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More health care changes for Minnesota

ST. PAUL -- Minnesota already is on track to establish a new way for its residents to buy health insurance, and now legislators are poised to change how the state takes care of its elderly, disabled and poor.

Senators debated late Thursday their plan to spend $11.2 billion in the next two years for health care, which is second only to public school funding in the $38 billion state budget.

The plan by Sen. Tony Lourey, DFL-Kerrick, builds on the federal Affordable Care Act, also known as Obamacare. State leaders this year established a federally required online health insurance sales program, which in several ways is tied to the Lourey bill.

Lourey said he was disappointed when handed a spending target $150 million less than in the current budget. "It was much lower than I was hoping for."

However, he said, his committee was able to craft a bill that cuts no state-provided health care.

"We raised some revenue in innovative ways," he said, including gaining $80 million by adding a surcharge on HMO revenues.

The bill would increase rates for nursing homes and other long-term care programs by 2 percent in 2015.

Republicans said Lourey's does too little to help nursing homes and other long-term care programs.

The long-term care industry says it would be better off with current law, said Sen. Julie Rosen, R-Fairmont.

Some of the 115-plus nursing homes in financial crisis could be forced to close, Rosen said. "It's going to be very, very tough."

Besides not providing enough money, the bill does not give nursing home administrators flexibility they need to make good decisions, she added. "We are tying their hands. ... It is going to be more expensive to do business."

Rural legislators, including in the House, where a similar bill passed earlier this week, say nursing homes often are the biggest employers in their districts. If they close, communities will be hurt, they say.

Among the biggest changes Lourey's bill would make is in MinnesotaCare, which provides state-subsidized health insurance to those who otherwise could not afford it. The bill would use federal cash for the program.

Lourey would remove an existing $10,000 MNCare cap on hospital costs and cut premiums in half.

MNCare now gets about half of its funding from Washington, but supporters of the Lourey bill said that under the legislation, up to 85 percent of funding would be federal.

Don Davis
Don Davis has been the Forum Communications Minnesota Capitol Bureau chief since 2001, covering state government and politics for two dozen newspapers in the state. Don also blogs at Capital Chatter on Areavoices.