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House, Senate health bills at odds over MinnesotaCare

Democrats in the Minnesota Senate released a plan today to fund health and human services for the next two years.

The proposal would increase spending by about $341 million to fund programs including child protection services, nursing homes and mental health services.

The Senate bill mirrors Gov. Mark Dayton's health and human services proposal, but it's vastly different from a Republican-backed House funding bill that would make about $1 billion in cuts to health and human services programs.

Senate Health and Human Services Finance Committee Chair Tony Lourey, DFL-Kerrick, said the two chambers have a long road of negotiations ahead of them.

"It's not actually possible to cut $1 billion out of the Health and Human Services budget and pretend like you're still meeting the needs of Minnesota,” Lourey said.

Some of the biggest savings in the House budget bill – about $563 million over two years – comes from eliminating MinnesotaCare, a program that’s targeted at people who make too much to qualify for Medicaid but can’t afford their own plan and aren’t offered one by an employer.

The House bill would move MinnesotaCare enrollees to MNsure, the state’s health insurance exchange, and provide a subsidy to help them pay for coverage.

But many people and groups testifying in the House Health and Human Services Finance Committee hearing Monday said ending MinnesotaCare would lead to gaps in coverage and potentially make insurance more expensive for people who need it most.

Jennifer Anderson, a volunteer with the American Cancer Society Cancer Action Network, said her daughter, Tanisha Brooks, is among the MinnesotaCare enrollees who could find herself in that situation.

Anderson said her daughter works a part-time job, and because she’s 27, Brooks can no longer be on her parents’ health insurance. Anderson said MinnesotaCare has made her daughter’s prescriptions affordable and allowed her to see her neurologist regularly.

“If you’re a parent, you know watching your child handle a disease or struggling in pain is beyond heartbreaking,” Anderson said. “I felt so helpless and inadequate because I couldn’t afford to pay for my daughter’s medication.”

The House bill does increase spending in some areas including homelessness programs, programs for people with disabilities, and mental health initiatives and that drew praise in Monday’s hearing.

"Our message this session is, we know what works, let’s build on it,” said Barb Lindberg, a member of the board of directors for the National Alliance on Mental Illness – Minnesota. “You’ve included many of the services we believe will greatly improve access to mental health services.”

There’s at least one area where the House and Senate bills overlap: nursing home funding. The House bill includes $138 million to help nursing homes keep up with salary costs, among other things, while the Senate bill would increase funding by $25 million and keep an already-scheduled 2.4 percent cost-of-living increase.

Both bills make big changes to MNsure, too. The Senate legislation would make the quasi-state agency a traditional state agency accountable to the Legislature and the governor. The House bill would require the state to get a federal waiver to allow people eligible for federal assistance buying an insurance plan on MNsure to bypass the website and buy a plan directly from a health insurance company.