Legislative Update: 1/9/15


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MNAAP Legislative News in Brief

  • The 2015 Legislative Session began at noon on Tuesday, January 6, and with the new session came a new majority party in the House of Representatives. Minnesota voters returned the House to Republican control in last year’s elections while at the same time reelecting DFL Governor Mark Dayton (the DFL-led Senate was not on the ballot in November 2014). The first task for the legislature will be crafting a biennial budget for the Governor’s consideration, an effort made easier by a projected budget surplus. The state’s constitution mandates that the session conclude no later than May 18, 2015.
  • The MNAAP has set its 2015 legislative priorities with the input and guidance of both the MNAAP Policy Committee and the full MNAAP Board of Directors. Central to the 2015 legislative agenda are a number of issues familiar to many in the MNAAP, including:
    • Ensuring access to care for all Minnesotan newborns, children, teens, and pregnant women, including access to health care homes and mental health resources. The MNAAP further supports efforts to address the primary care physician shortage.
    • Supporting efforts to invest in early brain development, including increased access and availability of quality early childhood education and early literacy programs. The MNAAP will advocate for initiatives to reduce childhood poverty and close the state’s alarming health disparities.
    • Advocating for efforts to keep kids safe, including support of additional regulations to ensure clean indoor air, further prohibitions on tobacco access, and preservation of hard-fought gains in restoring the state’s newborn screening program. We will support efforts to reduce childhood obesity and investments in infrastructure that promote health and wellness, as well as initiatives to increase the state’s vaccination rate.
  • Make sure to mark your calendar for the 2015 Pediatrician’s Day at the Capitol set for March 18, 2015. This important event is one of the key pieces of our advocacy effort, and your participation is important and impactful. Watch for more news and registration information in the weeks to come.

And they’re off…

With the crack of the gavel and calls for cooperation and bipartisanship, the 2015 legislative session began shortly after noon on Tuesday, January 6, 2015. All 201 legislators in the DFL Senate and GOP House gathered in St. Paul to officially begin the 2015 legislative session amidst the construction dust and debris of the ongoing Capitol renovation project.

First and foremost on the minds of legislative leaders will be their constitutionally-mandated job to pass a balanced biennial budget. That task was made somewhat easier with the announcement of a budget surplus going into the 2016-2017 biennium. While the $1.037 billion surplus is certainly good news, in the scope of a nearly $42 billion biennial budget it won’t completely remove disagreements among legislators and the Governor. Between now and the end of session – set this year for no later than May 18, 2015 – legislators will set the state’s budget for the next two years.

As noted above, the Capitol is in the midst of a comprehensive, three year, $272 million renovation. Given the scope of the project, 2/3 of the Capitol building has been closed to the public, and the Governor, dozens of Senators, and staff have been moved from their offices to temporary spots. The construction will add an interesting dynamic to the session. Of some horror to Capitol denizens, portable toilets have been brought in to make up for the closed bathrooms. Quarters are close, and the new digs are likely to build more impatience than understanding. A terrific video that documents the project is available here.

The Key Players

The November 2014 elections saw the nationwide Republican wave hit Minnesota, though in a somewhat smaller form. Two statewide DFL leaders who first came to office via the narrowest of margins – Senator Franken and Governor Dayton – were handily reelected in 2014, though the Republicans regained control of the Minnesota House of Representatives with a margin of 72 to 62. The House has now shifted from one party to the other in the last four elections.

With the new House majority comes new names in key positions of leadership. Often considered the second most influential political position in the state behind only the Governor, the new Speaker of the House is Rep. Kurt Daudt (GOP – Crown). The Republicans have elected Rep. Joyce Peppin (GOP – Rogers) as their new Majority Leader, while the DFL House Caucus has returned former Speaker Rep. Paul Thissen (DFL – Minneapolis) as the Minority Leader. Heading up the House HHS Finance Committee in the House will be Rep. Matt Dean (GOP – Dellwood) while Rep. Tara Mack (GOP – Apple Valley) will take the gavel to lead the health care policy committee in the House, now to be called the HHS Reform Committee. Reps. Tina Liebling (DFL – Rochester), Dianne Loeffler (DFL – Minneapolis), and Joe Mullery (DFL – Minneapolis) will take the lead for Democrats on these two committees. A link to the entire list of committee assignments is available here.

