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Pawlenty's cruelest cut: Health care

Thousands of Minnesotans would lose their coverage. Let's meet just a few.

By ABIGAIL STODDARD

Last update: May 4, 2009 - 7:33 AM

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Turn your head and cough it up.

That's the message to poor Minnesotans from Gov. Tim Pawlenty, who wants to solve a budget shortfall with the help of some of our neediest citizens.

With just weeks left in the legislative session, the governor and DFL leaders are deadlocked over spending cuts and revenue-raising sources that would balance the budget. A health care cut for the poor would be the unkindest cut of all.

As many as 84,000 previously covered Minnesotans will become ineligible for MinnesotaCare, a critical state-funded health insurance program, under Pawlenty's plan.

The 84,000 is the sum of two major cuts. The first would eliminate eligibility for adults without children by 2010 -- 55,000 Minnesotans. The second would eliminate eligibility for adults with children by 2011 -- 29,000 Minnesotans.

Where would the 84,000 go for primary care? Where would they get antibiotics to stave off acute illness? How would they maintain their treatments for hypertension, diabetes and high cholesterol?

The metro area has a handful of clinics that offer care on a sliding scale, but as unemployment rises, along with health-care insurance premiums and deductibles, even these clinics are becoming hard to afford.

There are a few clinics that provide health care at lower cost or free of charge, but they vary greatly in accessibility. Due to the budget freezes of the ailing economy, workers at these clinics scramble to keep up with rising demand.

The 84,000 come from all walks of life. Consider Antonia Adan, a full-time pharmacy technician at a Walgreens in south Minneapolis. She has the option of insurance from Walgreens but cannot afford to pay premiums for her and her 3-year-old daughter Belen, so Belen has MinnesotaCare. Adan pulls a picture of her daughter from her wallet. Belen is grinning ear-to-ear, with pinchable cheeks and dark hair in high pigtails.

"I filled out Belen's application in November, and I just got her card in the mail. I can't wait to get her in for a check-up," Adan says.

I found Adan at the Phillips Neighborhood Clinic, a free clinic in Minneapolis. She was translating for a friend who was being seen for high blood pressure.

"I only get insurance if I work full time, and I only work full time if my hours don't get cut. It happened last September, and I'm afraid it's going to happen again soon," she says.

If Adan loses her Walgreens health insurance, she'll be without any coverage in 2011, under Pawlenty's plan. Belen will have to hope her mother doesn't break an ankle or fall bedridden with an illness.

Adan's story is told on the faces of many patients at the Phillips Clinic -- a wide-ranging census that includes a 27-year-old Minneapolis Community and Technical College student and an out-of-work 35-year-old construction worker from Burnsville.

But the student-run clinic -- sponsored by the University of Minnesota and open two nights a week -- is not immune to the failing economy. While health care is free, the sources of medication are disappearing. A local Snyders filled prescriptions for clinic patients, for example, but the pharmacy closed in February, leaving clinic volunteers still searching for other options.

Akhmiri Sekhr-Ra, who works at the nearby Phillips Powderhorn Cultural Wellness Center, helps community members try to find culturally competent primary care, but many of the people deal with the stress of illness by isolating themselves.

"Loss of community, loss of culture, that is what really makes you sick," said Sekhr-Ra, adding that many patients head to the emergency room before coming to her door -- a truly inefficient and expensive outcome.

An alternative is applying for MinnesotaCare. It offers help and hope, though clearly not to everyone. Enrollment is denied to many people living with adult relatives, or to those whose employers offer health insurance the state deems affordable, or to those who have incomes or assets on the borderline of eligibility.

But this program will suffer if Pawlenty's chosen course of treatment becomes law. So will the 84,000.

They need a second opinion.

Abigail Stoddard is a student in the University of Minnesota's College of Pharmacy.

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