Cuts that hurt

The omnibus health and human services finance bill approved April 23 by the House Finance Committee would cut health and human services by $402.5 million in the next biennium and $567.8 million in the following biennium. It totals about 5 percent of the state’s overall budget, said sponsor Rep. Thomas Huntley (DFL-Duluth).

HF1362 attempts to maximize the $1.8 billion in federal stimulus dollars while making “painful” cuts in service programs, Huntley said. The bill would not change eligibility requirements for Medical Assistance or MinnesotaCare, but hospitals, long-term care facilities, the use of personal care attendants and those using public dental assistance would all receive reductions.

After working with disability representatives on which services they use the least, Huntley said, “It’s sort of like are we asking people, ‘Are you right-handed or left-handed cause we’ll cut off the arm you don’t use as much.’”

The bill was scheduled to be addressed by the House Ways and Means and Rules and Legislative Administration committees April 24. A Senate companion is expecting to be introduced in the next few days.

Spending reductions include delayed rebasing for nursing homes; a 3 percent cut to long-term care facilities; a 3 percent ratable reduction to hospitals, including reducing reimbursement rates for those on Medical Assistance and General Assistance Medical Care; and limiting personal care attendant hours to 310 per month per individual.

In an effort to minimize cuts, the bill would make changes to meet federal requirements for stimulus funds. Changes to Medical Assistance could result in a reimbursement rate of 62 percent from the federal government, with the state responsible for 38 percent. The current rate is 50-50.

Money would also be invested to meet the federal Children’s Health Insurance Program Reauthorization Act of 2009 that could result in an additional $20 million to increase the number of children on public health insurance by easing the enrollment process, Huntley said.

Another $4 million would be invested to meet provisions of, and receiving funding from, the federal Health Information Technology for Economic and Clinical Health Act that is designed to help the state convert health records to electronic form.

In an attempt to set a fixed amount given to providers for treatment of a specified group of people, a total cost of care pilot project is included in the bill. The human services commissioner would work with interested providers to establish the alternative payment reform for frequent users of high-cost health care services. Hennepin County Medical Center would be the main provider conducting the project, said Huntley.

Testifying before the House Health Care and Human Services Finance Division April 21, Brian Osberg, assistant human services commissioner, said the bill uses federal stimulus money instead of focusing on long-term solutions. The governor’s proposal would have eliminated 113,000 people from public health care and eliminated some basic services.

Huntley countered that under the governor’s proposal several hospitals would be forced into bankruptcy through uncompensated care for those 113,000 people. Those without care will show up somewhere else in the system costing more money in the long run, he said.