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Health bill heads to questionable future

Rep. Al Juhnke, DFL-Willmar, watches a Minnesota House debate Monday, when lawmakers considered a major health-care spending bill. Scott Wente/Minn. State Capitol Bureau

ST. PAUL - Minnesota lawmakers passed a massive health-care spending bill that favors nursing homes and programs for the poor, but may be short-lived.

The Democratic-Farmer-Labor Party-led Legislature on Monday advanced the health and human services budget bill that Republican Gov. Tim Pawlenty's administration says spends more than the state can afford.

It faces a likely veto with less than a week remaining before the Legislature's constitutional deadline.

The House approved the bill 80-51, the Senate 47-18.

The bill protects government-subsidized health insurance programs for low-income Minnesotans and cuts state payments to some health-care providers. It would spend $10.7 billion in state tax funds during the next two-year budget period, an increase of about $850 million over current spending.

State health-care spending was predicted to increase to $11.3 billion in the budget period beginning July 1, if left unchanged, so Democrats say their bill cuts spending increases by around $500 million.

"Every one of those cuts is painful," said Rep. Tom Huntley, House health-care finance chairman. "Every one of those $500 million in cuts will hurt somebody, but what we did was try to minimize the damage we could."

Huntley, DFL-Duluth, acknowledged that the spending package relies on revenue from a tax-raising plan that Pawlenty vetoed Saturday. The nearly $1 billion tax-increase plan would have spent about $400 million on nursing homes and hospitals.

Human Services Commissioner Cal Ludeman said the health-care funding bill spends more than the Pawlenty administration proposes and relies on federal dollars that will not be available in future years.

"It's just not sized right to get us to a balanced budget," Ludeman said.

Pawlenty wants to see less spending and more health-care reform, spokesman Brian McClung said.

"This is not a bill the governor supports," he said.

The DFL budget proposal does not make direct cuts to nursing home reimbursement rates - as an earlier Senate plan proposed - but does delay a rate increase many nursing homes had anticipated.

The bill proposes cutting reimbursement rates by nearly 2.6 percent paid to other long-term care providers.

There are 33,000 nursing home beds in Minnesota and about the same number of people treated in other long-term care settings.

Health and human services spending is the second-largest state budget area, behind public school education, but is the fastest-growing part of the budget.

"We are slowing the growth slightly," said House Minority Leader Marty Seifert, R-Marshall. "We need to slow the growth more."

Other Republican lawmakers said the bill short-changes nursing homes in rural Minnesota.

"When are we ever going to positively address the disparity between our rural and metropolitan nursing home funding?" Rep. Dean Urdahl, R-Grove City, asked.

Huntley said the proposal was drafted with two priorities - to protect nursing homes as much as possible and to minimize payment cuts to hospitals.

Democrats said hospitals and nursing homes would be in worse shape under Pawlenty's spending plan.

Assistant Senate Majority Leader Tarryl Clark, DFL-St. Paul, criticized Pawlenty's health and human services proposal.

"He is cutting health care deeply," said Assistant Senate Majority Leader Tarryl Clark, DFL-St. Cloud. "We believe that is fiscally imprudent."

The bill also:

  • Scales back dental services offered to adults on government health programs. Pawlenty proposed eliminating the services.
  • Cuts state reimbursements to pharmacists who serve government health-care programs for the poor.
  • Reduces state reimbursements to hospitals for inpatient services by 1 percent and to medical specialists by 5 percent.
  • Expands MinnesotaCare eligibility or lowers premium costs for about 2,100 farmers.

Here is how local senators voted on a health and human services spending bill:

Thomas Bakk, DFL-Cook, yes

Steve Dille, R-Dassel, yes

Michelle Fischbach R-Paynesville, did not vote

Dennis Frederickson, R-New Ulm, yes

Joe Gimse, R-Willmar, no

Bill Ingebrigtsen, R-Alexandria, no

Gary Kubly, DFL-Granite Falls, yes

Keith Langseth, DFL-Glyndon, yes

Tony Lourey, DFL-Kerrick, yes

Steve Murphy, DFL-Red Wing, yes

Mary Olson, DFL-Bemidji, yes

Pat Pariseau, R-Farmington, no

Kathy Saltzman, DFL-Woodbury, yes

Tom Saxhaug, DFL-Grand Rapids, yes

Katie Sieben, DFL-Cottage Grove, yes

Rod Skoe, DFL-Clearbrook, yes

Dan Skogen, DFL-Hewitt, yes

Yvonne Prettner Solon, DFL-Duluth, yes

LeRoy Stumpf, DFL -Plummer, yes

David Tomassoni, DFL-Chisholm, yes

Ray Vandeveer, R-Forest Lake, no

Jim Vickerman, DFL-Tracy, yes

Here is how local representatives voted on a health and human services spending bill:

Paul Anderson, R-Starbuck, no

Tom Anzelc, DFL-Balsam Township, yes

Karla Bigham, DFL-Cottage Grove, yes

Julie Bunn, DFL-Lake Elmo, yes

Matt Dean, R-Dellwood, no

David Dill, DFL-Crane Lake, yes

Steve Drazkowski, R-Wabasha, no

Kent Eken, DFL-Twin Valley, yes

Andrew Falk, DFL-Murdock, yes

Tim Faust, DFL-Mora, yes

Pat Garofalo, R-Farmington, no

Rod Hamilton, R-Mountain Lake, no

Larry Haws, DFL-St. Cloud, yes

Bill Hilty, DFL-Finlayson, yes

Larry Howes, R-Walker, no

Tom Huntley, DFL-Duluth, yes

Al Juhnke, DFL-Willmar, yes

Tim Kelly, R-Red Wing, no

Lyle Koenen, DFL-Clara City, yes

Morrie Lanning, R-Moorhead, no

Bernie Lieder, DFL-Crookston, yes

Doug Magnus, R-Slayton, no

Paul Marquart, DFL-Dilworth, yes

Denny McNamara, R-Hastings, no

Mark Murdock, R-Ottertail, no

Mary Murphy, DFL-Hermantown, yes

Bud Nornes, R-Fergus Falls, no

Dave Olin, DFL-Thief River Falls, yes

Mary Ellen Otremba, DFL-Long Prairie, yes

John Persell, DFL-Bemidji, yes

Tom Rukavina, DFL-Virginia, yes

Brita Sailer, DFL-Park Rapids, yes

Marty Seifert, R-Marshall, no

Tony Sertich, DFL-Chisholm, yes

Loren Solberg, DFL-Grand Rapids, did not vote

Phil Sterner, DFL-Rosemount, yes

Marsha Swails, DFL-Woodbury, yes

Dean Urdahl, R-Grove City, no

Torrey Westrom, R-Elbow Lake, no