Dems question GOP numbers on human services cuts

Medicaid plan
Nikki Villavicencio, left, of St. Paul, and Corbett Laubignat, of Bloomington, appear at a news conference at the State Office Building in St. Paul on Monday, Jan. 31, 2011. Villavicencio and Laubignat criticized -- and threw in the trash can -- a HMO proposal that would scale back the state's Medicaid benefits.
MPR Photo/Lorna Benson

Republicans in the House are proposing massive cuts to health and human services programs, to help erase the state's projected $5 billion budget deficit.

Supporters of the bill say it reins in one of the fastest growing areas of state spending. But Democrats say the GOP-acked plan cuts too deeply, and they aren't sure the budget savings will materialize.

The biggest chunk of the House GOP plan comes in the area of health and human Services.

Rep. Jim Abeler, R-Anoka, who chairs the House Health and Human Services Finance Committee, has proposed cutting $1.6 billion in spending from his budget. Health and Human Services is the second largest piece of state spending and the fastest growing portion of the budget.

Abeler says that growth has to be curtailed.

"If [people] think that somehow this whole arena can be held off the table -- our good Gov. Dayton, who's a good man, had $4.1 billion to spend and still reduced his budget by $800 million," said Abeler. "So don't be naive to think that nothing will have to change. Things are going to change."

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The bill calls for removing 7,200 people from the MinnesotaCare health insurance program. It also would save $300 million by cutting payments to HMOs and doctors that provide the least efficient care. It would save another $300 million by asking the federal government to change how the state delivers Medicaid services to the poor, the elderly and the disabled.

Rep. Abeler
Rep. Jim Abeler R-Anoka, left, talks with reporters as House Speaker Kurt Zellers, right, looks on during a news conference at the State Capitol in St. Paul, Minnesota, Saturday, May 15, 2010.
Craig Lassig/AP

Democrats say the math doesn't add up.

"We're going to vote on this bill on Thursday, and we will not know what it costs," said Rep. Tom Huntley, DFL-Duluth.

Huntley said several portions of the bill don't include any details about exactly how the cost savings would be realized.

"No experts have looked at this," said Huntley. "Nobody in the Department of Human Services. Nobody in the office of Management and Budget has looked at this proposal and given us a number of what it will save."

Huntley also criticized the plan for cutting programs that keep the disabled and seniors out of nursing homes. Supporters of that provision say it would streamline programs so that every county offers the same services.

"Nobody ... has looked at this proposal and given us a number of what it will save."

But Patti Cullen with the nursing home group, CareProviders of Minnesota, predicted that some nursing homes could be forced to close under the proposed cuts in the bill. She also said cuts in programs that keep people out of nursing homes mean greater pressure on her industry.

"If those services aren't available, then they go to a nursing home. But if a nursing home closes and isn't available, then what?" said Cullen. "We're very concerned about access implications with this budget."

Cullen also expressed concern that the bill would instruct the human services commissioner to cut payments to nursing homes, hospitals and other health care providers if savings promised by the bill aren't met.

Rep. Abeler characterized his proposal as a work in progress. Despite the requirement to move the bill out of his committee by Friday, Abeler said his main goal is to reach an agreement with the Senate and Gov. Dayton before the end of the session in May.

"I'm moving the bill toward resolution by March 23. At some point, we have to discuss the issue of revenue or not," said Abeler. "It's a big discussion item that has to be resolved."

The question about revenue looms over the entire state budget. Gov. Dayton wants to raise income taxes on Minnesota's top earners as part of his budget solution. Republicans argue that they can balance the books by holding the line on spending.

The Senate version of the health and human services budget bill is scheduled to be released later this week.