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MNAAP Newsletter

Threats to Children’s Health Care Abound

 

Eric Dick headshot

By Eric Dick, MNAAP Lobbyist 

The program that provides care to millions of America’s infants, children, and adolescents is under siege, and the threats come from multiple directions.  From Washington, D.C. to St. Paul to the boardrooms of major insurers, coverage for pediatric patients is under constant risk.

As of this writing in mid-July, legislation under consideration in the U.S. Congress remains a moving target. Solid intelligence about what is being included or left out of proposals is rare, and reports suggest that many different versions of these bills remain in play.

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Legislative Update: 6,000 Bills and Counting

“When they come back, the real work begins,” said Gov. Mark Dayton as legislators began the Easter/Passover break on April 10.
Despite being almost three quarters complete (as of this writing in mid-April), the most difficult and consequential pieces of the 2017 legislative session yet remain. While almost 6,000 bills have been introduced in both houses of the legislature this session, the year’s most important task – crafting a two year biennial budget – remains on legislators’ “to do” list.
Both the House and Senate have passed budgets that fund state government, including the Health and Human Service (HHS) programs. As is always the case with budget bills that span more than 700 pages, there are pieces that the MNAAP can strongly support, and there are elements that we forcefully oppose.

Most directly, the Senate HHS funding proposals cuts physician reimbursement for services provided under MinnesotaCare and Medical Assistance by 2.3% in 2017 and by 3% in 2019. The House takes a slightly different approach, counting on new client eligibility verification tools and efforts to reduce hospital readmissions to save state resources. Should these mechanisms not create the savings the authors intend, reimbursement to physicians and other providers would be cut by up to $204 million. These cuts, on top of Minnesota’s already anemic payment rates, represent a real threat to continued access to care for Minnesota’s most needy children and families.

There are bright spots in the budget bills. Both the House and Senate include funding for several MNAAP priorities.

Eric Dick headshotChildren’s mental health receives significant attention, with funding for school-linked mental health grants, text-based suicide prevention programming, and support for first episode psychosis training.

Minnesota’s yawning racial and economic health disparities also receive some attention with funding included for nurse home visiting programs for prenatal and postpartum follow-up for at-risk parents, another MNAAP priority.

The House and Senate both fund the Safe Harbor program, an effort to prevent child sex trafficking while supporting victims.
Foster families also receive support via several programs that aim to assist foster children who are not adopted.

When session began, there were real concerns that the MNAAP would be forced to play defense to preserve hard-fought wins on a number of issues, as well as preventing dangerous proposals from becoming law. There are legislators at the Capitol who seek to roll back the newborn screening program, repeal a minor’s ability to receive health care in certain limited instances without parental consent, and make Minnesota’s already-weak immunization law even weaker. And while harmful bills regarding some of these issues were introduced, I’m happy to report that none of these proposals gained traction this session.

The end of session is now in sight, as the Minnesota Constitution mandates that the session end no later than midnight on May 22. If you haven’t already contacted your elected officials to share your perspective on these important issues, now is the time to do so.

Legislators do want to hear from you, and your voice as a pediatrician is amongst the most credible and powerful.

Legislative Session Begins Amid Many Unknowns

Eric Dick headshotBy Eric Dick, MNAAP Lobbyist

There’s an old yarn that states that elections have consequences. That’s especially true when the results are so surprising and dramatic, as they were in 2016. Donald Trump swept into the White House and, with his strong coattails in Greater Minnesota, the Senate Republicans surprised many by gaining control of the Minnesota Senate. Minnesotans have once again chosen divided government, with the GOP now holding both the House and the Senate, while DFLer Mark Dayton remains governor.

There are tremendous unknowns facing health care and children’s health – both here in Minnesota and Washington, DC. How will the Congressional Republicans seek to repeal the ACA? Will majorities in Congress seek to turn Medicaid into a block grant program? What might that mean for kids and their health here in Minnesota? Closer to home, can agreement between Governor Dayton and the GOP Legislature be reached to avoid a government shutdown once summer arrives? How will pressures from increasing health care costs impact access to care for young patients? What’s the fate of MNsure and MinnesotaCare? And will new majorities in the legislature seek to change laws governing newborn screening, vaccines, or minor consent? Simply put, it’s too early to tell on all of these questions.

The work that will dominate the legislative session here in Minnesota will be assembling a biennial budget, having received the Governor’s budget proposal in January. Legislators will craft their own budget in response and – if things work as designed – the two sides will negotiate a final budget sometime in May.

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A Prescription to Vote

Eric Dick headshotBy Eric Dick, MNAAP Lobbyist

Political attack ads are omnipresent on TV and radio, our mail is filled with glossy political mailers, and yard signs dot neighborhoods across the state. While the presidential campaign is dominating much of the chatter among the political class and media, here in Minnesota all 201 legislative seats are on the ballot. Control of the House and Senate – and thus control of the legislative agenda in 2017 – is at stake.

Now is the time of year that candidates are appearing at your doorstep asking for your vote, participating in debates and forums at your local library, or shaking hands at the high school football game on Friday night. There are few better times to put questions to those candidates who are asking for your vote. Below are good questions to consider as candidates appear before you.

• How will you work to support health care access for all children?
• How will you put children and child health care at the top of your agenda?
• Which of key health disparities among Minnesota’s children would be a priority for you?
• Can I count on you to support efforts to invest in children’s health and well-being?

The challenges facing Minnesota’s children are real. One in five children in America live in poverty; they live in homes with food insecurity. All too many children and teens are the victims of violence, and community resources for the treatment of mental illness are woefully lacking. Minnesota’s youngest citizens face enormous racial and economic disparities in health care and education.
And while Minnesota is by many measures is the healthiest states in the nation, we have one of the weakest immunization laws in the country. We can do better by our kids.

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Legislative Update


Eric Dick headshot

By Eric, Dick, MNAAP Lobbyist

The 2016 legislative session began with optimism for action on key items yet largely fizzed in the last minutes of session. With a large surplus awaiting legislators when the session began in March, elected officials hoped to pursue a broad agenda including significant new investments in the state’s transportation system, support for new capital projects via a substantial bonding bill, and both new spending on state priorities and tax relief. But as the days ticked down to the mandated adjournment date of May 23 it became increasingly clear that agreement on pieces necessary to bring the session to a successful, orderly close were out of reach. Left incomplete at the end of session were a tax relief bill, new transportation spending, and a bonding bill. As of this writing in late July, negotiations about a possible special session to complete work on some or all of these issues were rekindled, but a date has not yet been set. As the summer begins to turn to fall, legislators’ thoughts will be increasingly focused upon their re-election efforts.

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