State health coverage still available to many

Minnesota legislative leaders have expressed outrage regarding Governor Pawlenty’s cuts to General Assistance Medical Care. These folks tell us our poorest Minnesotans will no longer have access to medical care.

Yet new information suggests that nearly all of these residents qualify for a different state-funded health program at less than $50 a year. And one of our final House floor debates shows partisan politics brought us to this point.

Some background: GAMC is a state health program designed to help providers pay for Minnesotans who use the health care system frequently and do not have health insurance. This $380 million program has no premiums, no co-pays, no caps on hospitalization and no residency requirements.

Minnesota is the only state that offers a program like this. It affects roughly 33,000 people, meaning it costs the taxpayers more than $11,500 to insure every participant each year.

According to the Department of Human Services, 90 percent of GAMC enrollees are eligible for MinnesotaCare, which requires a $4 monthly premium. Others may qualify for Medical Assistance, may be referred for admission or commitment to State Operated Services, or are incarcerated.

But the GAMC cuts will really be bad news for the 600 non-Minnesotans currently utilizing the program, as MinnesotaCare has a 180-day state residency requirement.

Further, because GAMC is a completely state funded program, federal funds that pay for Medicaid, or help pay for MinnesotaCare, are lost when those patients are enrolled in GAMC rather than a program with federal match.

At a cost of $1,000 per member per month, it does not provide anywhere near the care or reimbursement all Minnesotans should reasonably expect. It is a bad plan for the patients, a bad plan for providers, and it costs more than private health insurance, making it a terrible plan for taxpayers.

Unfortunately, the governor’s line-item veto of the program made this an extremely partisan issue. Instead of looking for compromise, the GAMC debate on the House floor became nothing more than political grandstanding.

House Republicans attempted to provide a fix to GAMC by paying hospitals more fairly for the care they provide to this patient population. We attempted to amend a health bill to prioritize $100 million to a reimbursement pool, which would help provide better care for the actual cost.

Rather than put the issue up for a vote, the author tabled his own bill, hurting those patients and providers who will now have to shift those costs to those privately paying for their insurance.

Instead, Democrats tried to override the governor’s veto of GAMC with no reforms. In other words, continue this inefficient spending without identifying how to pay for it in the face of a $6.4 billion deficit.

The governor’s veto was ultimately upheld.

Legislative leaders had one final chance to address the GAMC challenge on the last day of session with their proposed tax increase bill. Yet despite the $1 billion in tax hikes, this proposal did not offer a single penny of relief to the poor and downtrodden affected by the line-item veto.

As a final reminder, emergency care is going to be provided for patients with or without GAMC, and cuts from the line item veto won’t happen until after lawmakers receive two new budget forecasts - meaning the issue can be readily addressed in 2010.

In order for us to move forward in a positive direction, we need to have logical debates and solution-oriented conversations. We need to find better ways to pay for these health programs and reach our poorest citizens by addressing any underlying chronic conditions before they show up at the emergency room.

To be clear, I absolutely support the state continuing to provide health insurance for our poorest residents. But the current system is bogged down with bureaucracy, waste, fraud and abuse, and these problems need to be addressed now - not later.

We need to attack these issues with the right mindset. We can’t instantly pick sides and use them as a political football. It will take compromise and working together from the start. Let’s use our tax dollars in the most efficient way possible so that we can take care of those who really need the help.

The bottom line is that while GAMC is beneficial to those using it, it’s also an inefficient program in dire need of an overhaul.

Sadly, it took Pawlenty’s veto pen to bring this situation to light.

Rep. Tim Kelly, R-Red Wing, can be reached at (651) 380-4345 or rep.tim.kelly@house.mn.

Tags: opinion, columns, kelly