MAO Legislative Update
Eric Dick, MAO Lobbyist
Legislative Session Kicks Off
The 2017 legislative staff kicked off with the wrap of a gavel in both the Minnesota State Senate and Minnesota House of Representatives at noon on January 3, 2017. Legislators, staff, lobbyists, and the public at large returned to a Capitol building open again for the first time in several years, as the three-year renovation project has been largely completed. The newly refurbished building is beautiful and much brighter, and it contains significantly more space for the public.
The elections of November 2016 brought a big change to the Capitol, as the Senate flipped from DFL to Republican control. The fall elections also saw the House remain in GOP control, and with a bigger margin. While the two legislative bodies are now in control, passing bills into law will require the signature of DFL Governor Mark Dayton.
It will be interesting to watch the tone in which the legislative leaders and Governor Dayton interact. Much of the summer and fall of 2016 saw on-again, off-again negotiations about scheduling a special session to address unfinished business from the ’16 session, notably relief for increased health care insurance premiums. Efforts to reach agreement failed, and the rhetoric became quite heated.
Given that there are more than 40 new legislators and new committee chairs, the session will start slowly as most committee meeting will feature briefings on issues from state agencies and advocates. In the next weeks legislative leaders will announce the deadlines by which legislation must pass certain waypoints to be considered viable. The deadlines – likely in March – serve to help winnow the volume of bills under serious consideration. The Minnesota Constitution requires that the session end no later than midnight on May 22, 2017.
Budget, Health Insurance Likely to Dominate Session
Leaders in the House and Senate, as well as Governor Dayton, have made relief for consumers facing steep increases in their health care insurance premiums a priority. Legislators have heard from constituents of enormous increases in the their premiums for 2017, and there is universal support for helping these individuals.
While few details have been announced, most proposals would offer a one-time rebate to those consumers who purchase health insurance products in the individual market and are not eligible for federal tax subsidies. Earlier proposals from House Republicans have used the Health Care Access Fund to fund the rebates, while others - Governor Dayton, notably - have insisted on using the state's reserve account or general fund dollars. Only about 5% of Minnesotans would qualify; the vast majority of Minnesotans receive their health coverage from either their employer or government payers (e.g. Medicare, Medical Assistance, MinnesotaCare). In addition to one-time, short term relief for 2017, legislators and the Governor have committed to passing more substantial reforms to address future cost increases.
The primary task in front of legislators in 2017 is the crafting of a biennial budget that funds all operations of state government. Minnesota, unlike the US Congress, budgets in two year increments. The state’s budget is in a strong position, with a budget surplus of more than $1 billion. Passing a budget is the one item that must be completed. Should the Legislature and Governor fail to reach agreement on a budget by summer, a government shutdown could occur.
Also likely to see significant attention by legislators are tax cut packages, as well as investments in transportation. Legislators had hoped to pass these measures in 2016, but agreement could not be reached. As such, these priorities remain at the top of many elected officials agendas.
Key Issues for the MAO to Watch
While it is always difficult to predict exactly which issues will garner attention at the Capitol, the MAO will be carefully monitoring action at the Legislature for a number of specific issues.
Thanks to a bipartisan agreement reached in 2011, the state’s provider tax is set for repeal on December 31, 2019. With the GOP in control of the Legislature, an extension of the tax is unlikely. The MAO will partner with other physician and provider groups to strongly oppose any effort to extend the provider tax.
The MAO will also continue the partnership with the Minnesota Medical Association and others to pass medication prior authorization reform. The “Fix PA Now” coalition, of which the MAO is a member, will continue to press for passage legislation to simplify medication PA and ensure patients get the medications they need in a timely manner. The bill passed all necessary committees in the Senate in both 2015 and 2016, but did not receive a hearing in the House of Representatives. Advocates for the bill have held multiple meetings with key legislators in the House in an effort to ensure hearings in 2017.
There have been some rumors that audiologists will be pursuing legislation in 2017, though the intent of any potential legislation remains unknown. The MAO will carefully watch for bills that would change or broaden the scope of practice for audiologists at the risk of patient safety.
Many New Names in Key Positions
The work of the legislature begins with the committee process, and with the change in partisan control of the Senate many legislators will be taking on new leadership roles. Chairing the Health and Human Services Finance and Policy committee is Sen. Michelle Benson (R – Ham Lake), while Sen. Jim Abeler (R – Anoka) will chair the Senate’s Human Services Reform Finance and Policy committee. Abeler, a chiropractor, held the House HHS Finance Division gavel during the 2011-2012 legislative session prior to his election to the Senate in 2016. Taking over as Senate Majority Leader is Sen. Paul Gazelka (R – Nisswa), an insurance agent, while Sen. Tom Bakk returns to lead the now-minority DFL Senate Caucus.
The House will see some leaders returning to their position. Rep. Matt Dean (R – Dellwood) retains the gavel of the House HHS Finance division. Rep. Dean’s spouse is Laura Dean, MD, an OB/GYN who practices in Stillwater. With the retirement of the previous chair, the HHS Policy committee will now be helmed by Rep. Joe Schomacker (R – Luverne). Rep. Kurt Daudt (R – Crown) returns as Speaker of the House, while the House DFLers have elected Rep. Melissa Hortman (DFL – Brooklyn Park) to lead their caucus.
Two Physicians Elected to Minnesota Senate
For the first time since 2002, there are not one, but two physicians serving in the Minnesota Legislature. Representing Mendota Heights, Inver Grove Heights, and South St. Paul, Sen. Matt Klein (DFL) is a hospitalist who practices at HCMC. Also elected in November was Sen. Scott Jenson, a Chaska Republican. Sen. Jensen is a family physician. Both were elected by wide margins to fill Senate seats left open by retirements of incumbent legislators.
The last physician to serve in the legislature was Rep. Dick Mulder, a Republican from Ivanhoe, who served from 1995 to 2002.
Physician’s Day at the Capitol Set for February 15
Make plans to join your physician colleagues for the annual Minnesota Medical Association’s Day at the Capitol set for February 15. This day of advocacy and fellowship is an important effort in advancing policies that help physicians and patients, and is a great opportunity for you to directly engage with your legislators on the issues facing organized medicine. Following presentation from key legislative leaders, individual meetings will be scheduled for you and your local colleagues with your Senator and Representative. With the extensive three year-long renovation of the Capitol largely finished, it’s a great time to visit the Capitol.
The “White Coats Day” at the Capitol is a key piece of the organized medicine’s advocacy strategy, and your participation is important to our efforts. Please make plans to join us for this fun and enjoyable day. More information and registration details are available here.