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Health Care Spending Becomes Sticking Point In Budget Talks

ST. PAUL, Minn. (AP) — Legislative leaders on Wednesday began diving into the specifics of their disagreements for a new budget, highlighted by major disputes over potential cuts to health care spending.

Democratic Gov. Mark Dayton and top Republicans who control the Legislature have been trading private offers in meetings this week ahead of a Monday night deadline to finish their work. But the talks have mostly focused on big-picture numbers as they aim to narrow a $1 billion gap, Dayton has proposed a $46 billion budget, while Republicans' package clocks in at nearly $45 billion.

That work gets more difficult as the two sides hash out which individual programs and services will get more or less money. Nowhere is that clearer than in health care, a mammoth slice of the state budget that supports public health insurance programs for 1 million low-income residents, nursing homes and more. For every dollar in government spending, more than a quarter goes to those services.

Republicans are aiming to cut at least $400 million in health care spending, largely through efficiencies like audits to weed out ineligible enrollees from the state's public programs. Senate Majority Leader Paul Gazelka said it's an area they need to tackle given growing costs.

"We want to lower that spending curve a little bit," he said after more than two hours of private meetings with the governor.

But Dayton pushed back, expressing concern that the GOP's estimated savings are overblown.

"They make a number of assumptions that there are savings to be gained, a fairly simplistic approach to making those changes," Dayton said. "We believe that most of what they've proposed are going to result in real cuts to real programs and real people."

It's an integral part of the budget negotiations. As Republicans seek at least $875 million in tax breaks, a smaller cut to health care spending means a smaller tax bill.

And there are more still more specifics to tackle. The two sides haven't yet dived into a contentious debate over public school spending, though Dayton has offered to drop his request for $175 million to expand a new preschool program down to $100 million. The Republican budget would zero out that program, shifting the funding to a general early learning account that schools could use to pay for preschool offerings.

The two sides were expected to continue meeting through Wednesday evening.

As they chipped away at a budget deal, the Legislature was finally poised for a major breakthrough on Real ID. The House was expected to pass a bill that would upgrade the state's driver's licenses to meet higher federal standards, just before a January 2018 deadline when those IDs will be required to board domestic flights.

The Senate planned to take up the bill later Wednesday, and Dayton indicated he would sign it.

(© Copyright 2017 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)

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