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July 26, 2011

The Minnesota Legislature passed all of the state’s budget bills and Governor Dayton signed them into law at 9:00 am Wednesday, July 20.  This action was based on a compromise reached last week between Dayton, Speaker of the House Kurt Zellers and Senate Majority Leader Amy Koch. While the compromise was disliked by both sides, they agreed to it to end the 19-day state shutdown.

Overall the new budget spends $35.4 billion over the next two-year budget period. This is $1.4 billion more than the bills the Legislature passed and the Governor vetoed, and approximately $2 billion less than the budget proposed by Governor Dayton.  In the Health and Human Services area, the new budget spends $11.3 billion of general fund money. This is nearly $500 million more spending than the Legislature proposed and $180 million less than the Governor’s recommendations.

The Health and Human Services bill was first released to the public Tuesday night around 10:00 p.m. and voted on just after midnight. After reviewing the language in the bill, and after listening to the supporters and detractors summarize the bill, it is a mixed bag.

Key spending and budget elements:

  • It spends approximately $500 million more in HHS than was passed by the Legislature in May.
  • It continues the early enrollment of MA for adults without children. This results in the elimination of that state’s GAMC program and the capturing of federal matching money to cover this population.
  • It does not cut anyone completely off our public programs.
  • It does not limit us from receiving federal money from the Affordable Care Act (ACA).
  • It begins phasing out the 2% provider tax and repeals it altogether in 2019.
  • It provides $15 million to the State Health Improvement Program (SHIP) for FY 2012

Noted spending cuts:

  • It cuts general fund spending in the HHS areas by nearly $1 billion.
  • It cuts physician and other outpatient provider rates by 3% across the board.
  • It includes cuts to PMAP health plans ranging from 10-13% that most likely will be passed on to physicians and other providers in reduced payments.
  • It implements a voucher program for MinnesotaCare that will provide vouchers to adults without children earning between 200% and 250% of the poverty level.  These vouchers will allow enrollees to purchase coverage in the private market.  There is not enough detail in the bill to know whether the coverage they will be able to afford will adequately cover outpatient services without large deductibles.
  • It cuts the Medical Education and Research Cost (MERC) program by 50% in 2012, reducing to a 25% cut in 2013.

What is also important to note is there are a number of controversial items that were in the earlier passed HHS legislation that are not a part of this deal.  They include:

  • There are no changes to newborn screening program or limitations to the collection of that data.
  • There is no language limiting the use of vaccines that include “fetal DNA.”
  • There is nothing that reduces reimbursements to “high-cost providers.”
  • There is nothing that “silos” health care homes by creating pregnancy health care homes, mental health care homes, or other condition specific health care homes.
  • There are no new limitations on stem-cell research or abortion-related services.

Of particular interest to the MN-AAP, the bill does contain language creating the “Minnesota Task Force on Prematurity.”  The task force is charged with crafting a report to the Legislature.  The bill also continues the “Autism Spectrum Disorder Task Force,” on which a member appointed by the MN-AAP is to serve. It too is tasked with drafting a report to the Legislature.

May 31, 2011

Legislature Adjourns; No Budget Deal in Place

The constitutionally mandated adjournment came to the Legislature on Monday, May 23 with no budget deal in place.  A special session is a certainty, and a government shutdown looms if agreement is not reached by June 30.

Physician “Gag Rule” Bill Introduced

Similar to efforts in Florida and Mississippi, a bill has been introduced in the Minnesota House and Senate that would prohibit physicians from asking patients and patients’ families about the availability and access to firearms.  The bill did not receive a hearing prior to adjournment, but remains alive for the 2012 session.

MN-AAP Weighs in on MERC

Joining with more than a dozen physicians’ groups, hospitals, health care systems, and academics, the MN-AAP called on Governor Dayton and legislative leaders to reconsider the proposed deep cuts to MERC.  Arguing that cuts of the magnitude proposed by the Legislature would have devastating impact on medical research and medical education, the groups urged leaders to adequately fund this vital program.

May 3, 2011

Vaccine Safety a Focus of House Hearing

A controversial researcher presented her beliefs about a link between autism and vaccines to the House HHS Reform Committee this week.  Dr. Theresa Deisher, a Stanford-trained genetic researcher and President of Sound Choice Pharmaceutical Institute, offered testimony about her research into the link between the presence of “fetal stem cell DNA” in the MMR vaccine and growing rates of autism.  Offering contradictory testimony were a number of researchers from the University of Minnesota and the Minnesota Department of Health.

HHS Budget Conference Committees Continue

The conference committee working to reconcile differences between House and Senate HHS budget proposals continued this week, with few decisions being made.  The legislative proposals contain stark differences with that of the Governor.  Lucinda Jesson, Cmmissioner of DHS, weighed in with a letter noting several dozen significant concerns with the legislative proposals.

April 15, 2011

MN-AAP Decries Newborn Screening Changes

Gathering with a broad coalition of partners including parents groups, the March of Dimes, and Mayo Clinic, the MN-AAP led an effort to highlight dangerous changes to the state’s Newborn Screening Program contained in a Senate bill. The proposed changes would call for the destruction of the state’s registry of test results and dried bloodspots, and would seriously jeopardize the utility of the program. Scroll down for a fact sheet and action alert on newborn screening.

HHS Budget Work Begins

Members of the House and Senate gathered this week to begin work in reconciling significant differences in their approach to funding HHS agencies and programs. While comparable in the size of funding, the approaches of the two bills differ. The legislators’ position remains considerably different from that of the Governor.

Concussion Bill Moves Forward

A proposal to raise awareness of concussions and better manage a youth athlete’s “return to play” took several steps in both the House and Senate this week. The bill makes use of guidelines and educational materials made available by the CDC, and requires clearance by trained individuals before a youth may resume practice or competition.

April 1, 2011

Newborn Screening Program Under Attack

In a bill moving through the Senate, major changes are being proposed that would dramatically impact the state’s Newborn Screening Program.  The language proposed would allow parents to decline to have the tests (no change) or to elect to have the tests after which the blood spots would be destroyed (change).  Parents could elect to “opt-in” to have the blood spots stored for a period of no more than 24 months (change).  In addition, the bill would require immediate destruction of all currently stored blood samples.  It would also abolish the registry of congenital diseases which is used for the purpose of follow-up services.

House & Senate Move Budgets Forward

The finance bills setting budgets for HHS agencies and programs are moving through both the House and Senate.  Though very different in their approaches, both bills would cut deeply into public programs and eligibility, rely heavily on federal waivers, and contain a number of controversial policy provisions.

Repeal of Minor Consent Proposed

Under a bill discussed in the Senate, the state’s long-standing ‘minor consent’ law would be repealed.  Under the legislation, health services for minors would require consent by a parent or guardian.  Were a minor the victim of sexual or physical assault or incest, the minor could receive care only after seeking a judicial order.

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