Minnesota's nursing home and long-term care workers would get small salary increases in a health spending bill up for debate Monday in the state House, but some lawmakers question whether the increases are enough for financially challenged facilities in rural areas.
The Democratic-sponsored, $7 billion health and human services budget includes a 3-percent pay hike for nursing home workers and 2 percent for long-term care workers.
The bill's sponsors said it would give about 600,000 additional Minnesotans access to some form of health insurance in the next two years, though some of those costs would be covered by federal and not state funds. The bill also steers new money to expanding access to mental health treatment for students.
The bill includes several new ways for the state to raise money for health programs. It would increase a state surcharge on hospital budgets from 1.56 percent to 2.63 percent, a move that's likely to be felt mostly at Mayo Clinic and suburban hospitals that serve fewer medical assistance patients.
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The measure also would collect about $50 million by making HMOs return excess operating reserves fed by government insurance programs.
The House Democratic proposal spends about $170 million less on health programs than was requested by Democratic Gov. Mark Dayton. And while the bill has no direct cuts to safety net programs, it trims about $150 million from total spending that would be needed to fully keep up with inflationary growth in health costs. DFL legislative leaders have said it's a step toward controlling costs in one of state government's single biggest spending areas.
"Although there are certain things we'd like to do better on, especially funding for nursing home workers, we are not cutting them in this bill. They are getting a raise,'' said Rep. Tina Liebling, DFL-Rochester. "We're very proud of that.''
But some rural Republicans focused their criticisms of the bill on funding for nursing homes. Of the $150 million spending slowdown, about $26 million comes out of nursing homes. Republicans said homes in many small, rural communities are in danger of closing, and that Democrats should give 5 percent pay hikes to nursing home and long-term care workers.
"Every time we lose a facility out in greater Minnesota, it's just that much further for folks to drive to get the care they need,'' said Rep. Ron Kresha, R-Little Falls. "I think we really need to look at this, step back and make sure our values and priorities are where our budget is."
House Majority Leader Erin Murphy, DFL-St. Paul, said Republicans could have hiked care worker pay when they had legislative majorities in 2011-12.
"They don't have a real plan and they don't have credibility on this issue,'' Murphy said.
But some Democrats from rural areas also expressed a desire for more money for nursing homes. Rep. Jay McNamar, DFL-Elbow Lake, said six out of 10 nursing homes in his western Minnesota district are the largest employer in their respective communities.
The proposed pay increases are "not enough. We need help,'' McNamar said. He was successful in amending the bill to reduce a state surcharge on nursing home beds.
But an alternative Senate health spending bill actually increases the nursing home surcharge, and one on HMOs. The Senate bill excludes the hospital surcharge and the HMO reserve cap. It also indefinitely extends a tax on doctors that had been scheduled to end in 2019. The Senate bill awaits a floor vote.
Once both proposals have passed, lawmakers from both chambers will produce a final version in conference committee to be sent to Dayton for his signature.