House prescription's effect unclear
ST. PAUL -- Minnesota state representatives approved 70-64 a health-care spending bill late Monday without knowing how it would affect hospitals around the state.
Most Democrats favored the bill while most Republicans opposed it.
Highlighting debate was an amendment by Rep. Will Morgan, DFL-Burnsville, that the Democrat-controlled House put on the overall bill to change how funding would be distributed to hospitals.
Time after time when Republican lawmakers asked Morgan how his amendment would affect hospitals. His common reply was simple: "I don't know." He also said he only had a "rudimentary understanding" of the amendment.
"It is irresponsible to ask members to vote" without knowing an amendment's impact, an emotional Rep. Dan Fabian, R-Roseau, said.
His voice rising, he told Democrats: "This is the wrong process that you are using, and you know it."
The Morgan amendment, approved on a voice vote, took more than three hours of debate, starting a discussion lasting more than nine hours on a health-care funding bill costing $13 billion over the next two years.
The bill's chief sponsor, Rep. Tom Huntley, DFL-Duluth, said at least 600,000 more Minnesotans would receive subsidized health care under his bill.
Huntley and Rep. Tina Liebling, DFL-Rochester, said no individual should feel a cut in state-funded health care, but some hospitals would take a hit.
A few amendments were added to the bill, including one on a 71-62 vote that would require abortion clinics to receive licenses. Supporters said it was needed to keep patients safe.
To make up for much of a $150 million cut House leaders ordered in his bill, Huntley added to an existing surcharge on hospitals.
The surcharge on non-government hospitals would rise from 1.56 percent of patient revenues to 2.68 percent. The $105 million in new state revenue would be used to leverage federal money, Huntley said.
Surcharge revenue would be returned to hospitals, but not in the same amounts collected from each institution.
"Unfortunately, there are winners and losers," Huntley said, but did not have a list of how much each hospital would receive.
Republicans used the lengthy Morgan amendment debate to contact hospital administrators in their areas and generally said the hospitals would be hurt by the bill and amendment or said hospital officials did not know the impact.
"If we are so unclear on the impact, I don't think we should even vote on this legislation," Rep. Dean Urdahl, R-Grove City, said.
Huntley said the Morgan amendment would not affect how much the surcharge would bring in, just how funds would be divided among hospitals. Morgan said his amendment would divide the money more fairly than the original Huntley language, but Morgan could not say why it would be better.
Nearly 90 percent of funds in Huntley's overall bill would go to health care for the elderly and those with severe disabilities, Huntley said.
A highlight of the Huntley bill is raising nursing home payments 3 percent and other long-term care program payments 2 percent, with 75 percent of the money going to worker raises.
Rural Minnesota Republicans called on Democrats to boost funding, especially for nursing homes.
Rep. Paul Torkelson, R-Hanska, said there are some funding increases in the House bill, but "they're crumbs, frankly."
"We all need to pull together and properly fund this area," Rep. Rod Hamilton, R-Mountain Lake, said. "It's the right thing to do."
Rep. Jay McNamar, DFL-Elbow Lake, got an amendment included to gradually reduce the $2,800 per-resident surcharge nursing homes pay. The first reduction would be $440 next year.
Some of the new funding Huntley included in his bill would be used to put mental health experts in schools.
"They don't have to be hauled away to a clinic or hospital," Huntley said. "They can get their mental health treatment just down the hall from their classroom."
The state-subsidized MinnesotaCare health insurance program would expand to include Minnesotans with incomes 138 percent to 200 percent of the federally assigned poverty rate next year, before its clients join a federal program.
Health bill highlights
Key figures from a House bill funding health programs for the elderly, disabled and poor:
$13 billion total spending over two years
$105 million new funds from hospital surcharge
$1 billion more federal hospital aid expected over next four years
3 percent increase for nursing homes (75 percent must go to worker raises)
2 percent increase for other long-term care programs (75 percent must go to worker raises)
Reporter Danielle Killey contributed to this story.