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March 18, 2011

Legislature Takes Next Step in Budget Dance

House and Senate leaders announced their budget “targets” last week, the first step in producing a complete budget.  These figures establish the spending for each area, though not the specific details for programs.  The Republican-led legislature proposes considerably less spending, especially in Health and Human Services programs.

Federal Health Care Reforms a Subject of Continued Skirmishes

Proposals moving through House and Senate committees that would impair or prohibit implementation of the federal health care reforms continue to cause significant controversy.  A bill to prohibit the use of state funds for implementation of the ACA took its next steps, and questions over the authorization of state Health Insurance Exchanges dominated several committees.

Autism Task Force Bill Moves Forward

A bill to reestablish the state’s Autism Spectrum Disorder Task Force passed its first committee and will continue onward.  The proposal is the first of several autism-related bills to receive a hearing during this legislative session.

March 4, 2011

A (Somewhat) Smaller Budget Hole

Minnesota received some positive news about the budget earlier this week, as Minnesota Management and Budget announced that the budget deficit has shrunk from earlier forecasts. While still enormous in terms of both dollars and as a percentage of the total budget, the new deficit projected at $5.03 billion is much better than the earlier $6.2 billion projection. With the news, Governor Dayton updated his budget proposal, and in doing so removed his earlier proposal to reduce MinnesotaCare eligibility.

Tobacco Issue Move Forward

A Senate and House author stepped forward to close the “little cigar” loophole. In a quirk of the tax code, “little cigars” that are nearly indistinguishable from cigarettes are taxed and regulated at a far lower level than cigarettes. These products seem custom-made for youth, costing less than half of the price of a pack of cigarettes and coming in flavors such as peach and grape. The proposal would treat these products at the same level as cigarettes.

Provider Tax Gets Attention

During a discussion about granting an exemption to the provider tax, members of the House HHS Finance Committee engaged in an extensive discussion about the “provider tax.” Members from across the aisle noted the tax’s inherent unfairness to both patients and providers. Legislation is expected to soon be introduced that would lower the provider tax as surplus funds in the Health Care Access Fund rose.

February 18, 2011

Nearly 100 Pediatricians Visit the Capitol

On February 15, nearly 100 pediatricians and pediatric residents from around the state gathered at the Capitol to hear from key legislators and meet with legislators from their district. They communicated MN-AAP’s legislative priorities for 2011: the importance of access to care and early brain development.

State Budget Action Continues

On February 15, Governor Dayton took the first step in moving the state toward its biennial budget plan when he announced his budget proposal.  The plan relies heavily on increased revenue from the wealthiest Minnesotans as well as significant cuts.  The Governor’s plan faces a tough road in the GOP-controlled legislature.  Governor Dayton also vetoed the Republican’s “Phase One” budget balancing bill.  Their proposal would have shaved nearly $1B off the $6.2 budget deficit through cuts to local government aid, higher education, and HHS.

Federal Health Care Sparks Debate

The 2010 federal health care reforms continued to be a source of great debate at the State Capitol, with a number of efforts to slow or stop the initiative going forward.  One proposal seeks to require the state’s Attorney General to join other states’ efforts to block the federal bill, while another plan would prohibit the use of state funds to implement the federal reforms until its constitutionality is affirmed.  While he has not threatened a veto, such bills are unlikely to find favor with Governor Dayton.

February 4, 2011

Peds Day at the Capitol Set for February 15

Building relationships with elected officials has never been more important.  With a state budget deficit of $6.2 billion and 60 new legislators, communicating with those who will be making the decisions at the Legislature is critical to promoting children’s health and well being. The MN-AAP’s annual “Day at the Capitol” is a terrific way to do just that.  We’ve invited key legislators and opinion makers to address the group and we’ll arrange for you to meet with your own legislators, too. This is a terrific way to add your voice to the MN-AAP chorus at the Capitol.

We’ve also invited some key leaders to address our group as a whole.  As of this writing, Representatives Jim Abeler (GOP – Anoka, Chair of the House HHS Finance Committee) and Erin Murphy (DFL – St. Paul), as well as Senator Linda Higgins (DFL – Minneapolis), have confirmed their availability.

