After weeks of legislative drama involving a veto, a failed override, a lawsuit and a last-minute deal, the Minnesota Legislature on Wednesday approved a compromise plan to maintain state health coverage for more than 30,000 vulnerable adults.
The bill preserving the General Assistance Medical Care program is headed to a supportive Gov. Tim Pawlenty after clearing the House on a 121-12 vote and a final 50-12 Senate vote. The program had been scheduled to run out of money on April 1.
Top Democrats and the Republican governor struck a deal earlier this month to extend the program just hours before officials planned to start switching the patients to a less comprehensive state plan. The compromise slashes spending while putting hospitals in charge of coordinating care for patients who include the homeless, mentally ill, drug addicts and veterans.
"Even though we don't have a lot of money, we're still going to make sure you get the care that you need," said Democratic Rep. Erin Murphy of St. Paul, one of the key negotiators.
General Assistance Medical Care covers more than 30,000 people each month, most of them living on less than $8 a day. Pawlenty withdrew funding for the program unilaterally last year to help erase a deficit.
Under the compromise, General Assistance Medical Care will focus on paying safety-net hospitals to coordinate care and prescriptions for patients, with the goal of aggressively managing their conditions to avoid hospitalization and other costly services when possible. The new program will start in June and the current program is extended until then.
Most GOP lawmakers united behind the compromise, saying it showed state leaders could cut costs while still caring for the poorest residents in Minnesota. All House Republicans voted for the bill on Wednesday.
"When we are faced with incredibly challenging issues, this body can work, this process can work for the people that our programs serve and for the people that pay the bills," said Rep. Paul Kohls, R-Victoria.
All the no votes in the House came from Democrats, mostly from areas outside the Twin Cities where hospitals are expected to lose big on the revamped program.
Rep. Paul Thissen of Minneapolis, one of 11 Democrats running for governor, was among the critics. He said his colleagues caved in to Pawlenty's veto threats and settled for too little money to achieve the changes their bill envisioned.
"This bill is not the best we can do. This bill is not even better than nothing," Thissen said.
The vote came as state leaders grasped for details of the federal health care overhaul, which promises new dollars for public health care programs but also requires the state to put up at least a half-billion dollars in matching money from mid-2011 through 2014. Minnesota faces a $1 billion deficit through the middle of next year and a bigger projected shortfall after that.
Pawlenty opposes the federal health care overhaul.
Before the votes, he met privately with leading legislators to talk about federal funding for the General Assistance Medical Care patients and other low-income adults. The meeting was inconclusive. The two sides disagree about the exact cost to the state.