ST. PAUL -- It is easy to learn of Minnesotans' frustration with a costly and problematic health care system, Sen. Steve Dille said.
"As you go about the state and talk to people, that's one of the things that really troubles them," said Dille, R-Dassel, who has worked on health care issues at the Capitol and serves on a committee seeking reforms in the industry.
"Health care is the 1,000-pound gorilla in everybody's house," added DFL Sen. David Tomassoni of Chisholm.
Minnesota policymakers believe they are on the verge of offering relief to some stricken by the health care system. Their optimism is based on the state's projected $2 billion surplus and early indications that Republican Gov. Tim Pawlenty and Democratic-Farmer-Laborite lawmakers, who will control both legislative chambers, share some goals on health care as they head into the 2007 session.
Some even believe a cure to the ailing health care system is within reach, and that in the next two years all Minnesotans will have affordable health insurance and the industry will be more efficient.
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"I think we can pass a cover-all-kids bill this year," Rep. Tom Huntley, DFL-Duluth, said. Lawmakers would then return in 2008 to pass legislation ensuring all Minnesotans are covered with health insurance, he said.
"That's a pretty aggressive view, but I think the time is right and Minnesota is the place to do it," said Huntley, incoming chairman of the House Health Care and Human Services Finance Division.
Pawlenty, a Republican, surprised many lawmakers after his re-election in November when he called for health insurance for Minnesota's roughly 66,000 uninsured children as a step toward universal coverage.
"We'll have proposals to modestly increase coverage over time," Pawlenty later explained to reporters. "We can't do it all overnight because it is very expensive"
The governor's position helped to set the stage for potentially dramatic health care reform. Democrats like Sen. Linda Berglin, who want to expand eligibility in the state-subsidized MinnesotaCare insurance program for low-income citizens, believe progress can be made this year.
Pawlenty said expanding coverage isn't "a Republican or Democrat idea" and that there are different ways to do it. While offering few details before his budget proposal is released later in January, the governor has said greater health care access could be reached by:
n Making some health care products more affordable.
n Expanding some existing health care programs.
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n Providing tax credits to people who buy private insurance plans.
The governor, who in 2003 cut some MinnesotaCare recipients from the program to help erase a $4.5 billion deficit but later restored some of the funding, said health care access, cost and quality must be addressed. That could include dozens of policy changes that may not attract much attention but are necessary.
"A lot of it's just the hard work of going in and forcing, requiring, cajoling insurers, providers and HMOs to change the way they do business," he said, and urging people to maintain their health.
Berglin, the lead Senate DFL'er on health care and a frequent critic of Pawlenty, agreed that a comprehensive approach is needed.
"It's more than just giving people access," said Berglin of Minneapolis, who will oversee the Senate Health and Human Services Budget Division.
Many lawmakers believe uninsured children should be the first recipients of expanded coverage.
"We've got a lot of children that are not on (insurance plans) that should be on," Rep. Bud Heidgerken, R-Freeport, said. "That was a big issue in the last campaign."
The cost to provide MinnesotaCare benefits for uninsured children could be paid through the Health Care Access Fund, which currently holds roughly $160 million, he said.
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Sen. Keith Langseth, DFL-Glyndon, said he expects policymakers to expand MinnesotaCare to include more people.
"We aren't going to make a giant leap into universal health care," Langseth said.
Langseth predicted incremental changes will occur in health care, in part because Pawlenty won't push a more comprehensive agenda. "It's good campaign rhetoric, but he has got to give us a proposal."
About two-thirds of Minnesota's uninsured people could qualify for MinnesotaCare, he said, and lawmakers could approve allowing small businesses to join together to buy insurance.
One health care issue troubling Heidgerken is whether large companies provide coverage for employees. He said big business shouldn't force its employees to seek MinnesotaCare coverage because it is cheaper for the company than providing private coverage.
"I think it is a problem right now," he said.
Farmers are sometimes overlooked in discussions about expanding MinnesotaCare, Sen. Gary Kubly said. The Granite Falls DFL'er said he wants the Legislature to expand MinnesotaCare eligibility to make it easier for farmers to obtain the coverage.
Both lawmakers and the governor are interested in cutting health care costs in part by streamlining medical paperwork. Pawlenty sent a group of health officials to Utah in mid-December to study that state's policy on universal health plan billing.
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Minnesota legislators passed similar legislation more than a decade ago, Huntley said, but state government hasn't forced the industry to change. Lawmakers could pass a similar bill again, but the governor must "knock some heads" to make sure health insurers comply, Huntley said.
Top Republican legislators have warned against big expansions of government-sponsored health care programs. Senate Minority Leader Dave Senjem of Rochester said lawmakers should be cautious about moving toward "socialized medicine."
Rep. Marty Seifert of Marshall, the House minority leader, said legislators shouldn't overlook "market-based principles" as they tackle health care. He noted that discount retailers are now offering inexpensive prescription drugs.
"The free market does work in a lot of areas," Seifert told reporters.
Capitol Bureau reporter Don Davis contributed to this story.
