Clay County Commission

Dan Haglund
Quinn Jaeger certainly does not like to be the bearer of bad news.
But the Clay County Social Services director laid out the numbers bare for the Board of Commissioners on Tuesday morning. And the federal cuts and requirements look daunting.
To provide some context for the new outlook, the recently signed H.R. 1 reconciliation package, referred to by proponents as the “Big Beautiful Bill,” passed in early July.
It was signed by President Trump soon after makes sweeping changes to tax policy, safety net programs, border enforcement, student loans and energy policy.
The programs affected at Clay County Social Services include the Supplemental Nutrition Assistance Program (SNAP) and Medical Assistance/Medicaid (MA).
The new law includes massive cost shifts from federal to state and county governments.
The expected impacts will be reduced services, higher local administrative costs, an increase in denied services and an increase in workloads.
The implementation of these changes will begin next year and be completely phased in by 2029.
And although SNAP and MA are federal programs administered at the state level, counties are required to operate them under the Department of Human Services.
The reach and impact of Medicaid is pervasive in northwest Minnesota, with 28.1 percent of the population enrolled in the program. In Clay County specifically, 24.4 percent were Medicaid-enrolled last year (16,357 individuals).
“(Medicaid) is the single largest source of health insurance in Minnesota,” Jaeger said. “And it serves as the foundation of our state’s healthcare infrastructure. It pays for more mental health services for Minnesotans than any other insurance provider.”
Jaeger also noted that Medicaid covers roughly half of all substance use disorder cases as well as long-term care costs in the state.
Broken down even further, parents, children and pregnant women account for just 22 percent of Medicaid spending, while adults 65+ and people with disabilities number only 15 percent of enrollees but account for 60 percent of the spending.
Jaeger showed there are two major service changes to MA requirements, which include enhanced work and eligibility stipulations. There are currently no work requirements.
The new work requirements (80 hours per month of work, volunteering, education training, etc.) must be given to states by June of next year, with systems in place to support those changes by the end of the year. The actual law won’t take effect until Jan. 1, 2029.
And for Medicaid eligibility requirements, renewals must be confirmed every six months instead of annually, as it is now. Residency verifications will be bumped up to four times per year beginning Jan. 1, 2027.
Jaeger estimates that the workload on county employees is projected to double with these two new requirements.
Another change will be with retroactive coverage for MA applicants, which will be trimmed from three months to one month effective October 2026.
The overall fiscal impact of the recent H.R. 1 bill will reduce federal MA support by $880 billion over 10 years, with Minnesota projected to lose $12 billion to $14 billion in Medicaid funding over that time period.
Jaeger came up with some impact numbers for Clay County as well.
The county’s increased administrative burden will tally between $950,000 and $1.24 million annually.
“With a doubling of the work, we would need double the staff,” Jaeger said. There are presently 13 employees doing this work.
“The key driver of these anticipated cost increases are this new six-month eligibility re-determination, the work verification requirements and the quarterly address checks,” Jaeger said.
Regarding SNAP, there already is a work requirement in place for adults 18-49, but the new stipulations would push the upper age limit to 64. Any parents with any minor children are exempt from the work requirement now, but that will change to just parents with children under age 14.
The reconciliation bill reduces SNAP support by $186 billion over 10 years. In addition, the federal reimbursement for SNAP administrative costs will reduce from 50 percent to 25 percent effective Oct. 1, 2026.
That means Clay County will have to absorb a portion of that 75 percent outstanding share.
Jaeger said these changes will likely result in more service denials, sanctions and an additional administrative workload. And one residual result will be a strain on local food pantries.
Jaeger said there are about 3,400 SNAP cases per year in the county, representing 7,704 citizens.