Lower-income health care program scrapped as part of House budget cuts plan

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Tens of thousands of lower-income Minnesotans could be required to switch health insurance coverage under a bill approved by the House – but supporters say it's needed to slow down unsustainable spending.

The Republican-controlled House passed the omnibus bill, 72-60, well after midnight Wednesday morning.

The entire thing is to set the budget for the state's Health and Human Services programs, which currently eat up a large chunk of the state's overall spending.

But this plan is vastly different from what Democrats in the Senate approved last week, and it could turn into a lengthy showdown between both parties. They'll go to a five-person conference committee to try to find a compromise.

Here's what lawmakers are hung up on.

Ditching MinnesotaCare

One of the big issues is MinnesotaCare.

The program helps provide health insurance for thousands of lower-income Minnesotans who don't have access to coverage otherwise.

The limit is 133 percent to 200 percent of the federal poverty guidelines – that's a family of one making about $15,000-$23,000 a year. (Those making less are eligible for the separate Medical Assistance program.)

In March, nearly 85,000 people were enrolled in MinnesotaCare.

The bill the House passed early Wednesday scraps MinnesotaCare, the Session Daily says. Anyone who was eligible for it would instead be directed to sign up through MNsure.

A state tax credit would be offered to help enrollees pay for the different coverage, but it's not clear whether it would result in people paying more than under MinnesotaCare.

Why?

The goal of the overall bill is to cut costs and slow down spending, which supporters (mainly Republicans) argue is growing at too fast a rate to be sustainable.

The proposals cut a total of $1 billion in potential spending, the Star Tribune says– estimates say Health and Human Services needs $12.8 billion total to keep up with inflation, and the Republican proposal includes $11.8 billion.

The elimination of MinnesotaCare is part of that spending slow down.

Democrats – not one of which voted in favor of the bill – quickly blasted the plan.

DFL Rep. Tina Liebling, of Rochester, called it "unhealthy" in a statement.

They say the switch to MNsure could end up costing Minnesotans more, specifically in greater Minnesota where many MinnesotaCare recipients live.

MinnPost, which looked at the details, agreed with Democrats' claims, writing, "even with federal cost-sharing reductions, the premiums and out-of-pocket costs would be higher than under MinnesotaCare."

A numbers game

MPR reports it's part of a broader argument about the role of the Minnesota Management and Budget office, which traditionally has been seen as having the non-partisan, final say on projected budget numbers.

The issue is typified right now by a partisan argument over a specific budget cut.

According to the Pioneer Press, Republicans say the state could save $300 million by fixing errors that gave some Minnesotans subsidized coverage they weren't actually eligible for (though the opposite also happened, with some people not getting credits they should have).

But the Democrats opposed to it point to a note from Management and Budget saying the state would only save $16.5 million if those measures were implemented.

MPR says the Republicans are essentially ignoring its findings right now, saying they don't trust the analysis.

And if the Republicans, Democrats and Gov. Mark Dayton can't agree on even the base numbers, how are they supposed to settle on a final budget?

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