On health care, Pawlenty stops short of his election-year plan

The governor's proposal would expand eligibility for state-subsidized insurance programs. It would also pump more money into the mental health system and veterans' homes, as well as medical education and research. There's also money in his budget for buying antiviral medications and medical supplies to prepare for pandemic flu.

But nearly half of the governor's new health care spending priorities go to incentive programs. Some pay would providers who improve the care they give. Others are designed to help providers make the switch to electronic medical records.

Pawlenty says his budget focuses largely on reforming the health care system.

"If we don't get some reasonable control over it, it will consume most of the rest of the state's budget within 15 years," he said. "It is outstripping every other category of the budget by a long-shot and there are never ending demands for more and more and more in this area and it's going to have to be reconciled."

Department of Human Services Commissioner Cal Ludeman says the governor's incentive programs will help providers to do a better job providing quality care and they will encourage clients in state-subsidized programs to pay more attention to their health. Ludeman says that will save the state money in the long run.

"It's kind of a little bit counterintuitive," Ludeman said. "Do you need incentives to take care of your health? Not necessarily. Most people do a pretty good job. But on the margins we need to incent people to do the right thing."

The governor does propose spending approximately $31 million to expand subsidized health insurance for the poor, mainly through MinnesotaCare. But his plan stops short of covering all Minnesota kids, a goal he proposed last fall shortly after winning re-election.

That disappoints Children's Defense Fund Minnesota President Jim Koppel. He says there are currently 70,000 kids in the state without health insurance coverage and the governor's proposal covers only about 13,000 of them. Koppel says the plan doesn't even make up for the 20,000 thousand kids who were cut from the program during the state's budget difficulties in 2003.

"It's what happens when we move from campaign season to the Legislature convening and too many people getting trapped inside the Capitol and not hearing from constituents and remembering the promises they made the previous year," he said.

DFL legislative leaders say they're also disappointed that the governor's plan doesn't cover all kids. But House Speaker Margaret Kelliher says lawmakers aren't giving up on the idea.

"We will continue to push very hard on covering all Minnesota kids with health care, having a plan in place by the end of the session that will accomplish that," she said.

Overall, though, Kelliher and some other legislative leaders say they do share many of the same health care goals as the governor. In particular, they agree that the state should do what it can to reign in health care costs and make sure all citizens are getting a good value for their health care dollars. They say they are looking forward to working with the governor to figure out the best way to reform the system and to pay for it.