Legislature set to make more health care changes
ST. PAUL — Minnesota already is on track to establish a new way for its residents to buy health insurance, and now legislators are poised to change how the state takes care of its elderly, disabled and poor.
Senators debated their plan late Thursday to spend $11.2 billion in the next two years for health care, which is second only to public school funding in the $38 billion state budget.
The plan by Sen. Tony Lourey, DFL-Kerrick, builds on the federal Affordable Care Act, also known as Obamacare. State leaders this year established a federally required online health insurance sales program, which in several ways is tied to the Lourey bill.
Lourey said he was disappointed when handed a spending target $150 million less than in the current budget. "It was much lower than I was hoping for."
However, he said, his committee was able to craft a bill that cuts no state-provided health care.
"We raised some revenue in innovative ways," he said, including gaining $80 million by adding a surcharge on HMO revenues.
The bill would increase rates for nursing homes and other long-term care programs by 2 percent in 2015.
Republicans said Lourey’s does too little to help nursing homes and other long-term care programs.
The long-term care industry said it would be better off with the current law, said Sen. Julie Rosen, R-Fairmont.
Some of the 115-plus nursing homes in financial crisis could be forced to close, Rosen said. "It’s going to be very, very tough."
Besides not providing enough money, the bill does not give nursing home administrators the flexibility they need to make good decisions, she added. "We are tying their hands. ... It is going to be more expensive to do business."
Rural legislators, including in the House, where a similar bill passed earlier this week, say nursing homes often are the biggest employers in their districts. If they close, communities will be hurt, they say.
Among the biggest changes Lourey’s bill would make is in MinnesotaCare, which provides state-subsidized health insurance to those who otherwise could not afford it. The bill would use federal cash for the program.
Lourey would remove an existing $10,000 MNCare cap on hospital costs and cut premiums in half.
MNCare now gets about half of its funding from Washington, but supporters of the Lourey bill said under the legislation, up to 85 percent of funding would be federal.
The bill also would:
- Require new rates to be established so nursing homes are paid closer to their actual costs than happens under current law.
- Increase funds available for dental services received by the poor.
- Pay child care providers involved in several programs 2 percent more in the next two years.
Led by the Democratic Senate majority, a provision to license abortion clinics was rejected 35-30. However, the provision is in a House bill, so it remains active.
The proposal by Sen. Michelle Fischbach, R-Paynesville, would have required clinics that perform more than 10 abortions a year to obtain a state license. Democratic Gov. Mark Dayton vetoed a similar provision last year.
Lourey said the Health Department reports "there is sufficient oversight of the clinics. ... There is no evidence of poor quality or unsafe procedures being conducted in Minnesota."
Senators also voted down a proposal 35-28 to give health care workers a 5 percent pay increase, taking money from other programs.
Sen. David Brown, R-Becker, said many lawmakers voted themselves a 35 percent pay raise, but "it is not too much to ask" to give nursing home and other workers more money.
Several other GOP attempts to raise nursing home pay also failed.