Groups race to find replacement medical care for poor

Nurses protest GAMC cuts
Members of the Minnesota Nurses Association march up the state Capitol steps during a protest on Oct. 12, 2009 of cuts to General Assistance Medical Care.
MPR Photo/Tim Pugmire

Frederick Toran, 46, spends most of his time in the dark. The curtains in his apartment are tucked into the corners of windows so no light gets through.

Toran, a Minneapolis resident, has glaucoma.

"It doesn't hurt but you can feel it," Toran said. "It like you're eyes are constantly irritated by light"

Toran can't hold down a job. He doesn't know how he'd pay for doctor visits and all the expensive drugs he needs without General Assistance Medical Care, which provides coverage for approximately 33,000 adults without dependents who don't qualify for other health care assistance.

"I don't think I can," he said. "If I can't afford the medicine what'll happen in the next two months? I'll be blind. I'll be totally blind."

Gov. Tim Pawlenty cut the program earlier this year using unallotment, saying he needed to balance the state's budget. Toran hopes the groups racing to find a replacement for the program will move fast enough to save his eyesight. But those groups thought they had until March to find a solution. It turns out they probably don't.

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"Right now, we're seeing that more and more people are needing health coverage under the program so the money is going faster than we thought it would," said Michael Scandrett, director of the Minnesota Safety Net Coalition, a group is made up of dozens of hospitals, clinics, and other health providers. "It looks now like it could be some time in February when people could lose their coverage"

The one-month difference may not sound like much, but in this case it's huge. The Legislature doesn't open its session until February, leaving advocates with little time to pass a bill creating a new health program to cover GAMC patients.

Scandrett's group is in the early stages of crafting legislation they hope will earn bipartisan support and the governor's signature.

"This would normally be something you'd do over two years or more," he said. "We basically have to do that work in the next three to four months. We'll have some time for debate, but we don't have time for endless debate. We need to come to a decision by the end of December so we have a bill that will get passed."

"The money is going faster than we thought it would."

Scandrett said if a replacement program isn't passed, the state will see more people in poverty, more homeless, more people in jail, and more people in hospitals who can't pay; and those costs will be passed on to everyone else.

There are varieties of possible solutions, but as yet nothing concrete enough for advocates to talk about.

State Sen. Linda Berglin, chair of the Senate finance committee's health and human services division, said she's never tried to come up with legislation and pass it this fast.

Berglin said support for proposed legislation must be in place by Feb. 4, the day the legislature convenes.

"The legislature needs to have something ready when we're back in session," Berglin said. "We need to have been able to talk to our colleagues about it before then."

Lawmakers will still have to waive normal procedures so they can pass a replacement by the unknown date the money left in the GAMC program runs out.

But Berglin said any new program must cost less than GAMC does now if there's any hope of it earning the governor's signature. Coming up with a cheaper alternative may be more difficult than passing fast track legislation.

Hennepin County Medical Center's chief of Medicine, Scott Davies, points out that GAMC is already cost efficient, and general healthcare only gets so cheap.

Davies said it's not like dental care, where people who can't afford teeth implants get dentures.

"The trouble is, in medicine is there's no equivalent for dentures," he said. "If you have a heart attack, you have to have the same treatment. If you have leukemia, if you have breast cancer, you have to have the same treatment. There's not a denture option for this thing."

The center faces a $43 million shortfall next year without GAMC funding. Davies and other advocates agree any new program that provides coverage for GAMC patients would be better than none at all.