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MinnesotaCare enrollees wait for Legislature, and worry
Senate DFLers say they'll present a significant counter proposal on Thursday when legislative leadership and Gov. Pawlenty meet to talk about the state budget. Lawmakers are in the third week of a special session to resolve their differences on many issues including health care, education and taxes. The failure to pass a budget so close to the end of the fiscal year is causing concern for many people, including those who rely on state-subsidized health care. People who rely on the state's MinnesotaCare insurance and those who treat them say they don't know how to plan for their care beyond July 1.

St. Paul, Minn. — Julie Steberg, 45, is watching the debate over the state budget very closely. The Zumbrota resident is a stay-at-home mom with four children. Four years ago, Steberg was pregnant with triplets. Doctors ordered bedrest for Steberg, but she still delivered 10 weeks early. Steberg eventually lost her job when caring for the triplets became a full-time responsibility. Steberg and her husband, who's a farmer, enrolled in MinnesotaCare, a state-subsidized program for the working poor.

"I always thought that this would be a stopgap. I always thought that I would have my children, get them into school and then go back into the business field. But most employers now are not even offering health insurance," she says.

Steberg says her kids are mostly healthy, give or take the usual everyday bumps and bruises. Under the proposed budget, her kids will still be covered but Steberg and her husband may lose their coverage. Since budget talks are still in limbo, Steberg says she's not sure if she'll have health coverage in three weeks.

"I don't know how you prepare," she says. "There isn't enough in the budget already to put money aside for a possible health care premium. Some health care premiums are $600, $700, $800 a month. There's months we don't make that amount of money," she says.

Steberg and others like her are at the center of the budget debate at the state Capitol. House Republicans and Gov. Pawlenty want to cut at least 27,000 people from MinnesotaCare. They say state health care costs are rising too fast and need to be better controlled.

Rep. Fran Bradley, R-Rochester, says there isn't enough money on the table to pay for projected increases in education and health care.

"We have turned over every stone that we have possibly can -- at least that I can think of -- to try to do those things to make the program run more efficiently; make it more cost effective. When it's all done, though, that's not enough money and you have to make some choices that are tougher," says Bradley.

Both Bradley and Gov. Pawlenty say they won't support a plan that would increase income taxes on the state's wealthiest residents. Senate DFLers are pushing that idea so they can pay for increases to schools and maintain and expand health coverage.

Sen. Linda Berglin, DFL-Minneapolis, says it's unlikely that Senate DFLers will agree to any major cuts to MinnesotaCare.

"I don't think there's anyone in my caucus who would say 'OK, let's give in. It's OK for women with breast cancer to be left to die.' It's just too important. Not only is it a moral issue, it's a life-and-death issue for people. There's no reason that those types of needs get taken care of," Berglin says.

Health care advocacy groups say they're encouraged by Berglin's attitude and that Gov. Pawlenty has endorsed a 75-cent-a-pack tax on cigarettes. The governor is calling the charge a "health impact fee" but spends some of the money on education.

The Minnesota Hospital Association's Bruce Rueben says he would prefer to see all of the money dedicated to health care. He says without that funding, it's likely that hospitals and rural pharmacies will still face a reduction in state payments.

Rueben says cutting payments and removing people from health insurance will make health care more expensive for everyone. He says hospitals will be forced to make up the difference to balance their books somehow.

"The more they cut hospital rates, the more costs are shifted to working Minnesotans who pay for their health insurance to working Minnesotans or any Minnesotans who pay out of pocket for services," according to Rueben.

Rueben says more costly health insurance premiums will prompt businesses to forego any expansion plans. He says employers are unlikely to hire additional staff if health care costs continue to rise.

Rep. Bradley sees it another way. He argues that many small- and medium-sized businesses are not offering health insurance because MinnesotaCare is available. He says employers will be forced to offer coverage if MinnesotaCare eligibility is reduced.

"Today you hand them a MinnesotaCare brochure when they ask about benefits. Tomorrow you won't be able to do that and they may tell you 'Guess what? I think I'll keep looking.' And the market will react," he says.

Bradley also says Minnesota will still offer better benefits than any other state in the Upper Midwest. Those comments aren't comforting to Julie Steberg. She says she and her husband will probably go without insurance and hope that they don't have any major medical problems.