ST. PAUL, Minn. (AP) — Republicans are bringing Democrats back to the mat to save a public health care program for tens of thousands of low-income Minnesota residents as they seek to build up $2 billion in tax relief through cuts and cost savings.

GOP lawmaker’s efforts to abolish MinnesotaCare by 2016 has triggered echoes of 2005, when a GOP-led attempt to reduce enrollment — and Democrats’ refusal — played a major factor in a government shutdown. Expected to be unveiled later this week, abolishing MinnesotaCare will likely be the centerpiece of Republicans’ budget bill for health and human services as they try to push those 90,000-some enrollees to buy private coverage through the health insurance exchange.

Democrats have made it clear they’re still committed to saving the subsidized program.

“To eliminate health care for 90,000 low-income, low- or middle-income working families, with a $2 billion surplus is just cruel,” said Gov. Mark Dayton, who pleaded with the federal government to spare MinnesotaCare as President Barack Obama’s health care law took effect. “We all know what the consequence of that is going to be.”

MinnesotaCare was created in 1992 to fill a gap for Minnesota residents who don’t qualify for Medical Assistance but can’t afford coverage through the private market.

Rep. Matt Dean, the Dellwood Republican putting together a health and human services budget bill, said it’s time to rein in the state’s health care costs. Though the account that funds MinnesotaCare currently projects a surplus through 2017, its main source of revenue, a tax on health care providers, is set to expire by 2020.

State budget officials’ estimate of how much Dean’s proposal would cut from spending is still pending. It’s further clouded by an unspecified state subsidy Dean’s bill would offer — in addition to the federal subsidies offered on health insurance exchanges — to cushion the sticker shock of buying private coverage.

“It addresses the fact that it’s very hard for low- income Minnesotans to purchase private health insurance,” Dean said.

But that extra help isn’t enough to satisfy opponents of the bill like TakeAction Minnesota, a coalition of unions and advocacy groups. They doubt the subsidies will come close to bringing costs in line with the $50-or-less monthly premiums on MinnesotaCare.

“This would end the coverage that they have now and replace it with a not yet very defined and questionable maze of credits,” said Sarah Greenfield, TakeAction’s health care program manager.

Ruth Fen, a Minneapolis freelance art director, wound up on MinnesotaCare after months of lapsing coverage and thousands of dollars in out of pocket costs — all while undergoing tests and then treatment for cancer. Now she pays just $50 a month, and her insurance has covered everything she needs to keep her lymphoma in check.

“I have no idea what I’d do” if MinnesotaCare was cut, the 56-year-old said.

TakeAction is mobilizing against the possible cut, telling every MinnesotaCare member it can find to contact legislators with a plea to spare the program. The group has keyed on rural Minnesota, where GOP lawmakers won many districts to storm back to the House majority and many counties have high MinnesotaCare enrollment rates.

Former Republican Rep. Fran Bradley remembers the backlash from when he was in Dean’s spot a decade ago, pushing to tighten eligibility requirements to cut program costs. He saw signs with his face plastered on it, “accusing me of throwing kids on the street.”

Democrats succeeded in keeping MinnesotaCare intact in 2005 as lawmakers ended a nine-day shutdown. But Bradley said lawmakers are in a better environment this year to end what he calls a “duplicative” program: The health care overhaul expanded access to Medicaid and the looming expiration of the provider tax creates a need to act soon, he said.

Still, it won’t be a quiet fight, he acknowledged.

“I know there will be a lot of noise,” he said.

(© Copyright 2015 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)

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