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MNACEP Legislative Activities- O.J. Doyle, Lobbyist
Important Links Advocacy Report-
O.J. Doyle, Legislative Consultant, Jan '10
Minnesota government is facing its greatest financial crisis since the Great Depression. Current predictions indicate that the state coffers are facing a shortage for the current budget of about $1.5 billion. Governor Pawlenty continues to oppose any tax increases, preferring to handle the shortfall with accounting shifts and budget cuts. Education and healthcare programs represent the two largest pools of money, with the latter taking the brunt of the reductions. In addition, there appears as if there is going to be a $5 billion deficit in the next biennium. Our work will be cut out for us as we seek to protect the revenue stream for emergency medicine.
General Assistance Medical Care (GAMC) funding was eliminated through line-item vetoes and a process called “unallotment” where the Governor can stop spending in certain budget areas. One of our big priorities will be to pursue at least partial replacement of the lost revenue. This revenue source hits hospital emergency departments particularly hard.
We have a number of other legislative initiatives which MN ACEP is currently developing. The first bill should be fairly routine. It involves moving the CALS Program from the EMS Regulatory Board to the Department of Health. Over a decade ago, MN ACEP successfully lobbied for a state subsidy for the popular CALS Program, originally securing $108,000 per year which eventually was increased to $408,000. Of course, we will be working to protect these funds. Our bill to move the program to MDH is appropriate because all other trauma-related programs are housed there and it may be easier to protect funding if it is moved to a larger agency.
There will be another effort to eliminate the No Fault Automobile Insurance program. For the past 4 or 5 years, the insurance industry has pursued legislation to eliminate No Fault. The policy issues are not a concern for emergency physicians, but the loss of the provision which mandates a minimum medical benefit of $20,000 is a major concern. As most of our members know, this source of reimbursement is critical for the financial health of hospital EDs. It reimburses at nearly 100% of billed charges and payment is made in a timely manner. We have successfully fended off repeal efforts in the past and will continue to fight for retention of this medical benefit in some form.
Last session, we testified against legislation to license ‘birthing centers’. These facilities are intended to serve the needs of pregnant women for uncomplicated births. The concept isn’t the issue, but the way the bill was worded offered virtually not protection for patients in the case of a medical emergency. Further, there was no consideration for liability for emergency departments and physicians which may receive patients in crisis. We will continue to work with the authors to include protections for both patients and emergency medical providers.
Last, we will continue to pursue additional funding for trauma services, perhaps through the creation of an uncompensated care fund. There are a number of potential funding sources that we have been discussing with interested legislators. Most proposals involve dedicating a percentage of increases in: Taxes on alcohol; fines generated through the so-called “Photo Cop” traffic enforcement system; or, surcharges on motor vehicle registration. As of this writing, no decisions have been made, but we will continue to explore options.
2010 will probably be one of the most contentious legislative sessions in memory. Defending and enhancing statutes that benefit or support emergency medicine will be a top priority.
