Omnibus bill a ‘work in progress’

When he first introduced HF927, Rep. Jim Abeler (R-Anoka) called the omnibus health and human services finance bill “a work in progress,” and said there would still be time for input as it moved toward a House floor vote.

The bill may not be ready yet, but plenty of voices have chimed in with feedback.

More than 90 witnesses provided testimony during a March 23 House Health and Human Services Finance Committee hearing. Members listened and asked questions for more than six hours, but intended to save much of their discussion on the bill and its targeted $10.7 billion budget for March 24 when Abeler, chairman of the committee, said he expected a vote to take place.

As presented, the bill would cut

$1.6 billion in spending over the next two fiscal years. Much of the cost savings are expected to come from nursing home care reforms for the elderly and disabled and lower payments to HMOs that serve poor and disabled residents.

The bill also proposes a global Medicaid waiver that Abeler said would generate $300 million in cost savings — an idea some testifiers and DFL members scoffed at. They pointed out that should the federal government reject the waiver request, the bill’s alternative suggests cutting reimbursement rates to service providers.

If the implementation of the global waivers fails to generate the specified additional $300 million, those savings will come out of provider rates, said Toby Pearson, vice president of advocacy for Care Providers of Minnesota, a trade organization representing more than 500 long-term care facilities.

Kurt Rutzen opposed what he said might seem like a small increase to co-pays for residents on Medical Assistance.

“When you are on a limited income like myself, it adds up quickly,” said Rutzen, a Minneapolis resident and national board member for ARC, an advocacy group for people with intellectual and developmental disabilities.

Several witnesses, including those from organizations such as the Welfare Rights Committee and the Minnesota Catholic Conference, testified in opposition to a section of the bill that includes new restrictions on electronic benefit transfer card usage aimed at curbing wasteful spending.

Abeler told one witness he agreed with his sentiments that the EBT “proposal needs some work” for it to remain in the legislation.

Several testifiers praised aspects of the bill’s contents.

“You really listened to the rehab community with regards to services that actually save money by keeping clients out of the hospital and as healthy and functioning as possible,” said Maree Cook, administrator at Professional Rehabilitation Consultants, a St. Paul-based provider in specialized maintenance therapy.

Throughout the hearings, DFL members expressed concern about the process Republican committee leaders used in putting the bill together. They pointed to a lack of fiscal detail in the bill along with an aggressive timeline for approval before it is sent to the House Ways and Means Committee, where it is expected to be heard next week.

“The trajectory we are on here I think is very problematic,” said Rep. Tina Liebling (DFL-Rochester), adding that the bill was “half-baked” as it was presented.

“I respect your desire to think of new creative ways to do things,” she said, “But we have to do that in a process that allows people to weigh in so that we actually know what we’ve got when we vote on it.”

Abeler reminded members that more fiscal details on the bill would be released as discussion continued and as the proposed legislation moved to its next stages.

The bill’s companion, sponsored by Sen. David Hann (R-Eden Prairie), awaits action in the Senate Health and Human Services Committee.