The legislature, in an effort to balance the budget, will most likely be cutting or eliminating General Assistance (GA) and General Assistance Medical Care (GAMC). This would greatly hurt people with disabilities, particularly people with mental illness.
General Assistance is a state-funded program that provides a cash grant for living expenses for adults who are not eligible for Social Security Insurance (SSI) or Social Security Disability Insurance (SSDI)—though they may have applied or are appealing—but who are unemployable, have an illness or disability (such as mental illness or chemical dependency) or are residents of group residential housing. Around 11,000 people are on GA and another 13,000 people receive aid by living in group residential housing.
GAMC is a state-funded heath care program which covers low-income people who would qualify for Medical Assistance except that they don’t meet one of the categories for eligibility such as being disabled, a child, elderly, or so on. Approximately 35,000 people are on GAMC.
Currently, over 30 percent of the people who receive GA/GAMC have a mental illness and another 25 percent are chemically dependent.
They use GAMC and GA until they qualify for Social Security and Medical Assistance; sometimes their disability isn’t severe enough for them to qualify for SSI or SSDI. People with mental illness who live in what is called an Institution for Mental Disease, such as a regional treatment center or a Rule 36 facility (residential treatment facility), cannot be on Medical Assistance, nor does MA pay for their treatment. These individuals clearly need GAMC to pay for their health care, prescriptions and treatment.
Some legislators have discussed transferring people from GAMC to MinnesotaCare. However, MinnesotaCare is not the same as GAMC in that it is not an entitlement program, it has premiums and it has co-payments. The average payment per enrollee is $215 per month, which is very high when your income is limited. Additionally, and perhaps most importantly, the mental health benefits are different, with MinnesotaCare covering fewer services and less of the costs for inpatient psychiatric care.
GA/GAMC have been portrayed as programs that help unemployed single men—there has been virtually no discussion that they are used by people with mental illness. NAMI-MN is very concerned that GAMC will be cut, leaving many people with mental illness with no health insurance coverage.
Sue Abderholden is Executive Director of the National Alliance for the Mentally Ill of Minnesota.