The sharp partisan debate over how -- or whether -- to continue efforts at overhauling Minnesota's health care system boiled up again at a legislative hearing Tuesday, when several Republican senators questioned whether the state should accept $24.8 million in federal health reform grants.

"The federal government is essentially borrowing from the Chinese" to finance the projects, said Sen. David Hann, R-Eden Prairie, chairman of the Senate Health and Human Services Committee. "I want to know if the projects will actually help people."

The committee took no vote, but as its chairman, Hann will recommend by Friday to the Legislative Advisory Committee whether Minnesota should accept the grants, which fund eight projects aimed at strengthening programs for the sick, aged and disabled.

Battling state budget shortfalls and skeptical of federal health spending, Hann and other Republicans have been sharply critical of Gov. Mark Dayton's willingness to expand health programs.

Even if Hann and the advisory committee vote to reject the grants, the state still may accept them, Hann acknowledged, because Dayton deemed the grants "urgent," meaning the state might lose the money if it doesn't act soon.

The issue erupted last week in a rancorous exchange between Hann and Dayton after the senator asked for more information about the grants, a step that temporarily froze them. Dayton called Hann's action an "outrageous abuse of an individual legislator's power" and said it would "severely harm 5,000 Minnesota children with cancer and their families."

On Tuesday, Hann pressed Health Commissioner Dr. Ed Ehlinger to explain Dayton's charge. Ehlinger said all Minnesotans might be harmed if his department can't do its best work, with help from the grants, but could not explain the reference to 5,000 children.

Other Republican legislators questioned whether the largest grant, $18 million over five years to help communities combat smoking, obesity and other health risks, had any value. "We've been spending money on this for years and obesity is just going up," noted Sen. Scott Newman, R-Hutchinson."

Ehlinger said the state began a $47 million Statewide Health Improvement Program (SHIP) two years ago and that it takes time to change behavior and improve health.

"But that's where the health care savings will come, from having healthier people who require less health care," Ehlinger said. "It's an investment in future generations."

Hann noted that since part of the federal grant will supplement SHIP, the SHIP state funding "might be a target" for budget cutters next year.

Warren Wolfe • 612-673-7253