Pawlenty's broadside against social service spending

Even by the usual standards of political hyperbole, Gov. Tim Pawlenty's rhetorical assault on the state's social services on Thursday was unusually stark. In a speech to business interests, the governor appeared to suggest that one of the reasons for the crumbling roads and bridges in Minnesota is the spending on social services, including the state subsidized health care plan.

Pawlenty was speaking to the Burnsville Chamber of Commerce when he suggested cutting social services to put more money into roads and, presumably, bridges.

As quoted in the Star Tribune:

"If we don't get a handle on this at both the federal and at the state level, and at county, school district and city level, these programs are growing so fast and so out of proportion with the rate of the private economy, that within 15 years it will consume a vast majority of the state's budget."

Told by his host that a client with 11 children has tried to adjust his income under $50,000 to qualify for MinnesotaCare, the governor said he, too, has heard of people who try to adjust their income so they can qualify for subsidized health care.

None of which has anything to do with the state's spending on social services, at least as far as roads, bridges, and MinnesotaCare is concerned.

True, the state has an effective state subsidized health care plan. That's one of the reasons the state was recently cited as the second-most-healthy state in America. But the political debate that surrounds it often ignores the funding mechanism behind it. Money that could be used for roads and bridges is not going to MinnesotaCare because MinnesotaCare is not funded with taxpayer money; the state's share is funded by a tax on health care providers. Recipients also pay premiums (the family cited above would pay about $3,000).

When the governor moved for further cutbacks in MinnesotaCare in 2005, the so-called Health Care Access Fund had a $226 million surplus. That fund made an attractive target for the governor who faced a budget deficit.

The Minnesota Medical Association tried to get legislation passed last year to keep the MinnesotaCare funding from being diverted to other projects. It didn't pass but the MMA says it's going to try again next month.

In a speech earlier this month, the MMA says, Pawlenty vowed not to use the MinnesotaCare money to balance the budget, and even said he might try to lower the tax that funds MinnesotaCare; an interesting proposal if the cost of providing health care is as burdensome as Thursday's speech would indicate.

So what's going on here?

The governor's speech may be more a warning to legislators than an initiative. This month, two panels -- one of which was created by the governor -- will release proposals for revamping the entire health care system in Minnesota. They are reportedly leaning toward expanding health care for Minnesotans, but there are sharp divisions on how to accomplish that .

Times change. A year ago, Pawlenty was proposing expanding health care in the state. But that was before the budget deficit went up and a bridge came down.

sounds like a robbing Peter to pay Paul scenario.
As of January 2008 Minnesota Care's standard for eligibility rose from 175% of the Federal Poverty guidelines, to 200%. And this is part of an initiative passed last session..
hmmm. This is giving me a headache

Bob, you got it wrong - but you can be forgiven due to the complexities of Minnesota's health care programs.

Medical Assistance (MA) is a federal-state, jointly funded program that pays for health care services to low-income individuals, including families and children, the elderly, and persons with disabilities. MA is Minnesota's Medicaid program and is funded with a 50-50 federal/state split.

General Assistance Medical Care (GAMC) is a state-funded program that pays for certain health care services for low-income Minnesotans who do not qualify for other health care programs. GAMC enrollees are mainly adults between the ages of 21 to 64 who do not have dependent children. These enrollees are the poorest of the poor. We are one of the only states that provides this type of coverage.

MinnesotaCare provides subsidized health coverage to low- and moderate-income families and individuals, who pay a premium-based on a sliding scale. These folks are determined to be the "near poor." This is the program paid for by the tax on health care providers. Again, we are one of the only states to provide this type of coverage.

In addition to these programs, we greatly enhance the federal Medicare program, have our own SCHIP program, provide services for non-citizens, fund various federal and state programs that provide health care and other services for elderly people, provide assistance to Minnesota families in the form of income, health care, child care, and food purchasing, and provide enhanced health services for people with disabilities.

The Governor is enitrely correct. All of this is unsustainable. The cost of these programs is increasing more than 8% a year. Spending for this is crowding out spending for other priorities. It is THE biggest issue the legislature is facing.

My post pertained ONLY to MinnesotaCare because the person trying to get below $50,000 is trying to get on MinnesotaCare. I realize there is an MA component (and other components) to health care and I realize MinnesotaCare and social services spending are not synonymous. However, when people engage in this debate, they tend to lump everything into the MinnesotaCare bottle and THAT is incorrect and needs to be pointed out, which is the goal of the post.