It’s easy to be a part of Peds Day at the Capitol, too. To take advantage of the schedules of many area resident pediatricians, we’ve arranged for two sessions, the first orientated towards residents, the second geared toward community and faculty pediatricians. Both will present excellent opportunities to learn about the issues we’re following and to add your voice. Join us for either one… or both!

REGISTER today for this important event!

Budget Cutting Begins in Legislature

After a highly contentious debate on both floors, both the House and Senate passed what they are calling “phase one” in their work to craft a balanced budget.  The bills, passed on strict party lines, make permanent over $800 million in cuts originally found in former Governor Pawlenty’s unallottments of 2009 and passed by the Legislature in 2010.

The majority of the cuts contained within the bill are to local government aid programs, the university system, and various human service programming though, notably, not to physician reimbursement.  HHS programs for low-income Minnesotans such as General Assistance and Supplemental Aid Grants, as well as Child Support Enforcement Grants to counties would see cuts.

Republicans argue that beginning the work of cutting the budget now will make the next set of budget cuts more manageable, and note that the DFL legislature supported these very same cuts in 2010.  DFLers counter that the 2010 cuts were largely “backfilled”with federal stimulus dollars, so that the damage to programs and recipients was muted.  These cuts, they argue, will disproportionately hurt the neediest Minnesotans.

The House and Senate bills will now be referred to a conference committee, as the two versions of the bill differ.  Governor Dayton, while not specifically stating his intent to veto the bill, has repeatedly called for a single, comprehensive budget solution, rather than the “piecemeal” approach that the Legislature has begun.  The Governor is due to present his budget proposal to the Legislature on February 15.

“Freedom of Choice in Health Care” Bill Gets Hearing

A bill that would roll back Governor Dayton’s executive order enrolling Minnesota in the “early Medicaid” program made possible by last year’s federal health care reform package received two hearings in the Senate.  The bill, SF 33, is being carried by Senator David Hann (GOP – Eden Prairie), the chair of the Senate HHS Committee.  In addition to ending Minnesota’s enrollment in early Medicaid, the bill contains a “public policy statement” that declares that every resident of Minnesota has the “freedom of choice” in health care.   Click HERE to view the text of the bill.

The bill received its first hearing on January 26 in Senator Hann’s HHS Committee.
A number of individuals testified in opposition to the bill, including Minnesota Medical Association President Patricia Lindholm, a family physician from Fergus Falls.  Dr. Lindholm noted that passage of this legislation would serve to shift the costs of health care of those covered by public programs onto physicians, hospitals, employers who provide coverage for their employees, and all-rate payers.

Several individuals, including representatives from the Citizens Council on Health Care and the 10th Amendment Center spoke in support of the bill, arguing that the federal reforms passed last year infringed on Minnesota’s sovereign rights as a state.

Testimony on the bill was followed by contentious debate within the HHS Committee, with DFL members lamenting the lack of significant discussion on the state’s finances.  Much of the discussion focused on the U.S. Constitution, and the relative wisdom of a committee of the Minnesota Senate debating constitutional law.   A fiscal note prepared for the bill stated that the cost to Minnesota would total $45 million for the next biennium.  On Thursday, February 3, the bill received its second hearing in the Senate Judiciary Committee, where debate once again focused on issues such as the state’s rights and sovereignty.  The bill passed on a voice vote and was referred to the Finance Committee.

SF 33’s House companion, HF 199, is being carried by Rep. Steve Gottwalt (GOP – St. Cloud), chair of the House Human Services Reform Committee, though it has yet to receive a hearing.  Governor Dayton has stated his intention to veto any legislation that attempts to undo the state’s participation in early Medicaid.

MinnesotaCare Changes Move Forward

A proposal by Rep. Steve Gottwalt (GOP – Saint Cloud) to move a number of MinnesotaCare enrollees into private health insurance advanced earlier this week when it was passed by the House Commerce Committee. The bill’s next step is to be considered by the House Human Services Finance Committee.  The text of the bill, HF 8, is available HERE.  The bill’s Senate companion, SF 32, carried by Senator David Hann (GOP – Eden Prairie) also took its first step, as it was passed from the Senate HHS Committee to the Senate Commerce Committee.

