Democrats offer plan to save poor's health plan
Democrats want to use federal money, force counties to pay more and divert other funds to restore health-care coverage to Minnesota's poor.
A program known as General Assistance Medical Care is due to expire March 1 after Gov. Tim Pawlenty eliminated its funding to help balance the state budget. A DFL plan released at a Thursday State Capitol news conference would keep providing health care for the 70,000 adults earning less than $7,800 annually who now receive mostly free care via GAMC.
Pawlenty would put most of them on MinnesotaCare, a state-run insurance program that requires that premiums be paid. GAMC does not cost recipients.
Rep Tom Huntley, DFL-Duluth, said the plan restores $292 million that Pawlenty cut, but admitted it remains "a work in progress."
Key to the plan is a scheme, used elsewhere in state government, to raise a surcharge on hospitals and other health-care providers by $130 million in order to get a like amount of federal money. The increased surcharge then would be repaid to the providers.
More than $100 million in payments to hospitals and other providers would be cut, with no repayments planned, Huntley said.
Counties would be forced to pay $20 million more for poor people's health care, as well as paying for all health care jail inmates receive. A variety of other existing funds also would be used for the plan, which would last through June 30, 2011. Huntley and other Democratic health leaders say a new federal health-care law should kick in then, providing coverage to poor Minnesotans who otherwise could not afford it.
The plan also would require people now receiving GAMC help to use federal programs if they are eligible.
The DFL plan needs work, but is a start, Sen. Mary Olson, DFL-Bemidji, said Thursday.
"The decision to cut GAMC doesn't just affect the patients who are covered by GAMC," which at any given time may number 35,000 of the poorest and sickest in the state, she said. On average, the yearly total is closer to 70,000.
"It's also an additional cost to the rest of us and the potential consequences ... really impacts the rest of ... the whole system, causing insurance rates to go up and potentially causing certain facilities to either have to close or have to cut back on other services that the rest of us rely on too," Olson said.
There's a lot of potential fallout from Pawlenty's unilateral decision, Olson said in a telephone interview. Olson, a member of the Senate Health and Human Services Budget Division chaired by Sen. Linda Berglin, DFL-Minneapolis, attended a portion of the Capitol news conference.
"I'm really glad we continued to work, not only internally but also with the federal government, to find some way to deal with this issue," Olson said. "The idea of putting everyone on MinnesotaCare doesn't work. ... The governor's proposal to do that would really just lower the line that we're throwing people off of health care for a very short period of time."
A person enrolled in GAMC for five months would only be automatically enrolled in the MinnesotaCare program for another month and be cut again, she said. "At the same time, by rolling those people over, because their health care costs tend to be really high, we bankrupt the MinnesotaCare system for everyone else in a very short period of time."
That Pawlenty will work with the Legislature on a plan "is a step in the right direction," Olson said. Berglin is calling a committee meeting next week to lay out the DFL plan in more detail.
Minneapolis construction worker Al Phenow, 60, said that without GAMC, he could not receive treatment for arthritis, primarily shoulder and hip replacements. Nor could he replace an aging heart pacemaker, he added.
Even with state-provided health care, he said that he only has $20 a week to live on after he buys food. If Pawlenty's GAMC elimination occurs, he added, no money would be available.
Huntley, chairman of the House Health Fnance Committee, said Democrats' goal is to pass a health bill the first week of the 2010 legislative session, which begins Feb. 4.
The top Republican on the committee, Rep. Matt Dean of Dellwood, said that will happen only if DFLers work with Republican Pawlenty to reach a compromise.
Pawlenty, speaking on a conference call from Chile on Thursday, said he has doubts about the DFL plan, especially increasing the surcharge just to get federal money. He and Dean said federal officials are taking a dim look at such schemes, although Huntley said he thinks it will fly.
If federal officials do not back the plan, Dean said, hospitals will suffer.
"It does put the onus back onto hospitals to prop up this program," Dean said.
Dean plans to introduce a GOP plan at a Monday committee hearing. He said it, too, would cover everyone now on GAMC, but would do it for less than the DFL plan.
Figures Democrats prepared indicate their proposal would reduce payments to hospitals about half that of Pawlenty's plan to eliminate GAMC. Examples:
- St. Mary's Medical Center, Duluth, $5 million loss under Pawlenty plan, $1.3 million under DFL plan.
- Mahnomen Health Center, $22,000 under Pawlenty plan, $11,000 under DFL plan.
- North Country Health Services, Bemidji, $2.6 million under Pawlenty plan, $654,000 under DFL plan.
- St. Joseph's Area Health Services, Park Rapids, $483,500 under Pawlenty plan, $120,900 under DFL plan.
Don Davis works for Forum Communications Co. in its St. Paul Bureau. Brad Swenson works for the Bemidji Pioneer, which is owned by Forum Communications Co.