MINNESOTA HEALTH CARE ISSUES

Minnesota's next governor and Legislature will face a number of big health care decisions, including how to pay care costs for low-income people and nursing home residents while erasing a large budget deficit.

Among the issues:

Federal health care overhaul: Minnesota already covers poor, childless adults and now can expand Medicaid to get a 50 percent match for their care -- available to other states in 2014. The Legislature gave Gov. Tim Pawlenty and his successor authority to do that. Pawlenty declined because it would raise payments to providers but cost more than the current stripped-down state-financed program.

Minnesota could compete with health insurers with its own "public option" health plan for individuals and small businesses when it sets up a "health insurance exchange" in 2014. Nationally, the idea was so divisive that it was dropped from the federal law.

Paying for programs: The state faces a projected budget deficit of $5 billion to $7 billion on a $30 billion budget. Health and human services account for about one-third of state spending, and it may be difficult to avoid cutting some of those programs.

State health system overhaul: Minnesota has launched a $47 million program to reduce two major health risks, obesity and smoking; to encourage providers to become "health care homes," and to next year start giving consumers information about providers' quality and costs.