The Gottwalt and Hann proposals would provide subsidies to eligible adults without children with incomes above 133% of the federal poverty level to purchase individual, private insurance in place of MinnesotaCare.  Subsidy levels are determined on a sliding scale based on age and income.  Those individuals denied care in the private market would receive a slightly higher subsidy to seek coverage from the Minnesota Comprehensive Health Association (MCHA), Minnesota’s high-risk insurance pool.  The bill’s proponents argue that the bill would save the state money while opponents raised concerns about the poor being able to navigate the private market.

Rumblings Around Newborn Screening?

In an otherwise mundane and dry House HHS Finance hearing regarding the internal finances of the Department of Health, questions arose from several freshman GOP members about the newborn screening program.  The newborn screening program is a Minnesota initiative in which all babies born in Minnesota are screened for more than 40 disorders.  Several parents brought suit against MDH, claiming that the way the department operated the program ran counter to the authorizing statute.  The MN-AAP has long been a supporter of the program.

The legislators, Reps. Mary Franson (GOP – Alexandria), Kathy Lohmer (GOP – Lake Elmo), and Carolyn McElfatrick (GOP – Deer River), asked several MDH officials about the cost of the newborn screening program, the cost of the lawsuit defending the Department and the cost of storing the samples.  While the MDH officials didn’t have ready answers, they promised to provide those details to the committee.    While these legislators didn’t directly speak to a bias against the program, it seems likely that they are critical.

After these questions, Rep. Tina Liebling (DFL – Rochester) stated that any financial assessments should also attempt to put a figure on the savings from treating newborns from the conditions that are diagnosed via the screen.  Rep. Tom Huntley (DFL — Duluth) noted that one legislator had a child whose condition was successfully treated because of the early diagnosis the screen provided.

While no legislation has yet been introduced that would repeal or modify the newborn screening program, this line of questioning in committee clearly signals continued interest in the program.  The MN-AAP continues to monitor closely both the pending Supreme Court case and the Legislature for developments.

Committees Continue Issue Overviews

The pace of committee hearings remained relatively sluggish with many committees continuing their work to bring members “up to speed” on the issues before them.  One month into the legislative session, very few bills have been heard by committees and even fewer have been considered by the full House or Senate.

On Tuesday the Health and Human Services Reform Committee heard two presentations on the federal Patient Protection and Affordable Care Act.  The first was from Dr. Stephen Parente of the U of M’s Carlson School of Management and the second was from Peter Nelson of the Center for the American Experiment.  Both presenters talked about the positives and negatives of the legislation and suggested alternatives including med mal reform, expanded high-risk pools and long-term care insurance.

On Thursday, the committee heard from each of the Coordinated Care Delivery System (CCDS) hospitals (HCMC, Fairview/University, North Memorial)about the lessons learned from the changes made after the termination of the GAMC program. The final portion of the hearing was devoted to an overview of Minnesota’s Community Health Centers.  Witnesses from the Minnesota Association of Community Health Centers told the committee about their successes and challenges in working with low-income and uninsured patients.

Dr. Doug Wood, the Mayo Clinic’s leading health policy spokesman, testified before the Senate HHS Committee and the House HHS Reform Committee on Wednesday.  Wood outlined the challenges facing health care consumers, employers and the state in paying for health care.  His recommendations for reform included bundled payments for major acute episodes, a single statewide insurance exchange, using the federal employee benefit plan as the basic benefit set and promoting public health spending to reduce obesity and tobacco use.

“State of the State” Scheduled for Wednesday

Governor Mark Dayton will appear before a joint session of the Minnesota Legislature on Wednesday, February 9 to present his “State of the State” address.  Dayton will outline his budget and policy priorities.  During the gubernatorial campaign, Dayton identified jobs and education funding as top priorities.  To address the budget deficit, he said he would raise taxes on upper income households, which will meet strong resistance from the Republican legislature. The Governor’s budget will be released on February 15.

