House Republicans moved ahead early Wednesday in their efforts to cut about $1 billion in state spending on health and human services, setting up a clash with the DFL-led Senate and Gov. Mark Dayton, who have decried the cuts as draconian.

After seven hours of debate that started on Tuesday, the House approved the measure on a vote of 72-60.

The legislation's most controversial provision is a proposal to eliminate MinnesotaCare, the state's basic health care insurance plan for lower-income Minnesotans who don't qualify for medical assistance or have access to coverage through their job, among other requirements.

Republicans put forth an $11.8 billion budget for health and human services, which make up about a third of Minnesota's overall budget. Though spending would increase by $634 million over the current two-year budget cycle, it falls far short of the $12.8 billion that the Minnesota Management and Budget Office projects is needed to keep up with inflationary pressures.

"We need to get a handle on the growth in this budget," said Health and Human Services Finance Committee Chairman Matt Dean, R-Dellwood, as debate on his measure got underway. "If we do not get a handle on Medicaid spending and on our overall HHS spending, we can never ever get to where we want to be in higher ed, or K-12, or any of the other areas that are suffering because this area is growing unsustainably fast."

"This health and human services omnibus bill is unhealthy for the state of Minnesota," said Rep. Tina Liebling, DFL-Rochester. "It's unhealthy in a multitude of ways; of course the chief one everyone is aware of is the elimination of MinnesotaCare."

Liebling, the DFL lead on the health and human services committee, said that MinnesotaCare enrollees would face disruptions in their coverage and would probably bear higher costs they can't afford if forced into other health insurance plans.

Republican legislators say those enrollees would be able to obtain coverage through MNsure, though it's unclear if they would be provided a subsidy to defray the costs of deductibles or co-payments.

Debate got off to a contentious start Tuesday after DFL House members called into question a Republican estimate that the state would save $300 million by auditing public programs and identifying waste and fraud.

Minority Leader Paul Thissen, DFL-Minneapolis, cited a Minnesota Management and Budget report, or fiscal note, that estimated savings would be about $16 million.

Among other provisions of the House plan are reforms for MNsure, the state's health care exchange; $52 million for child protection services, and $138 million for nursing homes to boost the care provider wages.

"This legislation provides a major investment in nursing homes, establishes a sustainable reimbursement system, and encourages our workforce to consider a career in long-term care," said Rep. Joe Schomacker, R-Luverne, and chair of the Aging and Long Term Care Policy Committee.

Ricardo Lopez • 651-925-5044