The author of a Republican bill proposed in the Minnesota Senate Wednesday says it will transform and improve the state's health care system with deep cuts totaling $1.8 billion, but Democrats say it will eliminate care for hundreds of thousands of Minnesotans.
The most sweeping part of the Senate Health and Human Services proposal changes how the state's low-income residents get health insurance.
Sen. David Hann, R-Eden Prairie, wants to effectively end the MinnesotaCare health insurance program and dramatically reduce the federal Medicaid program.
“I don't know why they think because they're in Washington that they're smarter than we are here. I think we can do the job here.”Sen. David Hann, R-Eden Prairie
Hann aims to replace those programs, which serve more than 100,000 people, with a state subsidy to buy health insurance on the private market. Hann's bill asks the federal government to approve the change.
"As a matter of principle, we think they shouldn't be constraining us when we're trying to manage our budget and do what is best for the people of Minnesota," Hann said. "To me, the simple answer is it's our money. We're elected representatives. I don't know why they think because they're in Washington that they're smarter than we are here. I think we can do the job here."
But several Democrats say there's no guarantee that the federal government will approve such a waiver.
Sen. Linda Berglin, DFL-Minneapolis, said the Senate is "wasting its time" by moving forward with a budget that includes what she calls "phony baloney" numbers.
"Having a political principle is one thing. Having a budget document is another," Berglin said. "We have never been able to count savings from a waiver that we may not get."
Other Democrats are questioning the overall impact that the bill will have on the public. In addition to the switch from public programs to the private marketplace, the bill also changes required services for poor people. Eye care, dental care and, occupational and physical therapy are just a few of the services that are cut under the plan.
Sen. John Marty, DFL-Roseville, said the bill is mean-spirited.
"Even Republican rhetoric talks about protecting the vulnerable. They talk about protecting the vulnerable and this bill takes the vulnerable and takes a meat axe to their programs," Marty said. "That affects child care, that affects disability services, that affects nursing homes. That affects anybody who's sick."
Some of those affected are already lining up against the bill. Sue Abderholden with the Minnesota chapter of the National Alliance on Mental Illness said she's nervous about the shift in care. She also said the bill cuts tens of millions of dollars in grants aimed at helping children and adults with mental illnesses.
"What we're going to see is a lot more people showing up in emergency rooms and in jails," Abderholden said. "I hope that the public safety committee in the Senate also looks at whether we have enough prison beds for people who have a serious mental illness and chemical dependency. People don't disappear. They end up somewhere, and I think they're going to end up in a worse place."
Hospital officials are also criticizing the bill. Lawrence Massa with the Minnesota Hospital Association said it's ridiculous to think that low income Minnesotans are going to buy private, high-deductible health insurance. And even if they do, he said there's no guarantee they'll be able to pay those high deductibles if they get sick.
"If they can't pay it, the hospital eats the cost either through charity care or writing it off as a bad debt," Massa said. "That gets built into the bills that get paid by everybody else. It will mean higher health insurance premiums for people."
Massa also said hospitals would also lose federal funding that is matched under the Medicaid expansion recently authorized by Gov. Mark Dayton.
Hann is requesting that the state government stay out of the federal health care law altogether. His bill would forbid state funds from being used to implement the federal law.