DFLers vow to fight for health care aid

Even before they finish grilling state officials about Gov. Tim Pawlenty's budget proposals, which would push more than 113,000 people off state health programs for the poor, DFL legislators are casting about for other solutions to the state's massive budget deficit.

It's a laundry list of items big and small, intended to chisel chunks out of the projected $4.8 billion budget deficit.

Some might get broad support, such as promoting low-cost birthing centers and "ambulette" service for non-emergency medical transport. Both offer considerable but not-yet-calculated savings. Others would be controversial, such as requiring that all Minnesotans carry health insurance.

"I'm trying to avoid a panic attack," Sen. Linda Berglin, DFL-Minneapolis, said Wednesday. In her 35 years at the Capitol, she has become the Senate's big dog on health care issues.

"Where will low-income people go if we toss them off health insurance programs?" she said. "They'll go to emergency rooms, jails, prisons and mental health treatment centers -- at far greater cost."

In hearings that began last week, she and her House counterpart, Rep. Tom Huntley, DFL-Duluth, a 16-year veteran, have peppered Pawlenty's health and human services officials with sharp -- sometimes acerbic -- questions and observations about Pawlenty's proposals.

"Well, your timing is terrible," Huntley told Human Services Commissioner Cal Ludeman Tuesday. "You want to cut off health benefits for thousands of people just when the unemployment rate is going to hit 9 or 10 percent, and thousands more will lose their employer health insurance."

The state has little choice, Ludeman responded. Under the governor's proposal, state spending actually will rise by about $1 billion for low-income people on Medicaid for the poor, MinnesotaCare for low-income working people and other health programs. But he warned that without cuts, spending will swell by more than $2 billion.

"We just can't sustain that sort of growth," Ludeman said. "If we don't act, it will soon become impossible as the baby boom ages."

Federal help but deeper deficit

"Some parts of the governor's budget are probably all right,' Berglin said, "but we need a lot more creative thinking to avoid an even worse economic disaster."

Congress is at work on a federal stimulus package that might funnel nearly $2 billion to Minnesota for state health programs. Berglin and Huntley hope that aid will include a requirement that the state not cut eligibility for Medicaid and other health programs that Congress helps finance.

Regardless of congressional action, however, Berglin expects that a new state budget forecast, due March 3, to show that the projected state deficit has swollen to $6 billion.

In general, Huntley and Berglin say, spending cuts should be spread more broadly than the governor proposes, including in K-12 education. Spending on K-12 takes about 40 percent of the budget and would get an increase, not a cut, from Pawlenty.

"Everybody is going to be hurt somewhat" when the state finally hammers out a budget for 2010-2011, Huntley said. "This deficit is a disaster, and we can't tax our way out of it. We have to make cuts -- even in health and human services.

"We have to think longer than just this biennium," he added. "Hospitals, clinics and nursing homes are already under tremendous financial pressure. The governor's budget would mean higher insurance rates for everybody."

At work on a battle plan

He and Berglin want to prevent cutting low-income people off government-paid health insurance and ease the governor's proposed 3 percent cut in payments to hospitals and many long-term care providers. They also want to prevent Pawlenty from cutting in half a new statewide tobacco and obesity program, which was projected to cut health care costs by 6 percent over the long run.

Last year, the governor and Legislature agreed to finance that health campaign with $47 million from the state Health Care Access Fund, money primarily from a tax on health-care providers intended to support MinnesotaCare.

As he has before, Pawlenty wants to use half that fund to help balance the budget, but this time merge the fund into the state's General Fund.

"Over my dead body," Huntley said Wednesday.

"You will not use this fund to balance the budget," a fuming Berglin told an assistant health commissioner last week. "Did you hear that? I've told you this before. You will not use the Health Care Access Fund to balance the budget."

As she presides over Senate budget hearings and talks to constituents, Berglin takes notes for a growing list of potential budget savings: Maybe group homes could be increased from four-bed to eight-bed facilities; the Minneapolis Veterans Home budget could be cut by the $2 million in unauthorized overtime it paid last year; some of the worst sex offenders might get treatment in prison at $167 a day instead of in the Minnesota Sex Offender Program at $315 a day.

"It's a work in progress," she said. "I'm taking ideas from everybody."

Warren Wolfe • 612-673-7253