Rep. Erin Murphy. Representing St. Paul District 64A

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Health care reform on a local, state and federal level is vital. Across our district, our community and our state health care costs continue to rise and more individuals are lacking insurance. I ask that you be a part of health care reform. Sign up below to tell me your health care story - why are you interested in reform. You can chose to make your story private (between my office and your home) or public (the only information that will be shared if public will be your first name, city and your story). These stories will help us work on legislation that can truly make a difference for our state! Click HERE to share your story.

~Erin Murphy~
State Representative



Health Care Reform: Opportunities and Challenges for Minnesota
Testimony of Representative Erin Murphy
July 20, 2009

Good morning. My name is Erin Murphy. I am a registered nurse and a State Representative from district 64 A in St. Paul. Thank you for holding this hearing in Minnesota and for the invitation to testify today.

We must reform health care in America. In the middle of the debate, it may seem impossible to traverse the sharp policy and political questions before us but we must. The status quo is unsustainable and unacceptable. While individuals expect and often receive excellent care and cure, American lacks a coherent system of care delivery and payment. The result is a highly fragmented system delivering fragmented episodes of care.

Too little attention is paid to the ultimate goal of health.
Americans are paying a high price for underwhelming individual and population outcomes. We are in that rare moment of opportunity to change course. We must change course.

I am delighted to have the opportunity to share with you a perspective from Minnesota. As you well know, Minnesota is an innovator and has long the lead nation’s efforts in health policy, value and reform. Along with our upper Midwestern neighbors, we are a high value low cost state.

We must reform the nation’s health care delivery and payment systems to set the foundation for continued innovation and demonstration in Minnesota. We must embed what we know is working in Minnesota and the upper Midwest to deliver high value for lower relative cost across the Country. Finally, we must ensure that every American is covered so they get the right care at the right time for a good price.


For many years we have focused on coverage as a primary solution. That so many Americans lack coverage for needed care is wrong, plain and simple. That health care is so expensive that necessary treatment of disease is financially out of reach for so many is wrong, plain and simple. Relying on the emergency room as the primary point of care for the uninsured is wrong, plain and simple.

Getting everyone into coverage is imperative, morally and financially. An individual mandate and guaranteed issue of coverage, regardless of preexisting condition will yield more coverage with shared responsibility between individuals and insurers. A public option will give Americans a choice between private coverage and a publicly backed coverage that is portable.

A public option provides opportunity to further drive delivery and payment reforms. If the public option cements the status quo in terms of payment and delivery, it will compound the problems with which we are already struggling. But if the public option serves to propel reforms, it enhances efforts to deliver better care for a better price.

Minnesota has worked over two decades to assure coverage employing Medicaid, Minnesota Care and General Assistance Medical Care. The Governor’s line item veto of General Assistance Medical Care has undermined 20 years of effort in Minnesota. I ask that Congress consider this as it contemplates any state maintenance of effort. Maintenance of effort is an important means to balance state and federal efforts. Allowing state flexibility in policy reform while maintaining access provides state policymakers with the tools necessary for continued innovation.

Delivery Reform

Our fragmented delivery system is providing fragmented care and we are paying a high price. Care for those with chronic conditions such as diabetes and heart disease accounts for upwards of 60 percent of all Minnesota’s health care costs. This stark fact has served as a focal point in Minnesota. We must pursue policies to prevent the onset of disease and invested in care that will keep those with chronic conditions healthy and out of the hospital

Payment Reform

Current payment is weighted to specialists and procedures and away from interventions to maintain health. For example, a surgeon is paid more for the amputation of a diseased diabetic limb than is a primary care provider for disease management preventing the loss of the limb.

Medicare sets the standard in payment. I urge the inclusion of large scale payment reform such as accountable care organizations or a total cost of care model Without similar, or even more aggressive payment reforms in Medicare, our health care system’s growth will be unsustainable. Medicare’s participation is essential in order to create a critical mass of payers in the new system.

Short of large scale change, I urge state flexibility in Medicare payment. A Minnesota or upper Midwest demonstration in payment will permit us to demonstrate the Congress and the nation the means to deliver high quality care for a better price.

Achieving significant health care reform in this country has for decades been a uniquely challenging and complex issue. The grind between dogged political frames has proved insurmountable for policy makers. Entwined state and federal policy and funding, limits state policy reform efforts and calls for federal action. The urgency of growing costs and shrinking access compels our action. 40 years ago, America put a man on the moon, a seemingly unachievable goal. We did that- and we will do this too. We must.

Thank you for your courage and hard work. I stand with you in your efforts to enact federal reform while promoting and protecting the value the care delivered in Minnesota.


New Laws Effective July 1st

Dear Mighty Citizens,

On Wednesday, July 1st, several new laws passed during the 2009 legislative session went into effect. I want to provide you with some of the highlights these new laws.

Please note, the Governor’s unallotment plans will cut $2.7 billion from the budget and will affect many of the budget laws passed by the Legislature. I have also provided some new information about the Governor’s unallotment and their prospective impact, which began on July 1st.

We learned at a recent Legislative Advisory Commission hearing, from non-partisan State Economist Tom Stinson, the Governor’s proposed unallotment will result in 3,000to 5,000 lost Minnesota jobs. Stinson also said the balanced budget passed by the Legislature and vetoed by the Governor would only have resulted in about 1,000 lost jobs.

