Health care tops agenda as budget deals begin

05/26/2005

Jean Hopfensperger and Patricia Lopez,
Star Tribune
May 26, 2005

Health care issues took center stage on the second day of the special session Wednesday, with the Senate putting a new health care proposal on the negotiating table and a packed hearing on the governor’s proposed cigarette fee.

In fact, Sen. Linda Berglin, DFL-Minneapolis, was the only elected representative for the DFL Senate majority in the daily public summit talks with Gov. Tim Pawlenty and Republican House Speaker Steve Sviggum. Berglin heads the Senate Health and Human Service Budget Division.

She presented a plan that she said would prevent any MinnesotaCare enrollees from losing their benefits—a reference to MinnesotaCare budget cuts proposed by the governor and the House—and also would reduce costs to the state general fund.

The proposal would shrink the overall budget gap for health and human services between the governor and the Senate from $251 million to $210 million, Berglin’s staff said.

“It’s a concept worth exploring,” Pawlenty told her.

Specifically, the Senate plan would cut state spending on the General Assistance Medical Care (GAMC) program—now funded by the state general fund—by moving most of its enrollees onto MinnesotaCare. MinnesotaCare is funded by a separate fee paid by health care providers.

The idea shares some common ground with budget plans from the governor and the House, which tap the MinnesotaCare funding pool to pay for all of GAMC. Those plans also call for removing an estimated 47,000 adults without children from MinnesotaCare, in part, to make room for the GAMC program.

“I’m moving people into a permanent medical home in a way that doesn’t cut anyone from eligibility,” Berglin told Pawlenty and Sviggum. She said GAMC would become an “entrance point” insurance program for adults without children, who would move onto MinnesotaCare as they found jobs.

Both Pawlenty and Sviggum said they were interested in the idea, but they were concerned that it didn’t move the Senate significantly closer to their budget targets. Said Pawlenty: “Let’s see what we can do with this and get back to you.”

Pawlenty and Sviggum expressed irritation that Senate Majority Leader Dean Johnson did not attend Wednesday’s two negotiating sessions. By day’s end Pawlenty had sent Johnson a letter, urging him to return to the table so that broader global budget targets could be hammered out. Meanwhile, Berglin’s Health and Human Service Budget Division held a public hearing on Pawlenty’s proposal for a 75-cent “fee” on cigarettes.

During three hours of testimony, a common theme emerged from groups ranging from the Minnesota Medical Association to the labor union for service workers: The tax is a good idea, especially as a tool to prevent younger people from smoking.

But the money needs to be used to offset health care costs rather than pay for other programs, as Pawlenty proposes, the speakers said.

The last round of budget cuts to MinnesotaCare have left county hospitals picking up the tab for thousands of more patients, and straining local safety nets, said Amy Wilde, a Meeker County commissioner representing the Minnesota Association of Counties.

Wilde disagreed with the governor’s plan to use the majority of revenues to fund education.

Many speakers told stories about friends or colleagues who became ineligible for MinnesotaCare after last session, and have been unable to afford prescription drugs or medical attention—sometimes with disastrous consequences. Any cigarette fee should be used to restore last session’s budget cuts to health care, they argued.

Meanwhile, the cigarette fee will apparently not come up for discussion anytime soon in the Taxes Working Group, which met Wednesday, but could do little to close the gap that divides the House and Senate on revenues.

House Taxes Chairman Phil Krinkie, R-Lino Lakes, said he would like the Senate to be the first to hold a hearing on the fee. Senate Taxes Chairman Larry Pogemiller, DFL-Minneapolis, who co-chairs the working group with Krinkie, said that no, the House should hear it first because Pawlenty should prove he has the support of his own Republican members first.

Krinkie, who does not favor the proposal because he considers it a tax increase, said with a smile that he would hold a hearing “right after I hear the stadium bill.”

Krinkie is a noted opponent of attempts to build a Twins’ stadium with taxpayer money.