What happens when the indigent lose medical care?

Commissioner Peter McLaughlin said he's outraged at the governor for cutting off the county's poor from state health care assistance.

By KEVIN DUCHSCHERE, Star Tribune

Last update: September 15, 2009 - 11:25 PM

Hennepin County officials are making plans to help the 26,000 indigent residents they estimate will lose medical care next spring with the elimination of the state's General Assistance Medical Care (GAMC) program.

Commissioner Peter McLaughlin called Gov. Tim Pawlenty's veto of the GAMC program last spring "unconscionable" and predicted a grim scenario where the mentally ill will be stranded on the streets without their medications, leading to more police and emergency service calls.

GAMC, he said, "was a fairly low-cost way of helping those individuals to live a better life and to manage what can evolve into a public safety problem."

Dan Engstrom, the county's assistant administrator for the Human Services and Public Health Department, said it was likely that more people will wind up in the county hospital's emergency room or mental health center, and that the county's crisis phone lines will get busier.

In the next few weeks, Engstrom said, a plan will go to the board to mitigate the effects of GAMC's elimination. One strategy is to make sure that GAMC recipients who qualify are enrolled in the federal Medicaid program, which could provide similar coverage, or the state's Minnesota Care or the county's Assured Care program, which provide partial coverage.

Engstrom said that Hennepin County Medical Center also is looking at establishing a medical home program, similar to that used for people with HIV, to help low-income people without access to health care.

The County Board discussed the situation Tuesday during a presentation by members of the Adult Mental Health Advisory Council, which advises the board on mental health issues. Typically the council each year gives the board a list of unmet needs, but this year it's simply asking that existing services be preserved, co-chairwoman Judy Soderberg said.

About 75 percent of the people who use the GAMC program have "chronic and persistent mental illness -- the most needy of the needy," Soderberg said.

Commissioner Gail Dorfman said she heard last week of a low-income person on GAMC who is weaning himself now from his medication to better cope in April, when the program ends. "We're forcing people to make very untenable choices as a result of the cut," she said.

McLaughlin, a DFLer, reserved his strongest language for the Republican Pawlenty, whom he likened to "the resurrection of John C. Calhoun" for suggesting last week that the state might stay out of federal health care reform by invoking the Tenth Amendment.

Calhoun, a Southern senator in the years before the Civil War, argued that states had the right under the Constitution to nullify federal laws and even secede from the Union.

"To be saying that Minnesota is not going to participate in national health care reform after unalloting for 26,000 people here in our own county -- I just think is unconscionable, and I don't think I've ever been angrier with this governor than I am right now with those statements," McLaughlin said.

Kevin Duchschere • 612-673-4455

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