Conferees begin to compare, contrast omnibus health care finance bill

Five House Republicans, four Senate DFLers and one Senate Republican began the arduous task of rectifying wide gaps between the two omnibus health and human services finance bills Tuesday.

Led by conference committee chairs Rep. Matt Dean (R-Dellwood) and Sen. Tony Lourey (DFL-Kerrick), conferees walked through a half-dozen articles in HF1638/SF1458* but took no official action. Lourey said he hopes to complete the overview on Wednesday. There are no agreed upon spending targets among the lawmakers, so conferees are “limited in what we can do,” Lourey said.

House leaders expect to spend less than the Senate and to save millions in the next biennium through auditing the eligibility of people on welfare programs, requiring a 15 percent administrative cut within the Department of Human Services and the Department of Health, and through competitive bidding.

Also, the Senate does not intend to include policy-only provisions in the bill because due to the major differences between the House and Senate positions, “this probably isn’t a safe vehicle to carry policy,” he added.

Dean expects a lot of discussion about the proposed spending and savings in the bill and he looks forward to “a productive few days — or weeks.”

Despite their differences, there are several provisions the sides agree upon, especially in the area of mental health supports, group residential housing, child protection, telemedicine, durable medical equipment exemptions from competitive bidding, automated dispensing of over-the-counter drugs in nursing homes and new ABLE savings accounts for people with disabilities.

Though they differ on the amount of funding, both the House and Senate support appropriations to help homeless and sexually exploited youth. They also agree on special revenue plans for the health-related boards.

Additionally, both bodies would increase salaries for several types of health care workers, albeit at varying percentages.

A House only-proposal still to be discussed by conferees includes the culmination of work done by the House Aging and Long-Term Care Policy Committee, which approved an overhaul of how nursing homes are reimbursed for providing medical services to Medicaid patients. Provisions also address workforce shortages in health care by offering scholarships and student loan forgiveness.

One of the major differences between the two bills has to do with the future of MNsure and MinnesotaCare, two state-operated health care programs. The House calls for transitioning people off of MinnesotaCare and into MNsure, the state’s version of the federal Affordable Care Act. A related House proposal would shift MNsure from state to federal hands.

The Senate would make the head of MNsure a commissioner eligible to earn up to 133 percent of the governor’s salary; the House would limit the agencies “executive director” position to no more than 120 percent of the governor’s salary.

Other differences include:

• when and how to disseminate residential treatment services for CARE clients in Fergus Falls who have been committed to the human services commissioner who present complex and difficult care needs, and are a potential threat to the community;
• when to close the Children and Adolescent Behavioral Health Services psychiatric hospital in Willmar; and
• a Senate provision to require counties to pay either 10 percent or 25 percent of the cost of care for sex offenders discharged from the Minnesota Sex Offender Program.