GOP, DFL legislators remain far apart on health budget

Republican and DFL legislators remain deeply divided over one of the largest and fastest growing parts of the state budget: health and human services.

Gov. Mark Dayton and DFL legislators want to spend about $1.5 billion more than Republicans, who control both the House and Senate.

At the heart of the debate is what state government's role is in taking care of Minnesota's elderly and disabled, and how to handle increasing health care costs.

Republican Rep. Jim Abeler, chairman of the House Health and Human Services Finance Committee, and DFL Rep. Tom Huntley, who chaired the committee before Republicans took over the House this year, disagreed on those issues during a debate Friday on MPR's Morning Edition.

"Is it the government's job to look after you when you get old or me when I get old? Or is it my job to think about it? And if it's the government's job, we can't afford it," Abeler said.

Abeler said people should think about buying long-term care insurance rather than relying on government money to help if they aren't able to care for themselves. Continuing to dedicate more state funds for seniors' care is unsustainable, he said.

"As the demographics have changed, it used to be 10-to-1 of working people to seniors, and then it was 15-to-1. Now it's almost 2-to-1. Two people working in their 30s to help one person when they're older. How is that ever going to hold up? The model that worked 20 years ago and 30 years ago doesn't work today," he said.

Republicans want to shift low-income, adults without children away from Medical Assistance and into a coordinated care program based in hospitals. The proposal would save more than $900 million in the next two years.

But Huntley called it an 82 percent "draconian" cut that would only shift costs to hospitals and county property taxpayers. He said it would also cause health insurance premium hikes.

"Certainly there should be a reform, but you can't improve the efficiency by 82 percent. It's just not possible," Huntley said.

Huntley acknowledged that some reductions have to be made and said "they will all be painful." He said the way to do that isn't to eliminate programs but to make cuts to health providers across the board.

The thousands of people who would lose state-funded health insurance under the GOP plan would still need care, Huntley said.

"If we want to take care of our seniors or we want to take care of people who are very seriously ill, or do we want to let them die? That's the choice we have to make," Huntley said. "Those people don't go away. They still stay in Minnesota, they go to the emergency room if they have to, they get the most expensive care ... the hospital won't get paid, so they pass those costs onto somebody else. But the state budget looks good."

Abeler said Democrats have exaggerated the impacts the cuts will have.

"The people can get the same or better services for a lower amount than you would have thought. You can't equate the money with services," he said.

Huntley said efficiencies can only go so far.

"There is no way that some of these cuts are not going to have drastic effects," he said.

(MPR's Cathy Wurzer and Curtis Gilbert contributed to this report.)