MINNEAPOLIS, April 11, 2008 –  The House passed a health care reform package 83 to 50 Thursday the MMA supports.

Both the House and the Senate have passed comprehensive health care reform bills this year.

However, the House and the Senate versions have significant differences, and Gov. Tim Pawlenty’s support for either is unknown, so the final outcome of health care reform this year is still up in the air.

Thursday’s House debate stretched late into the evening. The MMA’s lobbying team was there urging lawmakers to support the bill not that the controversial Level 3 payment reform had been removed. They also distributed a letter of support for bill from MMA President James J. Dehen Jr., M.D.

The bill’s author, Rep. Thomas Huntley, DFL-Duluth, referred to the MMA’s support of the bill several times during the debate on the House floor.

The MMA supported the bill (H.F. 3391) because it no longer included the controversial payment reform proposal known as Level 3 that proposed holding providers accountable for the total cost and quality of care. Instead, the bill included a voluntary option for providers to explore innovations such as offering bundled or package pricing for services.

The bill also included many of the reform ideas in the MMA’s reform proposal, Physicians’ Plan for a Healthy Minnesota.

For example, if the proposal became law, it would . . .

• Provide new payments to support medical homes and chronic disease management;

• Push aggressive public health programs to reduce obesity by 50 percent by 2020 and cut tobacco use by 2 percent by 2011;

• And have the goal of increasing the state’s insured rate from 93 percent to 98 percent by 2013 through eligibility changes to state programs, affordability thresholds and financial assistance to those who can’t afford private insurance offered by their employer.

The House reform bill passed along party lines with nearly all of the DFL representatives voting for it.

Republicans, such as GOP House Minority Leader Marty Seifert, R-Marshall, said he opposed it because it wouldn’t really reduce insurance premiums for those with private insurance.
 
“We want something that’s real – real reform that’s going to reduce people’s insurance premiums,” he said, according to the Associated Press.

Advocates of the bill countered that prevention measures and payment reforms will result in savings by reducing inpatient costs and those savings could ultimately affect premiums in the private market.

Republicans also said the cost of the reforms, $270 million over three years, was too high and would ultimately deplete the Health Care Access Fund, which if left alone is projected to have a surplus of $403 million by 2011.

Gov. Tim Pawlenty wants to take about $250 million out of the Health Care Access Fund to help fix the state’s projected $935 million budget shortfall. He would also shift about $150 over three years from the fund to pay for general fund items.

The next step in the process will be for legislators to form a 10-person conference committee that will try to draft a compromise bill between the House and Senate versions.

But legislative insiders don’t expect a quick resolution.

It looks as if health care reform and this year’s battle about the deficit will be intertwined for the rest of the session, because Pawlenty wants to use the HCAF funds to fix the budget, and DFLers want to use those same funds to finance health care reform.

Given the complexity and gamesmanship involved with resolving both issues, insiders say it will likely take the rest of the session, which has a constitutional deadline of May 19.

As parties negotiate, the MMA will continue to oppose the Level 3 payment reform proposal in the Senate bill.

 “The MMA strongly opposes a payment system based on total cost of care that turns physicians into insurers and managers of risk,” Dehen wrote in the letter delivered to lawmakers Thursday. “The MMA will vigorously oppose any efforts by the conference committee to move in that direction.”