Pawlenty will sign health bill for poor

He'll approve the House-passed health bill after earlier cutting funds.

With just a week to spare before thousands of low-income Minnesotans were scheduled to lose state-sponsored health coverage, the House voted overwhelmingly Wednesday to approve a compromise measure that would extend the state's General Assistance Medical Care program (GAMC).

The 121-12 vote ended weeks of political battle that brought the program to the brink of death, after a veto by Gov. Tim Pawlenty, and produced intense lobbying by the state's hospitals, Catholic bishops and advocates for the poor.

The measure, which passed the Senate last week, allows GAMC to survive in a pared-down form and continue serving about 30,000 of the state's sickest and poorest residents.

The measure "is not what I might have wished,'' said a tearful Erin Murphy, a St. Paul DFLer, nurse, and one architect of the compromise. But, she added, the vote showed that "people who live in the shadow of society deserve care.''

Pawlenty, who helped negotiate the compromise with DFL and Republican leaders two weeks ago, will sign the bill, said Brian McClung, the governor's deputy chief of staff. He said the measure will "help rein in the costs of this program while continue to provide coverage to low-income Minnesotans.''

The GAMC program was set to expire April 1, after Pawlenty vetoed its funding last year as part of his effort to balance the state budget and also vetoed legislation aimed at its restoration last month.

Even as the compromise bill was moving toward passage, legislators were exploring whether the revamped GAMC may be a doorway to provide improved coverage for low-income Minnesotans by reaping an early benefit from the federal health legislation approved Sunday by Congress. A House committee was scheduled Wednesday night to explore what the state might gain with legislation to move state-financed GAMC enrollees into Medicaid, called Medical Assistance in Minnesota. The federal changes allow states to begin covering childless adults and would cover at least 50 percent of the cost.

During Wednesday afternoon's floor debate, several legislators, Republicans and DFLers praised the bill as a sound compromise, but others said it badly shortchanges the state's hospitals and clinics, which provide much of the care for a population with difficult combinations of disease, poverty and mental illness.

The change gives hospitals overall responsibility to care for GAMC recipients, though at rates far below the hospitals' costs. Funding was slashed from $400 million this year to $132 million.

"Now we are left with an unworkable bill and we all know it," said Rep. Paul Thissen, a Minneapolis DFLer and candidate for governor. "Starvation is not a path to meaningful and lasting reform.''

All 12 votes against the bill came from DFLers, mostly representing outstate population centers where hospitals could suffer most under the new structure.

The Senate voted Wednesday evening to approve some technical changes in the House version and will send the bill to Pawlenty on Friday.

"Will it work? I pray it does," said Rep. Jim Abeler, R-Anoka. "If we just do things the old way, [the cuts mean] we can only do less. But the nucleus of this bill is to redesign everything we do."

Rachel E. Stassen-Berger contributed to this report. wolfe@startribune.com • 612-673-7253 baird.helgeson@startribune.com • 651-222-1288

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