House passes bill to end health care exchange

Published 7:44 am Monday, April 10, 2017

ST. PAUL — Republican lawmakers approved a measure Friday that would scrap the state’s health care exchange and send Minnesota residents to the federal marketplace instead.

That provision was one part of the state’s $13.7 billion human services bill that was approved 74-53, largely along party lines. Republicans have said throughout session that the state’s health and social services costs are increasing rapidly without a system in place to control that growth.

Spending in the bill is up by $2 billion over the last two years, but rising costs mean that the measure actually cuts spending by $600 million.

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The legislation also expands opioid addiction services, raises pay for overnight health care workers, and attempts to find and remove ineligible people from claiming state benefits to save costs.

Democratic Rep. Tina Liebling of Rochester said it would be irresponsible to dismantle the state’s exchange with uncertainty still surrounding the federal market.

Since lawmakers and Gov. Mark Dayton agreed to a reinsurance plan, the state’s surplus has dropped to $1.5 billion. Still, Democrats argued during the bill’s hearing that Minnesota has plenty of money to help the state’s neediest residents, saying that the Republicans’ plan doesn’t do enough.

Rep. Liz Olson said she was extremely upset with legislators who pledged to her that they would try to raise bar for those who qualify for medical assistance. That program covers some of the state’s neediest, the Duluth Democrat said, and increasing the bar would have been a relatively modest cost increase.

“I was so disappointed when I saw this omnibus bill and I wondered where the fight stopped,” Olson said. “Where did the fire go out?”

GOP Rep. Matt Dean, the top health services Republican in the House, personally appealed to Dayton in his closing remarks about the legislation.

He said Republicans and the House committee took Dayton’s advice to avoid across the board cuts and to keep the bill relatively free of policy provisions.

“If you are looking at this from the governor’s standpoint … consider where we’re starting from and look at this as a signable bill through negotiation,” Dean said.

Those negotiations will begin as the Legislature attempts to reconcile the differences between the House and Senate versions of the bill, with the Senate bill tallying $335 million in cuts. But the governor will likely prove to be an even trickier negotiator.

Dayton wants to increase spending on health services in the state by $316 million and expand the health insurance market in the state to include a public option, something the Republican Legislature is expected to oppose.