Both the House and Senate omnibus health and human services bills contain cuts intended to rein in spending, but they differ in how much should be cut and where.
Sponsored by Rep. Matt Dean (R-Dellwood) and Sen. Michelle Benson (R-Ham Lake), HF945/SF800* was passed 36-30 by the Senate April 3 before it was amended and passed 74-53 by the House four days later. A conference committee began working to resolve the differences last week.
The House plan proposes $14.32 billion in spending during the 2018-19 biennium, a $620.95 million cut from current spending, while the Senate version contains $333.07 million in cuts. In stark contrast, Gov. Mark Dayton has called for a $328.04 million increase to current spending levels.
During a conference committee meeting April 19, Sen. Jim Abeler (R-Anoka) said that while many legislators support programs that Dayton proposes to fund, they can’t justify doing so through his proposed reinstatement of a 2 percent tax on medical providers.
Neither the House nor Senate would fund the $7.89 million operating adjustment recommended by Dayton. Without the funding, the Department of Human Services would struggle to meet state and federal requirements, much less implement new initiatives, said Commissioner Emily Piper.
Health Commissioner Ed Ehlinger said that while the legislative proposals fund valuable new public health programs, it does so by cutting existing public health activities.
Financial Differences — Savings
The Senate offer would chalk up most of its savings to provisions that delay payments, including measures that would shift $227.92 million in Medical Assistance costs from Fiscal Year 2019 to Fiscal Year 2020. Other delays would save $15.41 million in the 2018-19 biennium by putting off an update to inpatient hospital rates until July 2021 and $7.74 million by delaying the payment of local public health grants until the Fiscal Year 2020.
The House proposes a payment delay, as well, in Medical Assistance managed care payments, which would shift $135 million in costs from Fiscal Year 2019 to Fiscal Year 2020, however, the move comprises a smaller percentage of the House’s overall projected savings than the Senate.
The House bill also would save:
The Senate bill also expects to save:
Financial Differences - Spending
While the House and the Senate agree to spend money on many of the same proposals, how much they plan to spend doesn’t always coincide.
For example, the proposals differ on how they intend to reduce service fees to parents of children who are disabled. The House proposes a 25 percent reduction, costing $3.52 million, while the Senate proposes a 13 percent decrease, costing $1.03 million.
The Senate plan to implement a value-based reimbursement system for nursing facilities totals $2.97 million and aligns more closely with the governor’s $3.17 million plan. In contrast, the House proposes $1.43 million in modifications.
Still other provisions only receive funding in one of the two plans:
In the Senate version:
The House version would provide: