) to develop a clear explanation of the medical assistance-TEFRA option for the online application process. It also directs the commissioner to develop a cover letter explaining the TEFRA enrollment and renewal processes. This letter should clearly outline the program and be included with the materials sent to applicants who qualify for the TEFRA option. This legislation comes out of a concern that families are not clearly informed that their child may be eligible for medical assistance coverage through the TEFRA option when they apply for insurance through MNsure, even when the family does not qualify for medical assistance when accounting for parental income. My goal is to encourage DHS to make certain information on TEFRA is as easily available to families as possible. My legislation also directs the commissioner to convene a stakeholder group to consider additional ways to improve this process.

Another bill I am supporting would exclude parents of children determined to be eligible for the TEFRA option from being assessed a parental contribution fee for the cost of medical assistance services. Although we don’t have the fiscal note yet, a similar bill was introduced in 2015 and 2017. The cost of completely eliminating the fees in the 2015 proposal was $18.2M in FY16-17 and $23.7M in FY18-19, and the cost of reducing the fees for parents with income above 275% FPG in the 2017 proposal was $8.4M in FY18-19 and $10.7M in FY20-21. I am hopeful these bills will gain support this year so we not only address this growing problem but Minnesota can serve more children and families in need.

To contact me with your ideas and feedback, you can reach me by phone at 651-296-4154 or by email at You can also mail letters or pay me a visit in the Minnesota Senate Building, Room 2231, right across the street from the Capitol.

Senator John Hoffman
John Hoffman represents District 34, which includes portions of Anoka and Hennepin County.

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