A Cure for the Common Good

Pawlenty continues his slash-and-burn crusade to cut health care

About the only good thing that can be said about Governor Tim Pawlenty's latest round of proposed budget cuts is that this time he has spared us the specious rhetoric about everyone sharing in the sacrifice. Instead, just a few months after a blue ribbon commission Pawlenty himself convened released a survey indicating that the vast majority of Minnesotans would favor a tax increase to ensure universal access to health care coverage for state residents, the governor's proposed cuts will deny crucial and timely treatment for thousands of needy citizens.

Specifically, Pawlenty proposes raiding the entire $70 million surplus that currently exists in the state's Health Care Access Fund. This money, amassed in part from the membership fees and co-payments exacted from the working poor enrolled in the state's MinnesotaCare health insurance plan, would be used to help balance the general fund budget. It would also assist in paying for a Gang Strike Force and additional prison beds, items that Pawlenty claims are vital to the safety of the general public.

Pawlenty's proposed raid again puts him on a collision course with Minneapolis DFLer Linda Berglin, who chairs the Senate's Health, Human Services, and Corrections Budget Committee. Berglin is proposing that the bulk of the health fund surplus go toward maintaining health insurance coverage for approximately 8,000 residents who would otherwise be thrown out of MnCare during the course of the year. This includes an estimated 3,000 single adults, most of them with chronic conditions such as mental illness, diabetes, and hypertension, who exceed the $5,000 cap on coverage that was imposed as a result of Pawlenty's budget cuts last year. Another 5,000 people Berglin hopes to keep insuring are the working poor whose modest pay increases--often as little as five or ten cents per hour--price them out of MnCare eligibility.

The governor's proposed budget, which seeks to wipe out a $160 million deficit, anticipates criticism of his health fund raid: He proposes greater coverage of mental health and diabetic services, and expanding MnCare eligibility for those making over 75 percent of the federal poverty limit. But the relative pittance he provides to fund these initiatives--$7 million over the next three years--amounts to a fraction of the funds he is raiding and ensures that these people will inevitably be thrown off the health insurance rolls.

Through this cynical maneuver, Pawlenty is trying to deflect responsibility for further damaging the state's health care safety net. Minnesotans battling mental illness, diabetes, and hypertension will eventually end up costing the health care system more if their conditions go untreated. Inevitably, their health will deteriorate to the point where they will require emergency care at a safety-net hospital.

Yet Pawlenty proposes a 5 percent cut--more than $80 million over the next three years--on what the state pays hospitals for treating MnCare, Medicaid, and General Assistance Medical Care patients. These cuts would come at a time when hospitals are already reeling from the slash-and-burn budget Pawlenty and the Republicans enacted last year, which cut 5 percent out of reimbursements for MnCare and Medicaid patients and 10 percent for services provided to those on GAMC.

To punctuate his disregard for the yeoman uphill battle being waged by safety-net hospitals in saving the lives of vulnerable state residents, Pawlenty's proposed bonding bill denied a $1.4 million request by Hennepin County Medical Center for the expansion of their crisis intervention center, while greenlighting $19 million for the expansion of the Minnesota Zoo. In response, Randy Johnson, the chair of the Hennepin County Commissioners and, like Pawlenty, a Republican, intimated that HCMC will soon no longer be able to provide care for the 20 percent of the hospital's caseload that comes from outside the county without the state picking up some of the tab.

Johnson is not the only Republican no longer able to countenance the damage wrought by Pawlenty's budget axe. House Majority Leader Steve Sviggum (R-Kenyon) recently went on the record opposing the governor's proposed cuts to nursing homes around the state. And at a hearing on the proposed health care cuts last week, Sen. Paul Koering (R-Fort Ripley) exclaimed, "How cheap do we want to make it? Until our health care system becomes ineffective?"

Republicans will be made even more uncomfortable by public testimony, which begins today, on the potential impact of Pawlenty's latest proposed cuts. Among other things, they'll hear about the hundreds of people with traumatic brain injuries who are being denied appropriate care, and the hundreds of disabled forced to enter nursing homes rather than remain with their families or in their communities because the state wants to save money.

It remains doubtful, however, that these heart-rending stories will compel Pawlenty to change his priorities. The truth is, he's got more pressing political concerns. Last year, Attorney General Mike Hatch, whom many view as Pawlenty's likely opponent in the 2006 gubernatorial election, charged that the budgetary squeeze caused by Pawlenty's no-new-taxes pledge led his administration to release sexual predators rather than bear the expense of placing them under civil commitment. While Pawlenty angrily denied the accusation, it so happens that the state is committing 79 sexual predators this year, up from just 14 last year and eight the year before. Now Pawlenty needs more beds to house them and tougher sentences to ensure that others won't eventually be released. And that's a big reason why he's raiding the health care fund.

 
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