Parties duel over how to spend health care surplus

The revenue forecast released this week shows a projected $122 million surplus in the state's health-care access fund. Money in the fund comes from a tax on the services doctors, hospitals and clinics provide. Berglin and Bradley both want to use that money to pay for their plans, but the similarity ends there.

Berglin is a DFLer from Minneapolis who chairs the Senate Health and Human Services Budget Division. She wants to expand MinnesotaCare, the state's subsidized health insurance program. Her plan would extend the plan to more farmers, small businessess and single adults like Karla Swenson. The Roseville resident says she works two jobs, makes too much to qualify for MinnesotaCare, yet she can't afford private health insurance.

"It's very frustrating to work so much; more than 50 to 60 hours a week, and not be able to afford health care. I mean, how much overtime do I need to do?" Swenson said.

Swenson is among the estimated 270,000 working Minnesotans who don't have health insurance. Berglin wants to make people like Swenson eligible for MinnesotaCare by raising the income limit for single adults. Berglin's plan would also allow them to get benefits like dental care and mental health services that were eliminated during budget cuts three years ago.

"We believe that when money becomes available, cuts that have been made that were unfortunate in 2003 should be restored," Berglin said.

Berglin's proposal would also create a prescription drug discount program, and allow small businesses to provide health insurance for their employees through MinnesotaCare, which they can't do now. She says if more people have insurance, they won't rely on the emergency room for medical care, which will reduce premiums for insured Minnesotans in the long run.

House Republicans say Berglin is offering a big-government solution to the problem of rising health-care costs.

Fran Bradley, a Rochester Republican who chairs the House committee dealing with health care, says he's proposing market-driven solutions. His top priority is eliminating a surcharge paid by many small businesses to help fund the Minnesota Comprehensive Health Association. The association insures high-risk Minnesotans who've been denied health coverage. Bradley says the surcharge makes it even more expensive for small businesses to insure their employees.

"That's a direct hit on the small employers. That's $100 million or so a year right at the bottom line, and if we can get rid of that, that's almost an immediate... you don't find many things that you can do that have an immediate benefit in the health care marketplace where we are most vulnerable," according to Bradley.

Small businesses have been lobbying for the change for years. Jim Fries, who chairs the small business committee for the Minnesota Chamber, says the Legislature should act quickly.

"A lot of employers have had to say, 'I've got to eliminate my health care plan just to keep four employees.' That's a critical decision," he said.

Fries supports Bradley's proposal, which would encourage health savings accounts and provide consumers more information on the cost of their care. Bradley also wants to allow for-profit HMOs in Minnesota and require medical providers to charge everyone the same price for the same procedure.

Berglin was skeptical of Bradley's proposal. She says for-profit HMOs won't reduce premiums, and the health-care access fund shouldn't be used to eliminate the surcharge small businesses pay.

Given the opposing approaches, the stage appears to be set for partisan gridlock, with the House passing Bradley's plan and the Senate backing Berglin's proposal.

DFL Senate Majority Leader Dean Johnson says it would be unfortunate if nothing gets done this year.

"Because what we're talking about is helping people -- citizens, who have come forth today and have essentially pleaded their case. We have the money, all we need to do is change some policies and our two constituents, our two friends here, will be helped," Johnson said.

Johnson was referring to Karla Swanson and Collin Boser, a dairy farmer and single parent from Pierz who doesn't qualify for MinnesotaCare. Both appeared at Berglin's news conference.

But changing policies will likely be a lot harder than Johnson makes it sound. Gov. Pawlenty is proposing to spend some of the health care access fund that Berglin and Bradley are eyeing on his own mental health initiative.

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