Federal Court Rules Federal Reform Unconstitutional

In a significant opinion, a federal court in Florida ruled that the entirety of the federal health care reform bill (aka the “Patient Protection and Affordable Care Act,” or PPACA) passed in March 2010 unconstitutional.   While noting that many elements of the bill contained no constitutional question, Federal District Judge Roger Vinson ruled the individual mandate to buy health insurance to be unconstitutional.  Because the bill lacks a “severability clause,” he ruled the entirety of the bill to be in violation of the Constitution.  Severability clauses are a way in which the author of legislation can keep the remainder of a bill intact should a particular element be ruled unconstitutional.  To date, two federal courts have ruled that PPACA passes constitutional muster, while two courts have ruled parts of the bill to be in violation of the US Constitution.  The issue is certain to ultimately end up before the U.S. Supreme Court.

Here in Minnesota, a senior DHS official stated that the administration and department will be moving forward with state-centered changes that the ACA offers or mandates, regardless of the lower court federal ruling.  Officials in other states, including Wisconsin, have stated that they will be stopping all activity around the federal bill given the ruling.

House Bills Introduced in First Month

Below is a listing of House bills related to health care that have been introduced during the first month of session.  There are a similar number of Senate bills introduced as well.  Compared to years past the total number of bills (364 in the House) is significantly lower this year than in prior sessions.  Many believe it is because of the severe budget deficit and many new legislators waiting for the Governor’s budget recommendations to be released.  Click on the HF number to link to the text of the bill’s language.

Gottwalt; Anderson, S.; Quam and Woodard introduced:
H. F. 8, A bill for an act relating to human services; establishing the healthy Minnesota contribution program; requiring plan to redesign service delivery for lower-income MinnesotaCare enrollees; amending Minnesota Statutes 2010, section 256L.05, by adding a subdivision; proposing coding for new law in Minnesota Statutes, chapter 256L.

Bills introduced:
H. F. 11, A bill for an act relating to taxation; increasing the research credit; amending Minnesota Statutes 2010, section 290.068, subdivision 1.

Hayden; Greiling; Scalze; Murphy, M.; Laine; Paymar; Ward; Hausman; Murphy, E.; Liebling; Moran and Greene introduced:
H. F. 51, A bill for an act relating to health; guaranteeing that all necessary health care is available and affordable for every Minnesotan; establishing the Minnesota Health Plan, Minnesota Health Board, Minnesota Health Fund, Office of Health Quality and Planning, ombudsman for patient advocacy, and inspector general for the Minnesota Health Plan; authorizing rulemaking; appropriating money; amending Minnesota Statutes 2010, sections 13.3806, by adding a subdivision; 14.03, subdivisions 2, 3; 15A.0815, subdivision 2; proposing coding for new law as Minnesota Statutes, chapter 62V.

Lanning, Abeler and Hayden introduced:
H. F. 77, A bill for an act relating to human services; establishing grant programs to promote healthy communities and the development of circles of support initiatives; appropriating money.

Clark, Hayden, Huntley and Champion introduced:
H. F. 167, A bill for an act relating to public health; requiring the commissioner of health to research and report on autism; requiring the Department of Human Services to train autism service providers; requiring notification of autism service options for medical assistance and MinnesotaCare recipients; proposing coding for new law in Minnesota Statutes, chapter 256.

Hackbarth; Howes; Rukavina; Anderson, B., and Buesgens introduced:
H. F. 188, A bill for an act relating to health; providing an exemption from smoking prohibition in public places; amending Minnesota Statutes 2010, section 144.414, by adding a subdivision.

Gottwalt, Abeler, Holberg, Lohmer, Dean, Shimanski, Sanders and Banaian introduced:
H. F. 199, A bill for an act relating to health; providing a statement of public policy declaring that every resident of Minnesota has the freedom of choice in health care; amending Minnesota Statutes 2010, section 8.31, subdivision 1; proposing coding for new law in Minnesota Statutes, chapter 1; repealing Minnesota Statutes 2010, sections 256B.055, subdivision 15; 256B.0756; Laws 2010, First Special Session chapter 1, article 16, sections 6; 7; 18; 46; 47.

Gottwalt, Abeler, Lohmer, Fritz, Norton, Hayden and Brynaert introduced:
H. F. 200, A bill for an act relating to health; requiring collection and reporting of certain data related to Alzheimer’s disease; proposing coding for new law in Minnesota Statutes, chapter 144.

