After spending the better part of this past weekend watching the legislative sausage being made (and spending a few too many late nights at capitol), I have a few observations to share.
First, as much as its convenient to grouse about politicians, the fact is they have very hard jobs that they do in a very honorable way. I have the luxury of focusing on health care issues, but the average legislator, in addition to knowing about health care also needs to know agriculture policy, tax policy, economic development issues…and the list goes on.
Second, the challenges facing our state are enormous. Not only do we have a budget deficit this year, we’ll have a huge one waiting for the new incoming governor next year. And the range of perspectives among lawmakers (and the public) on how to best proceed moving forward are really quite vast.
On the one hand, Minnesotans are justly proud of the investments we’ve made over the years in education, health care, the environment and other areas. Many legislators and policymakers feel passionately that we’ve backslid in some of those investments the past few years, and would like to, at a minimum, stop what they consider to be additional slippage. On the other hand, other policymakers feel just as passionately that our investments have to match up with our means, and that the state spending should be restrained. In a time of deficit, these two perspectives can be very hard to reconcile, and the process of trying to come to agreement can be messy. And without good information, sometimes decisions can be made that have unintended impacts.
This is where advocacy can play an important role. We’ve been working this session to help to educate lawmakers about the importance of Medical Assistance (MA) to pediatric hospitals. Let’s face it: legislators face tough choices this year in Minnesota—without new revenue, they have to do the best they can within existing resources to make the best policy possible. That can mean reducing MA and other payments to health care providers like Children’s.
Unfortunately, across the board cuts to MA payment rates to hospitals do not have the same across the board impact. Certain providers (like Children’s) see much higher numbers of MA enrollees than other providers, and so MA cuts hit them harder and they bear a disproportionate impact. Helping lawmakers understand this disproportionality can help them think about ways to remedy or mitigate it.
While the cold reality is that sometimes, especially in tight budgetary times, legislators may not be able to fully address the concerns of high Medicaid providers, our goal is to continually help them to understand the impact of the decisions they make on child health so that they can make the best public policy possible for Minnesota.
Scott Leitz is the director of child health policy and advocacy at Children’s. Read more about him here.