There are many reasons why lawmakers might be tempted to defer the legislation.
For one the bill requires more spending in tough budget times. It will also likely result in some painful changes in Minnesota's health care industry - changes that some rural lawmakers worry will harm the financial health of small clinics and hospitals.
When negotiations on the health care bill got particularly tough two weeks ago, House sponsors held a news conference to show their colleagues that Minnesotans expect them to deal with reform this session. Members of the business community, labor unions and health care groups gathered at the Capitol. They urged lawmakers to resolve their differences.
It hasn't been easy, but since that news conference last month House members have found ways to compromise and still preserve the integrity of the reform bill, according to the co-sponsor of the House bill, Rep. Paul Thissen, DFL-Minneapolis.
"We've taken pieces out that either aren't fully ready yet or haven't met with broad approval. But there's a lot of it that remains and that makes significant change," he says.
At its core the House bill improves the way care is delivered and as a result, improves patient outcomes, Thissen says. Savings from those better outcomes would then be applied toward expanding MinnesotaCare coverage for uninsured people and toward bringing down the premium costs of private health insurance.
To pay for some of its up-front costs, the House bill would tap about $280 million over the next few years from a surplus in the Health Care Access Fund. The Senate plan would spend nearly the entire projected $400 million surplus in the fund on health care.
Those plans are at odds with Gov. Pawlenty's wish to use a big chunk of the Health Care Access Fund surplus to help plug the state's budget deficit. Thissen doesn't think the dispute is a deal-breaker.
"We are not tapping it and we are not going to tap it. We are going to use it for the purpose it was intended which is to get health care to people. And until the need to get health care for people goes away I don't see any reason that we should tap that for other purposes."
The governor hasn't said whether use of the Health Care Access Fund surplus is a negotiable point. But Thissen is confident a compromise can be reached, since he says House lawmakers have addressed many of the Governor's other concerns about the bill. Money is clearly a big hurdle for many lawmakers, says Maureen Reed, a member of the Governor's Health Care Transformation Task Force which came up with many of the recommendations included in the House and Senate bills. Now may be the best time for long-term change because the reform bill could save Minnesota billions of dollars in health care spending, she says.
"You have to do this health care bill if we want a long-term future in Minnesota that's not just cuts, cuts, cuts and more cuts down the line. So I'm a believer that a budget crunch is exactly the time when the tough stuff can be done." There is another reason, according to supporters, why the time for health care reform is now.
A lot of people came together from all political stripes to develop this reform plan. That's unique and may not happen again, says AARP Minnesota spokesperson Amy McDonough.
"Nobody wants to see another task force assigned to this. This has been studied. Minnesota is a really good place to do these reforms, to try payment reform and to try some of these things that are going to make a difference for people. So we don't want to see it put off."
Her organization is hearing that if health care reform doesn't pass this session, it is even less likely that the legislation will succeed next session, McDonough says.