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Surgical precision

Published (5/20/2011)
By Hank Long
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A bill that has traditionally been a sticking point in past session budget negotiations is now in the hands of Gov. Mark Dayton.

The House passed a conference committee report on the omnibus health and human services finance bill 69-63 May 19 that outlines $1.6 billion in projected General Fund spending reductions for the 2012-2013 biennium. The Senate passed the bill 36-28 about six hours earlier.

“We have worked hard to reach out to the administration and all stakeholders to develop a bill that protects priorities, promotes reform and creates a sustainable system,” said Rep. Jim Abeler (R-Anoka), who sponsors HF927/ SF760* with Sen. David Hann (R-Eden Prairie). The conference committee report calls for $10.9 billion in total health and human services spending.

The governor’s health and human services budget proposes $600 million in cuts for the next biennium, which DFL House members were quick to point out is the more balanced approach than the one the Republican majority in the House and Senate has taken.

“We ought to be trying to figure out how we can keep institutions alive until the economy recovers,” said Rep. Thomas Huntley (DFL-Duluth). “We will destroy institutions because of this bill. We will destroy hospitals, some groups that provide services to people who are handicapped and a lot of other damage.”

Republicans said health and human services spending has increased 109 percent in the past decade. The report would cut projected spending by 15 percent.

“We simply cannot afford the spending growth of the last decade,” Hann said, “and this bill takes the necessary steps to get a handle on unsustainable spending.”

The report’s biggest reduction in spending would come from the elimination of Medical Assistance eligibility for adults without children beginning Oct. 11, 2011, a provision not included in Dayton’s proposed budget. That alone counts for more than $921 million in savings for the next biennium. Other significant cuts outlined in the bill include a $93 million freeze on waiver spending and reforms to managed care and high cost providers that would save $197 million. The report calls for restoration of the General Assistance Medical Care and Coordinated Care Delivery Systems programs which would put $330 million back into the HHS budget. Both programs assist some of the state’s poorest residents.

Huntley, the DFL lead on the House Health and Human Services Finance Committee, said the Minnesota Hospital Association is not confident any hospital will sign up for the CCDS program because it is underfunded. He read a letter from the Minnesota Hospital Association that urged legislators to vote “no” on the conference report. The Republican plan would result in 125,000 people losing health insurance and take $1.2 billion out of the state’s health care systems, Huntley said.

Abeler said many of these people would be eligible for other plans, and he pointed to a provision in the report that would appropriate $450 million in health care service programs annually for people earning income between the federal poverty guideline and 125 percent of poverty.

Earlier in the week, House and Senate Republican leaders met with the governor’s staff and health and human services commissioners to discuss the differences between their numbers and Dayton’s proposed budget. Abeler said the parties have not yet achieved full agreement, but have been working in amenable fashion in attempt to do so.

“We are all about finding a resolution that we will undoubtedly have to do,” Abeler said.

Lt. Gov. Yvonne Prettner Solon told conferees May 17 that she hopes they keep in mind the state’s most vulnerable citizens as they attempt to negotiate with the governor on a solution.

“It’s also very, very important that we keep the (health and human services) infrastructure in place, including the hospitals, the providers, the nursing homes that provide that network toward our community, our Minnesota citizens,” Prettner Solon said. “I am hoping you will remember that issue as you go about your deliberations.”

Abeler said conference report figures represent overdue reform for a growth in spending that has become unsustainable.

“If we are not careful, we are going to wind up with our system being unable to serve in a very good way all the people we so very much care about,” he said.

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