About 55,000 Minnesotans would lose health care coverage this year and another 29,000 next year under Gov. Tim Pawlenty's proposed two-year budget.

Most of those affected are adults without children who are now on MinnesotaCare, the health-care-subsidy program for low-income working people, said Human Services Commissioner Cal Ludeman. The cuts would save about $500 million over two years, compared with forecasted spending.

Others losing coverage would be in various Medical Assistance programs for the poor, including people with traumatic brain injuries and disabilities as well as older people at risk of nursing home placement.

"The governor's budget seems to be cutting services to people who need them most," said Nan Madden, Minnesota Budget Project director at the Minnesota Council of Nonprofits. "This would hurt people who are struggling the most."

Under the governor's proposal, fees would also be cut by 3 percent to hospitals and others serving people on Medical Assistance and programs keeping older and disabled people at home instead of in institutions. Nursing home rates would be cut 1.3 percent, and 1 percent of new applicants would be denied nursing home care because they are not sick enough to be eligible under the new standards.

Medical Assistance, MinnesotaCare and General Assistance Medical Care no longer would cover podiatry, chiropractic or adult dental care, and spending for personal care assistants would be cut.

The Health Care Access Fund, set up primarily to fund MinnesotaCare, would be merged into the General Fund. The $47 million approved last session to finance community efforts over two years to reduce obesity and smoking would be cut to $26 million over four years.