Gottwalt, Abeler, Mack, Torkelson and Vogel introduced:
H. F. 222, A bill for an act relating to health insurance; requiring guaranteed issue in the individual market; requiring MCHA to reinsure ceded risk on certain health plans; ending additional enrollment in MCHA; amending Minnesota Statutes 2010, sections 62A.65, subdivision 2, by adding a subdivision; 62E.10, subdivision 7; 62E.11, subdivision 1; 62E.14, subdivision 1; repealing Minnesota Statutes 2010, section 62A.65, subdivision 6.

Mack, Hayden, Gruenhagen, Quam, Davids, Gottwalt, Abeler, Huntley, Eken, Kiffmeyer, Dean, Zellers, Ward, Persell, McElfatrick, Lohmer, Barrett and McDonald introduced:
H. F. 262, A bill for an act relating to human services; adding community paramedics to the list of community health workers; amending Minnesota Statutes 2010, section 256B.0625, subdivision 49.

Urdahl; Hamilton; Gruenhagen; McElfatrick; Gunther; Westrom; Murdock; Anderson, B.; Franson; Kiel; Swedzinski; Anderson, P.; Schomacker; Vogel; Koenen; Eken; Gottwalt; Lohmer; LeMieur; Scott; Dettmer and Shimanski introduced:
H. F. 264, A bill for an act relating to civil actions; prohibiting actions against certain persons for weight gain as a result of consuming certain foods; proposing coding for new law in Minnesota Statutes, chapter 604.

Hayden and Clark introduced:
H. F. 278, A bill for an act relating to health; creating medical homes for children with autism spectrum disorders.

January 21, 2011

Peds Day at the Capitol Set for February 15

Building relationships with elected officials has never been more important.  With a state budget deficit of $6.2 billion and 60 new legislators, communicating with those who will be making the decisions at the Legislature is critical to promoting children’s health and well being. The MN-AAP’s annual “Day at the Capitol” is a terrific way to do just that.  We’ve invited key legislators and opinion makers to address the group and we’ll arrange for you to meet with your own legislators, too. This is a terrific way to add your voice to the MN-AAP chorus at the Capitol.

It’s easy, too. We’ve arranged for two sessions: the morning session orientated towards residents, the afternoon session geared toward community and faculty pediatricians. Both will present excellent opportunities to learn about the issues we’re following and to add your voice. Join us for either one… or both!

Register today for this important event!

Early Medicaid Enrollment Gets Boost

Governor Mark Dayton made news earlier this week with his announcement that the “early Medicaid” expansion would begin by March 1, rather than the October date projected by outgoing Pawlenty administration officials.  With the Governor’s authorization earlier this month, up to 95,000 individuals will be eligible for the joint state-federal program, replacing the state’s General Assistance Medical Care (GAMC) program and expanding care for others presently covered under MinnesotaCare.

The changes were made possible by the federal health care reforms passed in 2010 and were the subject of much debate during last year’s legislative session and gubernatorial campaign.  One day after taking office earlier this month, Governor Dayton signed the executive order making the expansion possible.  The governor and DFL legislators were highly critical of earlier statements by DHS officials that the expansion would take up to 10 months to complete.

Starting March 1, GAMC enrollees will automatically be enrolled and will receive MA benefits. New applicants who are eligible for MA can enroll starting March 1. MinnesotaCare enrollees will transition to MA over a period of six months but will be eligible for MA benefits beginning March 1 and coverage will be retroactive. Current GAMC and MinnesotaCare enrollees will receive information from the Department of Human Services (DHS) about the expansion and any actions they need to take. Information will also be available on the department’s website.

According to the department, the state cost of MA early expansion is equivalent to the current cost of providing coverage to GAMC and MinnesotaCare enrollees who will shift to MA.

In related action, Senator David Hann (R – Eden Prairie) introduced SF 33, a bill that would roll back the early Medicaid enrollment and declare that every resident of Minnesota has the “freedom of choice” in health care.  The bill, the text of which is available here, has been scheduled for a hearing next week, though no companion has been introduced in the House.  Governor Dayton has stated that he will veto any attempt to undo the state’s participation and, in fact, participated in a press event this week with U.S. Health and Human Services Secretary Kathleen Sebelius singing the program’s praises.

