Needy GAMC patients to get coverage under MinnesotaCare, state decides: State makes shift to offset Pawlenty's cost-cutting measure
Jason Hoppin
Nov 07, 2009 (Pioneer Press - McClatchy-Tribune Information Services via COMTEX) --

Aiming to ensure health care coverage for thousands of often homeless and chronically ill Minnesotans, the state said Thursday that it would shift the group into a program aimed at Minnesota's working poor.

But Democrats reacted swiftly to the move, arguing that it may not be a long-term solution for about 35,000 patients currently on General Assistance Medical Care, a $381 million program for those who make less than $7,800 annually that Republican Gov. Tim Pawlenty axed earlier this year in a cost-cutting move.

"This one-time action provides the greatest benefit to enrollees and maintains their health care coverage," Department of Human Services Commissioner Cal Ludeman said.

The GAMC program is expected to end around March 1, 2010. The program serves many people, often homeless and suffering from mental illness or chemical dependency, who show up at hospitals for care. Hospitals have warned that losing the program could have devastating effects on their balance sheets.

The loss of the program is especially troublesome to urban hospitals such as Hennepin County Medical Center in Minneapolis and Regions Hospital in St. Paul, which together provide a quarter of the charity care in the state. During the last week, for example, Regions saw 73 GAMC patients in the emergency room, treated 131 on an outpatient basis, saw 40 people with serious mental illness and performed emergency, same-day surgery on eight.

Sen. Linda Berglin, DFL-Minneapolis, who chairs a

key Minnesota Senate health care committee, wondered whether the move is legal and said it likely would accelerate the depletion of MinnesotaCare funding.

That fund was slated to run out in late 2012 or 2013, and Berglin said the shift means it will now be exhausted in April 2011.

"I think it's going to bankrupt the MinnesotaCare fund, and it's going to put all the people on MinnesotaCare at risk," Berglin said.

Rep. Erin Murphy, DFL-St. Paul, said the consequences of bankruptcy include freezing new enrollment. After that, single adults -- which make up many of the GAMC recipients -- would be removed from the program.

Ludeman said people enrolled in a health care plan through GAMC would stay on that plan in MinnesotaCare. Local county bridge programs would pick up their premiums until they renew their eligibility in MinnesotaCare, after which patients will be responsible for paying the premium.

Rep. Matt Dean, R-Dellwood, praised the move.

"The most important thing, it's a patient-centered solution, not a political solution," Dean said. "I think the governor recognized that these folks needed to maintain their care."

MinnesotaCare serves thousands of Minnesotans who can't afford health insurance and don't receive it through their employers.

It differs from GAMC in important respects. It charges a nominal premium, and recipients must apply, sometimes waiting months before coverage kicks in. MinnesotaCare also caps annual payments to hospitals at $10,000, which many GAMC patients, who show up at hospitals emergency rooms in dire shape, exceed.

Democrats questioned whether GAMC recipients could maintain their MinnesotaCare coverage, since many don't have an address or have trouble filling out forms and returning them on time.

Berglin and Murphy said the Legislature is drawing up a proposal to replace GAMC and would likely introduce it as soon as the 2010 session gets under way in February.

Jason Hoppin can be reached at 651-228-5445.

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