House health care bill makes the tough choices

Published 12:50 pm Saturday, May 1, 2010

The 2010 legislative session is scheduled to end on May 17, just two weeks away. We have worked hard this session and worked quickly to address some of the big challenges facing our state. The early weeks of session were marked by strong cooperation and bipartisanship.

There are 134 members in the House of Representatives. Out of the 108 bills the Legislature voted on by April 8, 94 passed with over 100 votes. This strong showing of support from both Democrats and Republicans is a welcome indication that we are working together to get Minnesota back on track.

There are two major bills left to be completed by the end of session, health care and education. This week the Health and Human Services Committee released its budget proposal, a balanced plan that reduces spending by $302 million and accesses $408 million in federal dollars made available in the recently enacted federal health care reform legislation. The plan reduces the deficit in the next biennium by over $1 billion.

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I do not serve on Health and Human Services, but I know the decisions about where to make cuts were not easy. The HHS budget is 28 percent of total state spending, and yet last year, this budget absorbed 70 percent of the overall budget cuts. I have personally been contacted by countless advocates for nursing homes, hospitals, the disabled community and senior citizens, to name a few, asking not to cut their budgets again.

These were tough choices to make, and I know the members of the committee agonized over their decisions. In the same way, it will be difficult for me to decide whether or not to vote for passage of this budget plan.

The good news is that the HHS budget does not cut funding for nursing homes or hospitals this year. This component alone could save hundreds of health care jobs across the state.

The budget provides funding for General Assistance, a $203 monthly payment for disabled or unemployable adults that has not been increased in 24 years. It also maintains MinnesotaCare coverage for 35,000 adults without children. Both of these programs are eliminated in the governor’s budget plan.

The legislation includes funding to provide MinnesotaCare to voluntary firefighters, increased funding for rural pharmacies and improved access to dental care for low-income Minnesotans. It also includes many good policy provisions, such as requiring insurance companies to provide the same reimbursement for oral chemotherapy as for other forms of treatment. A person stricken with cancer should receive the treatment that will work best for them, not the plan the insurance company will pay for.

There are hard cuts in this bill, including cuts in funding for counties, specialized physicians, and one-time mental health grants. An additional $8 million is cut from agency administration, which should primarily affect political appointees and management.

Because Minnesota is a leader in providing high quality health care for so many people, we are one of 11 states eligible for early enrollment in Medical Assistance. By enrolling people without children who earn less than the federal poverty guideline into Medical Assistance, we receive a 50 percent federal match for the costs of the enrollees. This population is currently covered by either the state funded General Assistance Medical Care or MinnesotaCare.

By choosing this early Medical Assistance option, funding for health care providers will be improved significantly, and Minnesota will capture millions of dollars that will otherwise go to any of the other 10 states eligible for early Medical Assistance enrollment.

One of the beneficiaries of the early Medical Assistance will be health maintenance organizations. To partially offset the 20 percent increase in payments they will receive, an HMO surcharge is included in the bill. This is very similar to a proposal supported by the governor and GOP House leaders in 2003, so health care leaders are optimistic it will be supported again this time.

As I mentioned earlier, I am still in the process of deciding whether or not I support this legislation. I was reminded only recently that these cuts pale in comparison to the tough choices we will face next year when our state deficit could be as high as $7 billion. Nonetheless, cutting is never easy, and it is very personal to those on the receiving end.

As always, it is an honor to serve. Please contact me with your thoughts on what cuts we should make, and what areas should be protected. I can be reached at (651) 296-8216 or by e-mail at I look forward to hearing from you.

Robin Brown, DFL-Moscow Township, is the state representative for District 27A.