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Health care spending plans beginning to take shape

Rep. Tom Huntley of Duluth listens to debate Monday on his bill to fund state health and human services programs. He leads the committee that drew up the bill. Tribune photo by Don Davis

ST. PAUL -- Hospitals take a funding hit while most nursing homes are protected.

Low-income Minnesotans keep their government-subsidized health insurance while some doctors lose state aid for treating the poor.

Facilities caring for patients with long-term illnesses lose some state support while more children are eligible for public-supported health insurance.

Those are among trade-offs offered in similar, but competing, health-care and human services proposals lawmakers debated Monday. The bills fund the second-largest -- and fastest-growing -- portions of the state budget.

The Minnesota Senate version passed 40-23. House lawmakers were still in session at press time.

The House and Senate plans, each spending around $11 billion in the next two years, are vastly different than Gov. Tim Pawlenty's health finance proposal, which cuts some programs to slow health-care spending. The Republican governor argues that unless spending increases are curtailed, health care will consume the state budget.

The House proposes cutting $400 million from what health and human services programs otherwise are projected to cost in the next two-year budget period. The House bill would add 50,000 Minnesota children to the health care rolls, while at the same time cutting funding headed to many health-care providers.

"That means there's 400 million reasons to vote against this bill," said Rep. Tom Huntley, DFL-Duluth, chairman of the House health finance committee. "I don't like this bill. I think the cuts are going to hurt a lot of people and a lot of institutions."

Just over $600 million is cut from the Senate plan, amounting to a 7 percent decrease in projected spending increases. Sen. Linda Berglin, a Minneapolis Democrat and Senate health finance chairwoman, said her committee "did a pretty good job considering the (spending cut) target we were given."

Senate Democrats have proposed a $2.2 billion tax increase, and yet they also propose cutting funding to nursing homes and other health-care programs, said Sen. Michelle Fischbach, R-Paynesville.

No one would lose state health care in either the Senate or House proposal. That is one of the biggest differences with Pawlenty's human services budget proposal, which would drop at least 84,000 people from the MinnesotaCare health insurance program.

Nursing home funding is among the most politically sensitive human services programs, and all three proposals delay anticipated state aid increases to the facilities.

However, like Pawlenty's proposal, the House bill makes no reductions to nursing home reimbursements. Other types of long-term care facilities, such as for developmentally disabled patients, lose reimbursement

Senate Democrats' bill would cut $6.5 million collectively from nursing homes that receive the highest level of state reimbursements among facilities in their region.

Like the other spending bills, House and Senate negotiators will begin working out differences between the health finance packages in the coming days.