Governor Announces DHS Appointment

Gov. Dayton announced his pick of Hamline University Law Professor Lucinda Jesson to direct the largest agency in state government, the Department of Human Services.  This position has been highly anticipated as it is expected that the HHS budget will be the main target for budget cuts by the Legislature.

Jesson is a former prosecutor and a deputy attorney general under former A.G. Skip Humphrey.  She also served on the Dayton transition team. Jesson, who directed Hamline’s Health Law Institute, will have one of the toughest jobs in state government.  With health care costs growing more rapidly than other portions of state government and subsidized health programs a top target of the new majorities in the Legislature looking to erase a $6.2 billion projected budget deficit, the task at HHS is daunting.

The commissioner has since announced that Anne Barry, the DHS Chief Compliance Officer, will be the new Deputy Commissioner.

Several individuals familiar to the pediatric community were named to key positions, including Scott Leitz.  Leitz worked on health care reform for the Department of Health and served most recently as the director of public policy for Childrens Hospitals and Clinics; he will be assistant commissioner and will lead all the divisions currently under the Medicaid director and the assistant commissioner of health care.

Lauren Gilchrist, daughter of Dr. Gerald Gilchrest, a pediatrician and member of the MN-AAP Policy Committee, has been appointed the assistant commissioner for health policy and reform. A former senior health policy advisor to Sen. Al Franken and a health policy fellow to Sen. Edward Kennedy, Gilchrist will spearhead the agency’s efforts to implement health reform, coordinating across DHS with the Departments of Commerce and Health.  Additionally, Maureen O’Connell, a legal advocate, will be the new assistant commissioner for the Chemical and Mental Health Services Administration.

Legislative Committees Begin to Craft Budget, Continue Overviews

Republican leaders in the Senate and House announced the start of their budget balancing work with bills that make Governor Pawlenty’s unallottment reductions permanent.  In total there would be $840 million in one-time spending cuts permanent. These include $584 million in cuts to tax aids and credits (primarily to local governments); $185 million to higher education; and $72 million to various health and human services programs.  Minnesota Management and Budget (MMB) is also to identify $200 million in savings that could be achieved by capturing unspent funds in agencies’ budgets.

Hearings on these cuts to health and human services programming were held in the House Health and Human Services Committee this week and proved to be contentious.  The HHS cuts, found in HF 128 available here, permanently extend the 2010 cuts to basic care programs (though not physician reimbursements).  Programs for low-income Minnesotans, such as General Assistance and Supplemental Aid Grants as well as Child Support Enforcement Grants to counties, would also see cuts.  Committee DFLers voiced significant opposition to the cuts, though efforts to stop the bill failed on party-line votes.  Republicans, including the Chair, stated that these cuts were identical to those ratified by the DFL controlled legislature at the end of the 2010 session.

While new bills continue to be introduced in the legislature (already totaling slightly more than 260 in both bodies), the majority of the committee actions thus far have been informational in nature.  All of the health care committees have taken testimony from various agency and department officials, non-partisan legislative staff, and a number of interest groups.  With so many new members on all committees, the chairs are using these first weeks to bring their members ‘up to speed’ on the issues before them.

Chairman Gottwalt Introduces Plan to Change MinnesotaCare

Rep. Steve Gottwalt (R – Saint Cloud), chair of the House Health and Human Services Reform Committee, introduced HF 8, a bill to shift a significant portion of MinnesotaCare enrollees to private insurance.

His bill, available here, would provide subsidies to eligible adults without children with incomes above 133% of the federal poverty level to purchase individual, private insurance in place of MinnesotaCare.  Subsidy levels are determined on a sliding scale based on age and income.  Those individuals denied care in the private market would receive a slightly higher subsidy to seek coverage from the Minnesota Comprehensive Health Association (MCHA), Minnesota’s high-risk insurance pool.

Rep. Gottwalt notes that under his proposal, physicians and hospitals would receive the significantly higher reimbursement rates of private payers, rather than the low Medicaid rates.  Fiscal notes prepared by non-partisan staff for earlier, similar proposals have suggested that the bill would save over $100 million over a biennium.  Critics have countered that the savings would largely come from individuals being unable to navigate the private market and dropping coverage.

