The bill passed off the House floor Monday night on a 70-64 vote after more than nine hours of debate. Rep. Jim Abeler was the only Republican to vote in favor of the bill, while DFL Reps. Joe Radinovich, Jay McNamar, Shannon Savick and Paul Rosenthal voted against the DFL funding bill. The bill would provide a 3 percent cost-of-living increase for nursing homes and a 2 percent increase for long-term care providers, while funneling new funding to mental health care programs in schools and expanding MinnesotaCare to provide insurance coverage to poor adults in the state. The bill also cuts about $150 million from projected HHS spending, a budget target that initially caused House Health and Human Services Chairman Tom Huntley to consider resigning his chairmanship.
“Obviously I disagreed with leadership on part of our budget, but we need to get people’s attention and make sure they understand that we have to make sure we do something about health care spending in this country,” Huntley said. “I had a target, I didn’t like the target, but we met it, and it is important that we reform the health care system.”
But Huntley managed some of the cuts by adding a surcharge to hospitals in the bill, which will bring in about $105 million over the next biennium. He acknowledged it will be a “hit” to some hospitals. “[The surcharge] is done because we can capture federal money and give the money back to the hospitals,” he said. “Unfortunately, there are winners and losers in that system, but the money we raise from hospitals goes back to hospitals.”
DFL Rep. Will Morgan opened the debate with an amendment he said aimed to make the hospital surcharge in the bill more evenly distributed around the state. Republicans cried foul, saying the amendment hadn’t been vetted in committee and members had no idea how it would affect hospitals in their districts. That sparked a nearly three-hour debate on the proposed change to the bill. “You didn’t do your homework,” GOP Rep. Matt Dean said.
The amendment was ultimately adopted on a voice vote. Shortly after concluding that debate, the House accepted an amendment from GOP Rep. Glenn Gruenhagen to sunset the hospital surcharge in 2017. McNamar also successfully tacked on an amendment that would reduce a surcharge on nursing home beds, or the so-called “granny tax,” by $440 per bed in 2015.
Republicans also took issue with the level of funding for nursing homes in the bill, calling on Democrats to meet the 5 percent increase sought at the start of session by care providers. Republican members of the “Rural Caucus” held a press conference Monday to criticize the majority party for proposing to raise several billion in new taxes but not putting more of that money into senior care.
GOP Rep. Paul Torkelson said nursing home advocates say current law would be better for them than the DFL budget bill, characterizing the increase as “crumbs.”
“Every area in the budget got an increase except health and human services,” Torkelson said.
“It’s very, very difficult to stomach what it’s going to do to the nursing home industry,” said GOP Sen. Julie Rosen. “We have a crisis out there in rural Minnesota.”
Republicans in the House brought several amendments on the floor to pay for that increase, as well as fund other programs, by transferring money from the Health Care Access Fund, the Statewide Health Improvement Program and the health insurance exchange. At the urging of Huntley, all such amendments failed on the floor. DFL House Majority Leader Erin Murphy said she thought Republicans “may be playing a little bit of politics” with nursing home funding.
There were several other fairly significant amendments added to the bill as the debate stretched into the evening. That includes one from DFL Rep. John Ward to require licensing for abortion clinics. That amendment passed on a 71-62 vote, with some rural Democrats joining with all Republicans to vote yes. “Yes, it is a pro-life [versus] pro-choice vote,” Ward said, noting that he was denied a hearing on the bill in committee earlier this year.
House members also overwhelmingly adopted an amendment from GOP Rep. Steve Drazkowski to prohibit violent criminals from receiving public assistance, and in a strange twist late in the debate, DFL Rep. Tina Liebling amended another amendment from Drazkowski requiring all welfare recipients and state legislators to take a drug test. Both amendments passed.