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Health care reform comes to the Capitol — sort of

State Sen. Linda Berglin, DFL-Minneapolis, has a soft-spoken demeanor that belies her tenacity at the Capitol on health care issues.

State Sen. Linda Berglin, DFL-Minneapolis, has a soft-spoken demeanor that belies her tenacity at the Capitol on health care issues. Health care reform has been overshadowed this legislative session by the transportation bill, the budget deficit and the looming bonding bill initiatives, but some are viewing it as a key legislative piece this year.

To that end, some thought Berglin’s Senate File 3099 might hit the Senate floor today, but Berglin and others crafted a 75-page monster, one that lawmakers wanted to digest before acting on it.

“The Republican caucus in the Senate wanted more time,” Berglin said this afternoon at a media conference at the Capitol. “Forty-five minutes is not enough time to understand a bill as big as S.F. 3099.”

A Senate Majority Research cheat sheet on the bill notes that it was constructed with input from both the Legislative Commission on Health Care Access and the Governor’s Health Care Transformation Task Force. The bill has Republicans signed on as co-authors, went through 10 separate committees and has the theoretical blessing of Gov. Tim Pawlenty — who, as Berglin noted, “agreed to the framework of the bill.”

But that doesn’t necessarily mean smooth sailing. The bill purports to increase health care access to 47,000 uninsured Minnesotans and has four separate articles: “Public Health, Health Care Homes, Access and Continuity, and Health Insurance Purchasing and Affordability Reform.” In short, it’s a sweeping piece of legislation.

What the bill will do

 Some key components, according the Senate Majority Research, include:

• A “health improvement plan that is designed to lower obesity and cigarette use, and alcohol and chemical dependency.”

• “Better automation and coordination between public health care programs” and “financial incentives to programs helping people enroll in MinnesotaCare.”

• A “Health Insurance Exchange” that “will be operate similar to a stock exchange where health insurance products will be available for purchase by individuals and small businesses.”

Some “fiscal notes” on the bill:

• The “health improvement” plan will cost $20 million in 2009 and $80 million in the 2010-11 biennium.

• Some $8 million will be appropriated from the state’s Health Care Access Fund (HCAF) in 2009 for start up of the Health Insurance Exchange.

• Next year the HCAF expenditure will be $38.4 million and $253.7 million for the 2010-11 biennium. “These funds,” according to the Senate Majority Research, “will go to expand MNcare,” and other administrative and access funds.

However, as Berlgin noted, “At the time we talked about the bill, we did not know the extent” of the state’s current $935 million budget deficit. For that, the sticky wicket will prove to be HCAF. The governor wants to use some $250 million in surplus from that fund to help balance the budget.

“The governor doesn’t propose expanding health care access” with that fund, Berglin said, hinting that it shouldn’t be used as a slush fund. “We’re pretty lucky in Minnesota to have the Health Care Access Fund, and we need to be good stewards.”

Still, it’s likely that Pawlenty views it as key piece of budget salvation, something that will likely lead to serious politicking across the aisle next week, when lawmakers reconvene after an Easter break.

Then again, it’s a solid bet that the bill might go poof, as the bonding bill and the budget crisis threaten to dominate the rest of the legislative session. But Sen. Tarryl Clark, DFL-St. Cloud and the assistant majority leader, expressed optimism that something would get done on health care reform.

“In the Republican caucus,” Clark concluded, “they’re saying ‘Gee, this might be one of the things we can get done together.'”