I don’t have all the answers but due to a rich and unrestrained family discursive tradition, I have strong opinions. I’m quite willing to share them.
Minnesota shouldn’t be balancing budget deficits on our state’s most vulnerable citizens. Specifically, we shouldn’t use affordable heath care access fund surpluses to write down Minnesota’s projected $935 million biennial budget deficit.
But, that’s exactly what Governor Pawlenty proposes. He would transfer surplus Health Care Access Funds cash, money that is supposed to be used for affordable heath care access, into Minnesota’s general fund as a deficit off-set. The result will force more Minnesotans into heath care’s most expensive delivery point: the emergency room. Those costs must be borne by the provider’s charitable mission funds, written off against provider revenue, underwritten by programs like HCAF or covered by some mysterious third party.
When I recently checked, mysterious, benevolent third parties last appeared in Charles Dickens’ Great Expectations.
The final, ugliest alternative occurs when providers turn away patients, denying service because patients can’t pay and providers can’t afford free medical service delivery. Policymakers recognized this quandary’s societal costs when they created the HCAF, sensibly establishing a provider tax funded mechanism to expand affordable healthcare access.
Now, Governor Pawlenty wants to undermine a program that works to move Minnesota forward. Rather than abandon his regressive, punitive “no new taxes” policy for a fair, progressive alternative, Pawlenty pits a combined have-nots and have-only-a-littles against the struggling-to-keep-it-togethers.
Last week, Governor Pawlenty wrote state legislative leaders, throwing down yet another gauntlet with his usual pithy, condescending élan. “The intent of the offer was to identify the additional spending cuts in collaboration and agreement with the Legislature. However, if you prefer that we unilaterally identify additional reductions they would come from health and human services programs in the general fund. As noted in my 2008 supplemental budget recommendations, the use of surplus HCAF dollars was intended to maintain eligibility in subsidized health care programs…Your opposition to the use of the HCAF surplus leaves me no alternative but to revisit other options.”
In other words, Minnesota’s neediest citizens are simply another gubernatorial political bargaining chip and Pawlenty is quite willing to up the ante.
Who loses? The uninsured, Minnesota, smart public policy, and progressive values. Who wins? Minnesota’s wealthiest taxpayers eager to preserve a rich folks-friendly tax structure.
I’m not alone in my frustration. I’ve been hearing from readers, advocates, healthcare professionals and HCAF assistance recipients. Charitably stated, they’re frustrated as well.
Last Sunday, a fellow church congregant rose and addressed the HCAF surplus raid. She brought her professional social worker’s perspective to bear, outlining need and consequence. The need for affordable health insurance and healthcare is growing; the consequence of its absence is grim. It was a hard message to hear but one that bears repeating.
Yes, Minnesota must balance its budget, resolving the projected biennial deficit, but we can and must do so within a smart, sensible, progressive policy framework. It’s time for Governor Pawlenty to act in Minnesota’s best interests. It’s increasingly clear that when we need real state policy leadership, we get gubernatorial game playing.
Slashing affordable health care access and raiding the HCAF is bad public policy that undermines a strong Minnesota future. Beyond bad policy though, it’s flat out wrong.