Lawmakers breezed through a mammoth North Dakota Human Services budget that gives raises to nursing home workers and higher reimbursements to providers for Medicaid services.

The bill calling total spending of more than $2 billion passed 88-4 in the House and 45-1 in the Senate. A few objections were raised by lawmakers who wanted more money for children's health insurance.

"We are taking care of the most medically fragile," said Rep. Chet Pollert, R-Carrington, head of the bill's negotiating committee.

The bill sets aside $18 million to give $1 an hour raises to workers in long-term care facilities around the state. Many of the rural nursing homes are having trouble finding and keeping workers.

"It's not just the wage thing," said Sen. Tim Mathern, D-Fargo. "If a nursing home is reducing its beds because it can't find employees, it will be gone within three or four years."

The bill also covers a $400,000 debt for a Rolla hospital for lab work and X-rays that were not covered by Medicaid, a medical assistance program for seniors and the poor. Lawmakers said the money should keep the Presentation Medical Center from closing.

"If we don't take care of that problem, what will happen is that hospital will not make it," Pollert said. That would increase Medicaid caseloads in Rugby and Devils Lake, he said.

Twenty-seven of 34 hospitals are losing money in North Dakota, Mathern said.

The bill would increase payments to Medicaid providers, to try to ease the burden on health care facilities. It aims to pay up to 100 percent of costs to hospitals, chiropractors and ambulances, and up to 75 percent of the cost to doctors.

The budget also raises the amount of money that Medicaid clients can spend on living expenses, including food and shelter.

Some lawmakers, mostly Democrats, said the bill should have raised child health insurance coverage for low-income parents. Supporters said families whose net incomes were up to 200 percent of the federal poverty level should be allowed to join the program, as was suggested in Gov. John Hoeven's budget.

The bill covers people up to 160 percent of poverty. Legislators said raising the percentage to 200 percent would subsidize coverage for some families that could afford to buy their own.

"I came here to support the governor's budget on 200 percent of poverty (on children's health)," said Sen. Tracy Potter, D-Bismarck. "I'm disappointed it's going to be less than that."

The bill does include $300,000 to promote the program.

Carol Olson, Human Services executive director, said her department is still digesting the numbers, but overall she is happy with the final package.

"This is a very big and very complex and complicated budget," Olson said. "We've had fewer questions or fewer concerns on our appropriations bill than what we've had in the past."

The bill is HB1012.