For example in pointing out that we are one of the few states offering MinnesotaCare style coverage, what EXACTLY are you saying? Whenever *I* hear comparisons to other states, I hear the word "luxury" and maybe so. But if the Health Care Access Fund develops a surplus, that's a program that's working as designed and that money is NOT taking money away from roads and bridges, unless you have a plan to raid -- what the MMA characterizes in such situations -- a slush fund.

As far as the constant comparison to other states and their situation, why is it in matters of health care, we don't want to be BETTER than other states, whereas when we talk about roads and bridges and education and economic development, being BETTER than other states is the goal? When the state was cited as being #2 of all states in health (down from #1)... I don't recall anybody putting out a press release saying we should try to be less healthy so we can drop down closer to, say, Iowa.

There is, of course, a debate to have on MA, but that's not the point of the post.

"Spending" on MinnesotaCare is not crowding out spending on roads and bridges (which the governor believes should be funded by bonding, by the way), unless he does what he did the last time people were thrown off MinnesotaCare: view the health care access fund as a slush fund to be raided for non-health care needs.

It's also worth looking at what people lost when MinnesotaCare was last raided. And while injecting "illegal immigrants" has its purpose, what about the people who needed test strips to monitor their blood sugar levels? Minnesotans. Elderly Minnesotans, in some cases.

Nobody ever stands up in front of a chamber of commerce and says "we're spending too much money helping your grandmother manage her diabetes."

Also, I believe the net effect of some of the last round of MinnesotaCare cuts was to push some people to MA, a program about which there is now concern about its cost. Why?

And, finally, how about a plan? I get the "we're spending too much" ... but when one utters "roads and bridges" around here, we all know what images comes to mind. Injecting the the providing of health care to a fallen bridge? That's a new one.

The governor has never been above imagery:

"It's one of the big-spendin', tax-raisin', abortion-promotin', gay marriage-embracin', more welfare-without-accountability-lovin', school reform-resistin', illegal immigration-supportin' Democrats for governor who think Hillary Clinton should be president of the United States."

You correctly point out the importance of the coming debate. But aren't we better off making it an intelligent and informed one, rather than another vague imagery riff for the base?

By the way, not mentioned in his speech yesterday was his comment after barely beating Mike Hatch in 2006

"We all, I think, can chart a path toward universal coverage."

Say what?

"Told by his host that a client with 11 children has tried to adjust his income under $50,000 to qualify for MinnesotaCare, the governor said he, too, has heard of people who try to adjust their income so they can qualify for subsidized health care."

OOOOOHHHHHH my-my.
That's my goal in life, to maliciously live at a poverty level so that I can receive health benefits at an affordable cost. What kind of skewed thinking is that?!!! Who would go to all of the trouble and paper work and hoops and time and effort needed to mess with, just so they could be on Minnesotacare?

(Collins: Someone who didn't have access to health care coverage at work and was willing to do what he could to get it. Let's assume the guy made $55,000 a year and was intentionally trying to lose $5,000 a year for the opportunity to spend $3,000 a year in premiums and pay all the co-pay stuff. That's a person willing to spend, in this example, $8,000 a yea.. $666 a month just to get in the game. That's not a person looking for a free ride. That's a person who's desperate.)

And then for the Govenor to imply that they'll teach 'em, ('Em' refering to low income families), a lesson and they'll just cut that liberal health spending even more and give the money to Transportation. You show 'em' Timmy.
Whatever happened to helping each other?
A good answer would be Universal Healthcare wouldn't it?

Who would go to all of the trouble and paper work and hoops and time and effort needed to mess with, just so they could be on Minnesotacare?

What I meant by that comment was that the Govenor's thinking is a bit skewed if he is thinking that the "11-child- $50,000 -man" is "scamming" to get Minnesotacare. I know desperate-I made $121.00 too much inorder to continue receiving Resources For Childcaring, when Pawlenty changed that income cut-off line.

I am a single mother who would like to participate in her son's childhood. School for me right now is not looking doable. I have an Associates with some college. An Associates degree will land you a $15.00 an hour job (if you can find one) and this is with years of experience under your belt.

This topic is a loose thread that pulls apart a whole garment.

So wait,

Has the fund been raided yet?

That's the governor's plan. However it's a subject of negotiation. Latest rumor is Pawlenty will take half of what he intended to take.