One Month Reprieve: GAMC still vulnerable

General Assistance Medical Care (GAMC), which provides health care coverage for Minnesota’s poorest residents, will end April 1, not March […]

General Assistance Medical Care (GAMC), which provides health care coverage for Minnesota’s poorest residents, will end April 1, not March 1 as previously planned. The Minnesota Department of Human Services announced the delay in late January.

Gov. Tim Pawlenty and Minnesota Human Services Commissioner, Cal Ludeman announced that state funding is available for the GAMC program until April 1 and eligible enrollees can continue on the program through March 31.

“This extra month of GAMC coverage is possible because program costs and new enrollment were lower than projected,”  Pawlenty said. “The extension means that people can remain on GAMC through March and then will automatically be transitioned to MinnesotaCare.” Now that the change will take place a month later, Ludeman said the transition process for approximately 28,000 enrollees now on GAMC will be the same as announced in November. No action will be required on the part of these enrollees, who will receive a notice from DHS about the transition. New applicants otherwise eligible for GAMC can apply for MinnesotaCare at their local county office.

Health care reform was a theme at the annual Martin Luther King Jr. Day march in St. Paul Jan. 18, 2010.

“Transitioning people on GAMC to MinnesotaCare maintains health care coverage for enrollees,” said Ludeman. “We continue to work with counties, providers, community agencies and faith-based organizations to help enrollees through the transition.”  DHS has held a number of briefings and community meetings to share information about the process.

The prospect of even a brief reprieve hasn’t slowed efforts by state lawmakers, health care professionals and advocates for GAMC clients to find an interim replacement for GAMC. Supporters of the program, including many disability rights advocates, planned to rally when the 2010 legislative session convened Feb. 4.

Holding a rally at the start of session is unusual but it underscores the intense efforts underway to replace GAMC.  Pawlenty eliminated the program in spring 2009, indicating that recipients could be moved to other state-run programs. But some state lawmakers say that would bankrupt other health care programs and put more people at risk.

On Jan. 12 Sen. Linda Berglin, DFL-Minneapolis, unveiled her ideas for a 16-month replacement for GAMC. She said the hope is to have something in place before GAMC ends.

Sixteen months from now the new federal health care reform Medicaid laws could cover GAMC patients, Berglin told the committee. But that is only if Congress succeeds in passing its pending health-care legislation.

If federal health care reform is not adopted, state lawmakers said any interim program would have to remain in place.

Berglin admitted to a Senate committee that her solution is imperfect. It also wouldn’t serve everyone currently on GAMC. But it would provide assistance for many who would otherwise be left out.

Dozens of people crammed into the hearing room, with many submitting testimony. Several testimonies came from persons with disabilities who rely on GAMC to meet basic medical needs. They described an array of debilitating medical issues and indicated that without GAMC, they would not be able to maintain housing or even part-time employment.  Many had high level college degrees, enjoyed successful career and owned their own homes before being debilitated by health problems and losing their jobs.

Some said that at one time they held jobs with employerpaid insurance and lost their jobs in the economic downturns.

People on GAMC earn less than $8,000 a year and often face mental illness, chemical dependency and homelessness. Speaker after speaker said that without GAMC they would have no health care coverage at all.

Trixy Weddig of Duluth told the committee that GAMC has made it possible for her to have a home and do volunteer work.  But without GAMC, she questions how she would pay more costly MinnesotaCare premiums, as well as rent and living expenses, on General Assistance. “I don’t know what I would do,” she said.

Health care workers, advocates for the homeless, elected officials and representatives of hospitals also spoke in support of the program, although some raised concerns about how cash-strapped hospitals and counties would help cover the costs. So did Minneapolis Police Chief Tim Dolan, who said that GAMC provides critical help for people his police officers encounter every day.

The proposal has support from a coalition of affected groups including hospitals, counties, insurers and advocates for the poor. Berglin would pay for her proposal by cutting state payments to hospitals and increasing a Medicare surcharge tax paid by hospitals and health plans. She would also require counties to come up with 10 percent of the costs.

But while some speakers support GAMC, cash strapped county officials and hospital representatives continue to question how they can pay to help with an interim solution.

Legislators hope to meld proposals from Berglin and other state lawmakers into one bill, with the goal of having a replacement for GAMC in place early in the session.

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