Members of the Senate were not on the ballot in November and there have been no changes in leadership or health care-related committee chairs. The Senate HHS Finance chair remains Sen. Tony Lourey (DFL – Kerrick) while the Senate HHS Policy Committee will continue to be Sen. Kathy Sheran (DFL – Mankato). Lead Republicans on the two committees remain Sen. Julie Rosen (GOP – Faimont) and Sen. Michelle Benson (GOP – Ham Lake) respectively. The Senate Majority Leader remains Sen. Tom Bakk (DFL – Cook) while the Senate Republicans will continue to be led by Sen. David Hann (GOP – Eden Prairie).

Budget Picture Rosier, but Concerns Loom

As noted above, the fiscal forecast announced in early December shows a surplus for the state in both the current period and the 2016-2017 biennium. Much of the $556 million surplus in the current biennium has been deposited in the state’s reserve account – known as the “rainy day fund” to many – due to a change in state law adopted in 2013. Analysis of the forecast by officials at Minnesota Management and Budget (MMB), the state’s bookkeepers, show that the surplus came about because of both higher-than-anticipated tax receipts and lower-than-expected state spending, particularly in health care. MMB also projects that revenue in the 2016-2017 biennium will exceed spending by $1billion which, when combined with the remainder from the current biennium, puts the surplus at $1.037 billion.

The good budget news will make legislator’s budget-setting task easier. DFLers will likely be successful for their push for more spending in key areas and the Republican-controlled House will likely be able to move forward some targeted tax relief. But the budget numbers are not as rosy as they might seem. Should the economy take a turn for the worse the next budget forecast – due in March – may show a smaller number. And in the scope of an almost $42 billion budget, a surplus of $1 billion is a relatively small number.

It’s also worth noting that the budget forecast paints a more troubling picture for the area of the budget that is of special significance to health care interests. The Health Care Access Fund, the budget fund for much of the state’s health care spending, shows a deficit beginning in 2017 and growing in subsequent years. That deficit will grow quickly in the future as the state’s provider tax is repealed at the end of 2019. Those deficits will put tremendous pressure on legislators to find new funding, cut programming or eligibility for health care, or rescind the repeal of the provider tax.

MNAAP Sets 2015 Session Agenda

With the input of both the MNAAP Policy Committee and the Board of Directors, the MNAAP has set its legislative priorities for the 2015 session. The issues on which the MNAAP will focus are familiar ones to many who have been involved with the chapter in the past and include:

  • Access to Care. The MNAAP supports efforts to ensure efforts to ensure coverage for every Minnesota newborn, child, adolescent, and pregnant woman. The MNAAP will advocate for increased pediatric mental health access and coverage, health care homes, and support efforts to address pediatric workforce shortages workforce shortages. As healthcare reform and transformation continues to change the environment in which we provide care, the MNAAP will continue to lead to ensure children’s health remains central to the conversation.
  • Early Childhood Brain Development. Minnesota’s pediatricians will continue to advocate for initiatives and programs that support early brain development, including high quality early childhood education and early literacy programs. Such programming serves as a starting point to address the significant health and education disparities present in Minnesota.
  • Preventative Health Initiatives. The MNAAP will continue to support efforts to keep children and adolescents healthy. As such, we strongly support efforts to increase immunization rates among infants, children, and teens. Tobacco and nicotine remain a problem in Minnesota, and the MNAAP supports efforts to preserve clean indoor air and reduce minor access to tobacco and e-cigarettes. As pediatricians, the MNAAP recognizes the tremendous utility of universal newborn screening, and we will continue to protect our hard-won legislative gains from recent years.

While these particular issues have been identified as priorities for 2015, other issues will continue to be on the radar for the MNAAP. We will work to support efforts to reduce childhood obesity, and will closely monitor proposed changes to the state’s child protective services. We’ll also closely watch for efforts to endanger the physician-patient relationship, and will strongly advocate for programs that reduce the incidence of childhood poverty and homelessness. Where appropriate and advantageous, we’ll leverage our involvement in existing coalitions to maximize our voice in the halls of the Capitol.