It’s disappointing the Governor has pursued a go-it-alone unallotment strategy that will cost our state 3 to 5 times the amount of lost jobs as the balanced budget we sent him and he vetoed.

For more information on the new laws passed during the 2009 session, visit:

For information on the Governor’s unallotment plans, visit:

Please contact me with your ideas, input and questions. Erin

New Laws Effective July 1, 2009


Focused on job retention and core services in an agricultural funding bill that reduced the departments base budget to help solve the budget deficit.


Strengthened protection for domestic assault victims with new laws. A prosecutor must now provide victims of domestic abuse and harassment with information on civil protection orders. The law also increases from 12 to 24 hours the time an officer may arrest a person whom the officer has probable cause to believe committed domestic abuse.

Energy and Environment

Modified successful electronic waste law to strengthen manufactures incentives for proper disposal of waste.
Increased transparency in environmental agencies and departments by requiring them to display their budgets on a Web site.
Directed about $400 million in Legacy funds to projects critical to environmental and cultural heritage. These funds come from the dedicated funding constitutional amendment passed by the voters last election.


Passed new law to direct the Minnesota Gambling Control Board to conduct a 12 month review of licensed charitable gambling organizations in order to provide transparency where gambling funds are directed.


Boosted accountability and reduced spending in state government budget bill, including a cut to the State Legislature. State Government received largest percentage cut of any budget area this session.
*Governor’s unallotments will affect state government laws passed by the Legislature. See section on unallotment for more details.

Health Care

Made changes to meet federal Children’s Health Insurance Program Reauthorization Act that will result in additional $20 million in federal dollars cover kids. New law is expected to provide health care to 20,000 previously uninsured Minnesota children.
Cut health care and human services spending by about $500 million, but preserved funding for nursing homes, health care access, and minimized job losses at hospitals and clinics.
*Governor’s line-item veto of General Assistance Medical Care (GAMC) and unallotments will affect health care laws passed by the Legislature. See section on unallotment for more details.

Higher Education

Capped tuition increases at University of Minnesota at $300 per year and at 3% for MnSCU campuses.
Passed several provisions in higher education funding bill to make college more affordable, such as expanding state grant program, work study, and child care assistance grants and creating middle income scholarship.
*Governor’s unallotments will impact higher education laws passed by the Legislature. See section on unallotment for more details.

Jobs and Economic Development

Passed jobs and economic development budget bill that reduces funding to help solve the budget deficit, while preserving programs critical to getting unemployed Minnesotans back to work.

K-12 Education

Protected K-12 schools from cuts with education funding bill that held base funding flat.
Reduced unfunded state mandates to schools with new laws to provide funding flexibility in these tough times.
*Governor’s unallotment plans will impact education laws passed by the State Legislature. See section on unallotment for more details.


Passed “Brandon’s Law” which expands state’s missing children law to include adults who go missing under dangerous circumstances. The law is named after Brandon Swanson, who went missing after his car was stuck in a ditch in Southwest Minnesota.
New law requires child restraint for young riders. Youth in motor vehicles must be in child passenger restraint system until their eight birthday or until they reach 4 foot 9 inches tall.


Preserved veterans’ services from budget cuts with passage of targeted budget bill.

Unallotment Information

We learned more about the Governor’s unallotment plans this week at our second Legislative Advisory Commission meeting. Perhaps most important, we learned the Governor’s unallotment will result in 3,000 to 5,000 job losses. The areas that will be most affected by job losses are private sector health care related jobs, K-12 education jobs, and local and state government-related jobs such as police and fire. Non-partisan State Economist Tom Stinson said the balanced budget passed by the Legislature would have resulted in 1,000 lost jobs. In other words, the Governor’s unallotment will result in 3 to 5 times the amount of lost jobs as passed by the Legislature.

Here are further details on the impact of the Governor’s unallotment plans and information we learned at the Legislative Advisory Commission hearing.

K-12 Education

$1.7 billion shift or delayed payment to K-12 schools. Schools may have to borrow money in the short term, increase levies, cut their budgets, or some combination of the three. State Economist Tom Stinson estimates 300 to 600 lost jobs.

Higher Education

$100 million cut from the University of Minnesota and the MnSCU system on top of the $60 million in cuts that were signed into law this session. Tuition is likely to increase and over 1,000 jobs are likely to be lost.

Property Taxes

$300 million cut from local government aid to cities and counties, which will increase property taxes significantly and result in over 1,000 lost jobs. St. Paul will be cut about $16 million and Ramsey County will be cut about $10 million. The Governor also cut $50 million from the renters’ credit program, which will result in an average tax increase of $129 to $441 for 304,900 Minnesota renters. The average tax increase for the 84,700 seniors and disabled Minnesotans who use the renters’ credit will be $144.

Health Care, Hospitals, Services for the Disabled

$236 million was cut to various health care programs, most of which serve seniors, the disabled, and mentally ill. According to State Economist Tom Stinson, these cuts will result in over 500 private sector job losses. We also learned the state of Minnesota will lose $72 million in federal matching dollars as a result of these cuts.

State Government

$33 million in across the board cuts to state agency operating budgets with exemptions for public safety, military and veterans affairs, corrections, and State Operated Services within the Department of Human Services