Thursday, May 29, 2003

A story released today by the Associated Press reports that lawmakers in Minnesota have just cut more than $1 billion from that state's health and human services programs.  As a result, low-income single workers without children will have to pay more for basic health care needs.

The health bill was slowed by a fight that pitted Gov. Tim Pawlenty's administration and House Republicans against Minneapolis DFL Sen. Linda Berglin, a health policy expert who sought to preserve as much of health insurance programs for the working poor as possible.

Berglin's doggedness forced the Republicans to back down on one of their most high-profile proposals, to eliminate the state's health insurance program for low income working people, called MinnesotaCare.

"I respect the willingness to fight to the end," House Speaker Steve Sviggum said of Berglin. But Sviggum shook his head as he raised the notion she could fight for the bill's last $1,000. "OK, we're cutting one billion dollars? That's one million thousand dollars, right?"

Even after the cuts, total state spending in the bill is nearly $7.5 billion in state dollars, roughly a quarter of the state's total budget.

The savings come from a wide group of trims, cuts and outright elimination of programs. The deal makes fewer people eligible for state-subsidized child care and health insurance, toughens welfare rules, cuts insurance for non-citizens and reduces payments to hospitals and doctors.

But it makes relatively few cuts in programs for the elderly. It mostly restores, for example, senior volunteer and nutrition programs, which Pawlenty originally proposed eliminating state money for.

Children's advocates said the results reflect political realities.

"Kids don't vote," said Minh Ta, public policy director of the Children's Defense Fund of Minnesota. "You saw where raw political power came into play."

The deal makes more than $86 million in cuts to child care services, changes that will immediately push about 1,200 families off state subsidies and eventually decrease the number of people eligible by about 40 percent.

Ta said the changes would make Minnesota less generous with child care help than West Virginia and Mississippi.

But some of the biggest savings are made by restricting low-income, childless adults from the MinnesotaCare insurance program.

An unmarried person earning between 75 percent and 175 percent of federal poverty guidelines, or $6,735 to $15,715, would retain basic catastrophic coverage, designed to make sure hospitals get reimbursed for emergency care.

Beyond that, they'd only be able to sign up for a bare-bones insurance plan that would require monthly premiums and new co-payments in exchange for a maximum of $2,000 per year worth of medical services. The figure will rise in later years.

One analysis of Pawlenty's original plan figured that 68,000 people would lose access to health insurance by 2007. Estimates under the current deal were not available.

Regardless, Rep. Fran Bradley, the Republicans' lead negotiator on the issue, said he didn't feel he had cut enough from the MinnesotaCare program.

"I really think the MinnesotaCare program was begging for a little bit better restraint," he said. "I'm sure that we haven't done enough and it's just going to come back and bite us."

The deal also adopts most of Pawlenty's plans for welfare changes, though Senate Democrats succeeded in making it a bit easier for welfare recipients to count education as work. The current welfare system requires most recipients to work to qualify for benefits.

And it moves ahead with a plan to restrict people from using food stamps to purchase junk food, although the state would have to get approval from both the federal government and the Legislature before implementing it.