The new $11.3 billion Minnesota Health and Human Services budget carries a wide range of changes, including cuts to many providers and what could be steps to overhaul how services are financed. That's up from $10.1 billion for the previous two years, but below the $12.3 billion projected for this biennium. Among the changes:

SPENDING CUTS

• Medicaid rates: 10 percent cut to hospitals, though some may be "earned" back later by cutting hospital readmissions and emergency department use; smaller cuts for services by dentists, physicians, ambulances, managed care health insurers, physical, speech and occupational therapists and other professionals.

• State grants reduced by about $40 million for mental health care, community programs for children and others.

PROGRAM CHANGES

• MinnesotaCare for low-income workers will switch to vouchers to help those earning 200 percent or more of poverty level --$21,780 for a single adult -- buy private insurance, starting June 2012.

• Managed care health insurers must submit competitive bids starting this year for MinnesotaCare and Medicaid in the metro area this year, expanding statewide later.

SYSTEM CHANGE

• State will seek federal permission to shift financing of Medicaid programs to pay providers for achieving results.

NO CHANGE

• About 140,000 very poor childless adults moved this year from state health programs to state-federal Medicaid will remain there, despite Republican opposition.

• Minnesota may seek and accept federal health-system overhaul money from Accountable Care Act, despite Republican opposition to the federal law.

To read the law, go to www.startribune.com/a571.