Is Pawlenty breaking a promise?

If there’s one thing in the current budget deficit that had Minnesota doctors — and subscribers to the MinnesotaCare plan — worried, it’s that Gov. Tim Pawlenty would raid the state’s health care access fund. The fund — which is money consisting of a tax paid by health care professionals, premiums by subscribers, and federal money earmarked for health care — was raided by the administration a few years ago to close a gap in the state budget. Thousands of Minnesotans, who paid premiums to MinnesotaCare, lost their health care.

So on January 6, when Pawlenty held a campaign fundraiser and was asked about the fund, the Minnesota Medical Association took notice of the answer, posting it on the organization’s Web site.

“We were pleased to hear him commit to not using the surplus to balance the budget,” said Dave Renner, MMA director of state and federal legislation, who attended the fund raiser as a representative of MEDPAC, the MMA’s political arm.

Today, however, Pawlenty said tapping the health care fund is part of his solution to the state’s budget deficit.

In December, the MMA President Dr. James J. Dehen sent Pawlenty a letter (see pdf) outlining why this would be a bad idea:

“As you know, physicians in this state have never believed that the “sick tax” was a fair or appropriate way to fund the HCAF. We believe that it is a selective tax that is regressive and falls more heavily on the sicker of our citizens. Yet, in recent years we have not actively worked to repeal this tax as long as it remained dedicated to addressing health care access. Transferring money from the HCAF to pay the General Fund’s shortfall is inappropriate.”

Pawlenty says using the health care fund will be used for other health care “for the disadvantaged, and says nobody will be removed from government health programs. But, he conceded, an expansion of MinnesotaCare will be canceled. At the same time, the governor proposed a reduction in the state sales tax.

Pawlenty, who had flipped his position on health care after his narrow victory for re-election in 2006, signaled his a return to his earlier attempts to cut health care in a speech before a Burnsville business group three weeks after allegedly making his January “hands-off the health care access fund” promise.

Dave Renner, the MMA lobbyist, told me this afternoon the fund has become the “health care slush fund.” He said he fears “a disproportionate amount of cuts (will) come out of health and human services area. At a time we’re trying to reform health care and expand coverage to the uninsured, this may result in cutting those programs.”