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Facing a lobbying blitz from the Mayo Clinic and other hospitals, Minnesota Democrats said Monday night they only had the votes to pass a watered-down nurse staffing and safety bill.
The Keeping Nurses at the Bedside Act that would have given nurses a say in staffing levels was replaced with the Nurse and Patient Safety Act, which aims to reduce workplace violence without creating committees to oversee staffing levels.
It was the final bill approved by the Legislature before the midnight adjournment deadline and passed with bipartisan support in both the House and Senate.
It also was a bit of a sour note for DFLers at the end of a legislative session that was historic by political and financial measures.
Democratic-Farmer-Labor Party members, with a narrow majority in both chambers, and Gov. Tim Walz enacted a progressive agenda with billions in new spending and taxes. Republicans had little recourse to stop Democratic plans after losing their narrow edge in the Senate during the November 2022 election, which also saw Walz reelected to a second term.
The roughly $72 billion two-year budget Democrats passed before the required adjournment Monday includes unprecedented spending increases for education, housing, transportation and social programs. They’re using the state’s $17.5 billion budget surplus to pay for it.
Most of the increased spending is ongoing, and Democrats have approved roughly $3 billion worth of tax increases in the next budget and more to come to cover the new costs.
Both chambers adjourned around 10 pm., well ahead of the midnight deadline, and are due to reconvene Feb. 12, 2024.
“The work we’ve done over the last five months will make a generational impact on our state — it will lower costs, improve lives, and cut child poverty,” Walz said in a statement.
There’s also been plenty of policy changes enacted in the last five months, including protecting abortion rights, legalizing adult-use cannabis, providing driver’s licenses regardless of immigration status, automatic voter registration, paid family and medical leave, and expanded access to government-run health care.
“It was a fantastic, very productive session,” said House Speaker Rep. Melissa Hortman, DFL-Brooklyn Park.
“In the end, we passed some historic and transformative legislation,” said Senate Majority Leader Sen. Kari Dziedzic, DFL-Minneapolis. “While we may not have always agreed, I think the product became better.”
There wasn’t much bipartisanship, at least not on consequential issues. Republicans rarely voted in favor of DFL budget or policy bills, and it took until the last weekend of session before the two sides could agree on an infrastructure bill that needed a supermajority in order to borrow money to pay for it.
“At the end of the day this has been the most partisan session, not just in my memory, but in the history of this state,” said Senate Minority Leader Mark Johnson, R-East Grand Forks, who said lawmakers missed a lot of chances to compromise. “What is our legacy going to be if we don’t work together.”
In fact, many of the most controversial bills — taxes, health care, transportation, marijuana and more were approved in the final days of the session mostly along party lines. Other things, like legalized sports betting and the new regulations for nurses staffing, just didn’t make it.
With about five hours to go before adjournment Monday night, Democratic lawmakers acknowledged they didn’t have the votes in the Senate to approve nurse staffing requirements. They had hoped to mandate new hospital committees that would include nurses and other caregivers to set staffing levels.
“The corporate power in health care is real. We touched it and it pushed back,” Sen. Erin Murphy, DFL-St. Paul, who was the primary Senate author of the nurse staffing bill, said of the Mayo Clinic’s demand it be exempt from the staffing bill. If it wasn’t, the Rochester-based hospital group threatened to pull $4 billion in future investments from the state.
The carve-out angered lawmakers and other hospital groups and eventually killed support for the staffing provisions. The new bill includes better workplace violence protections, student loan forgiveness and a study of why so many nurses are leaving their jobs.
Hospital leaders and health groups had argued giving nurses more of a say over staffing levels would be costly and eliminate the flexibility they say they need to operate and care for patients’ changing needs.
“We deeply appreciate the legislators’ thoughtful consideration and their willingness to listen to our concerns regarding legislation impacting patient care,” the Minnesota Hospital Association said in a statement. “We acknowledge that there is much work to be done, and we remain devoted to ensuring that the best possible care is accessible to all Minnesotans.”
Nurses had pushed for the staffing committees say they were needed because cost cutting has led to chronic understaffing and danger for hospital staff and patients.
“The true answer to safe staffing is adequate staffing,” said Mary C. Turner, president of the Minnesota Nurses Association, which pushed for the committees. Turner was visibly upset the staffing pieces were pulled from the bill, but still noted other safety protections were among the “strongest in the nation.”
After approving a $3 billion tax deal and $1 billion in new spending for for transportation over the weekend, health care dominated much of the debate on the final day. The House and Senate approved a health and human services budget with $1.6 billion in new spending.
It includes authorizing the first steps to implement a public health insurance option in the state, likely through the modification or elimination of income limits for MinnesotaCare, the state health insurance for the working poor.
The health and human services bill also includes a broad increases in spending for social programs including child care assistance. It also allows immigrants in the U.S. without proper authorization to apply for medical assistance.
Lawmakers also advanced a bill that will give Attorney General Keith Ellison more oversight powers over medical mergers and whether they are in the public interest. The legislation comes after Fairview Health Services announced plans to merge with South Dakota’s Sanford Health.
Hortman said there’s a chance the Legislature might need to come back later this year to consider the Fairview-Sanford merger, but lawmakers are waiting for a detailed plan from the University of Minnesota about how its teaching hospital will be impacted by the deal.
The Legislature also approved a bipartisan set of bills worth about $2.6 billion to repair state infrastructure and sent $300 million in emergency aid to nursing homes.
