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Lawmakers weighing cost of preserving MinnesotaCare
by Tom Scheck, Minnesota Public Radio
July 12, 2005

Rep. Fran Bradley and Sen. Linda Berglin are trying to line up support for a budget deal that included preserving the MinnesotaCare health care program. (MPR Photo/Tom Scheck)

Gov. Pawlenty and legislative leaders plan on spending the bulk of Tuesday counting votes to make sure new budget bills pass when the House and Senate debate them on Wednesday. The bills are based on the budget agreement reached over the weekend that put an end to the partial government shutdown. Legislative working groups have completed most of their work assembling bills relating to taxes, health care, transportation and education. Disagreements over how to fund health care programs were a major factor leading to the shutdown, and the budget agreement has not put an end to the controversy.

St. Paul, Minn. — The $9 billion health and human services budget determines funding for everything from protecting the state's most vulnerable people to providing chemical dependency assistance to those in need. The proposed budget would increase funding for nursing homes and other long-term care facilities by 4 percent over the next two years.

Senate DFLers are applauding another provision ensuring that MinnesotaCare recipients will continue to have health insurance. Even Republican Rep. Fran Bradley of Rochester, who proposed cuts to the subsidized health insurance program, says preserving eligibility is a major piece of the health budget.

"The people who were concerned, the one thing you read in the papers and heard all around was MinnesotaCare. That headline is gone. As well it should be because we did maintain eligibility where we are," he says.

Doctors, hospitals and other health care providers say they're pleased about the new headline. They say cuts to the program would have added to the state's uninsured population and in turn raised uncompensated care costs.

That's not to say hospitals don't have other concerns. Bruce Rueben with the Minnesota Hospital Association says Minnesota hospitals will lose about $60 million in the proposed budget because of a 5-percent rate cut for inpatient services. Reuben says that was an acceptable trade-off for protecting MinnesotaCare.

"The restoration of eligibility was our higher priority because of the impact it has on the people we serve. It doesn't make the cuts easier to swallow. We'd like to have full restoration of eligibility and no cuts but that wasn't going to happen this time around," he says.

Child care advocates and parents who rely on child care assistance are also seeing another cut in funding this biennium. Chad Dunkley, the president of the Minnesota Child Care Association, says cuts to child care subsidies will leave providers some $50 million short of what they say they need to keep their programs operating.

"This is going to take us a giant leap backwards from the bad shape that we were put in 2003," according to Dunkley. "As a provider who tries to provide quality services, my services will be far less accessible to families on this program because of the decisions that they made again in cutting child care programs."

While lobbyists and other groups are concerned about cuts in the budget, others say the budget is growing too fast. Republican Rep. Tim Wilkin of Eagan says he's worried that state subsidized health insurance programs like MinnesotaCare will continue to eat up other portions of the health budget.

"The Legislature is really going to have to grapple with the increasing cost of health care and really decide which priority are we going to handle and give them the assistance with these programs or are we going to continue to have middle income people on these programs because I don't think we can afford that long term," Wilkin says.

Wilkin says he also doesn't like the 75-cents-a-pack cigarette tax that's a part of the health and human services budget. Gov. Pawlenty is calling the proposal a "health impact fee" since it will cover the cost of smoking-related illnesses covered by state insurance programs.

Republican House Speaker Steve Sviggum says many of his colleagues don't like the tax and he isn't sure how many Republican votes it will get. DFL Sen. Linda Berglin says she'd prefer another way to raise revenues but says the cigarette tax was the only option that would end stalled budget negotiations.

"People that might think about it whether they can vote for it because of that provision really need to look at the rest of the bill because there are many things that their constituents will be looking for that will be coming with this bill," Berglin says.

If the health and human services bill or any other bill doesn't pass the House and Senate on Wednesday, it's likely another partial government shutdown could occur on Friday. That's when a so-called "lights on" bill would expire and thousands of state workers would be back off the job.