Pediatrician’s Day at the Capitol March 18

Make plans to join your pediatric colleagues for the annual Pediatricians’ Day at the Capitol set for March 18, 2015. This day of advocacy and fellowship is an important effort in advancing policies that help our young patients, and is a great opportunity for you to directly engage with your legislators on the issues facing children and adolescents. Following presentation from key legislative leaders, individual meetings will be scheduled for you and your local colleagues with your Senator and Representative.

With most of the Capitol closed to the public due to construction, our 2015 Day at the Capitol will be a little different than years past. Stay tuned for more details. Register now!

Senate Leaders List Physician Workforce as Priority; House Leaders Point to MNSure Reforms

Investing in the physician workforce was included among the top priorities by Senate leaders during a press conference on the first bills introduced for the 2015 session. SF 3, carried by Senator Greg Clausen (DFL – Apple Valley), would provide additional funding for loan forgiveness programs for physicians and other health professionals who agree to work in a rural or underserved area of the state for at least three years. Current law provides for physician and dentist loan forgiveness programming, though this bill expands the list of eligible professions to include mental health, long-term care, and public health practitioners. The funding level will be determined as the bill makes its way through the committee process.

Similarly, House Republicans announced their 2015 legislative priorities this week. One of their first bills, HF 5, authored by Rep. Tara Mack (GOP – Apple Valley), would make health insurance products purchased outside of the health insurance exchange eligible for the same tax credits as those products purchased within MNSure. Her bill also caps the salary and benefits of the director of the state insurance exchange and applies many of the state’s open meeting laws to meetings of the MNSure board and committees.

Legislative leaders often use the first bills introduced in a session as symbols of their priorities for the upcoming year. Other bills introduced by the majority Senate DFLers include bills to make available universal pre-K education (see below for more information) and fund disaster relief for those counties affected by last summer’s severe weather. Republican House leaders made a similar announcement when they presented their first bills for 2015. Among the priorities listed by Speaker Daudt and Republican leaders are a package of business tax cuts, regulatory relief for businesses, and investment in the state’s roads and bridges.

Universal Pre-K Education Proposed by Senate DFL

Announced as part of their legislative priorities for the 2015 session, Senate DFL leadership announced a proposal to provide free universal pre-K education for 4-year olds. The bill, authored by Sen. John Hoffman (DFL – Champlin), establishes criteria for qualifying early preschool programs, including curriculum standards, screening measures, developmentally appropriate literacy, language, and math skills. The cost of the program is not yet known. St. Paul DFLer Rep. Erin Murphy is expected to carry the bill’s House companion.

Task Force Seeks Changes to Child Protection System

In response to a series of highly critical stories in the Minneapolis Star Tribune about child maltreatment and deaths, Governor Dayton last fall formed a task force to review the state’s child protective service programming. The Governor’s Task Force on the Protection of Children was made up of 23 individuals, including judicial officials, representatives of law enforcement, social workers, county social service representatives, and others, including Mark Hudson, MD, a pediatrician. The group is chaired by Lucinda Jesson, Commissioner of the Department of Human Services (DHS) and Toni Carter, a Ramsey County Commissioner. Four legislators from both the House and Senate and both parties are also members of the committee.

The group announced its set of initial recommendations in December 2014. Among the first proposals are calls for better use of maltreatment reports filed with county agencies. Prior histories of alleged abuse, the recommendations state, are an essential element of screening and assessing family situations. Screening decisions should be made in a team-based environment, including law enforcement. The recommendations also include a call to examine the state’s mandated reporter statute, as well as an upgrade in the information technology used by social service agencies. Changes to the state’s data practice act to allow mandated reporters access to reports that they have submitted are also proposed.

For more information on the Task Force and its recommendations, visit the group’s web site here. A number of the initial package of recommendations has been packaged as a legislative proposal, SF 4, authored by Sen. Kathy Sheran (DFL – Mankato). The bill has bipartisan support.

Annual Sponsors

Children's Minnesota
Gillette Children's
Hennepin Healthcare
University of Minnesota Health
Essentia Health
Mayo Clinic
Shriners Healthcare for Children-Twin Cities