The bill received its first hearing in the House Health and Human Services Reform Committee this week.  Committee DFLers expressed some interest in the plan, though voiced concern about whether the plan would allow some lower income individuals to lose their care entirely due to the complexities found in the private insurance market as well as the hurdles of a high-deductible burden.  Democrats were rebuffed in their efforts to amend the bill with a requirement that the private insurance products provide mental health coverage.  Also defeated were amendments that would mandate that individuals denied coverage be referred to MCHA (though that option remains for those denied), as well as limits on the cost of premiums and deductibles.  The bill passed committee on a voice vote and was referred to the House Commerce Committee.

The bill’s companion is being carried by Senator David Hann and is set to receive its first Senate hearing in his committee next week.

Federal Conformity Dependent Coverage Health Care Reform Act (SF 47/HF 79)

Employees will not have to pay state taxes on the value of health insurance for dependents and adult children up to age 26 (permitted under the Federal Health Care Reform bill) for tax year 2010 under a provision that passed in House and Senate tax committees this week.  Both private employers and public employers were hoping that the bill would have also passed this federal conformity for 2011 and beyond as it creates administrative hurdles to value and withhold the appropriate state taxes for this benefit for certain employees with dependent coverage.  The Senate tax committee chair, Senator Julianne Ortman (R – Chanhassen), hopes to take up the issue for tax year 2011 and beyond within the next 30 days.  Unfortunately, this issue has gotten tangled up in whether or not a legislator supports the “ObamaCare” bill.  There were several new members who were concerned that supporting the federal conformity act may be confused with support of the Federal reform bill.

House HHS Finance Work Groups Formed

House HHS Finance Committee Chairman Jim Abeler (R – Anoka) and House HHS Reform Committee Chairman Steve Gottwalt this week announced the formation of 8 study groups intended to review issues and develop reform proposals.  It’s unclear what role the public will have with these work groups and whether their meetings will be open to the public.  The groups and their members are:

  • Welfare (Reps. Lanning & Hayden)
  • Child Care (Reps. Franson, Peterson & Slawik)
  • Hospitals (Reps. Kiffmeyer, Murphy, Norton & Benson)
  • Health Care and Dental (Reps. McDonald, McElfatrick and Gruenhagen, Huntley & Laine)
  • Mental Health and CD (Reps. Barrett & Diane Anderson)
  • Waivers (Reps. Lohmer, Mack, Hosch & Loeffler)
  • Long Term Care (Reps. Hamilton & Schomacker)
  • MDH, Rural Health & Public Health (Reps. Quam & Huntley)

Talk of a Government Shutdown?

The House Health and Human Services Finance Committee on Thursday received testimony from senior Minnesota Management and Budget staff about the process for shutting down state agencies.  The staff described the steps taken in 2001 to prepare for a shutdown, which was averted, and in 2005, when some state agencies were closed for 8 days.  In both cases, “critical life, health, safety and life functions” were ordered to be maintained.  Partisan tempers flared when DFLers questioned whether the hearing was a signal the Republican majority wasn’t serious about completing its work on time, while Republicans, including Committee Chairman Jim Abeler, noted that the value of the briefing was to prod legislators to complete their work to avoid the trauma and disruption of a shutdown.

Health Insurance Exchange Federal Funding Sought

In a reversal from former Governor Pawlenty, the Dayton administration has announced that it will seek a $1 million federal grant to begin the work of developing a state health insurance exchange.  Under Governor Pawlenty, Minnesota had previously declined the opportunity to seek the grant.  The move was announced after Governor Dayton held discussions with U.S. Health and Human Services Secretary Kathleen Sebelius.  Federal officials have indicated that the state will receive the funding by March 1.

State of the State and Budget Plan Dates

Governor Dayton will deliver his “State of the State” address February 9. He also announced that his budget will be released on February 15th. State law requires the governor to present his budget plan by the 15th and Dayton announced that he is using the entire time to put his budget together.   With the delay in the election results, the announcement did not come as a surprise.

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