Nurses, doctors, hospitals urge shift to medicaid

  • Article by: WARREN WOLFE
  • Star Tribune
  • May 11, 2010 - 10:49 AM

Leaders of the state's hospital, nurse and doctors' associations added their voices to a health care debate between Gov. Tim Pawlenty and DFL legislators Monday, urging the state to cover its poorest residents with the state-federal Medicaid health program rather than a slimmed-down state plan negotiated last month.

With a week to go before the Legislature is to adjourn, the groups urged enactment of a bill supported by DFL leaders and opposed by Pawlenty that would shift about 37,000 patients from General Assistance Medical Care (GAMC) to Medicaid, called Medical Assistance (MA) in Minnesota.

"It has now become clear that the new GAMC program will not be able to provide adequate, sustainable health care to the population it was designed to serve, and a shift to MA is needed," they said in a letter to the governor and legislators.

A revamped GAMC is scheduled to start June 1, but only four of 17 key hospitals have agreed to participate.

The four hospitals are scrambling to assemble "comprehensive care delivery systems" to deliver all levels of medical care instead of solely more expensive emergency room treatment.

"There's a better way, and that's to take advantage of the opportunity of covering these patients through Medicaid in all care settings," said Lawrence Massa, president of the Minnesota Hospital Association.

Medicaid will begin covering the affected patients in 2014, but the federal health overhaul signed by President Obama in March allows Minnesota and 10 other states to expand coverage early because they already offered that care out of their own budgets.

Pawlenty planned to eliminate GAMC this spring after removing its funding last year, and in March he vetoed a bill to continue it. He later struck a compromise with DFLers requiring hospitals to cover the GAMC population for a fixed sum of money, less than half the $400 million allocated last year, and argued that it would reform health care by forcing hospitals to invent efficient ways to treat patients.

However, the four Twin Cities hospitals that agreed to participate historically have cared for less than half of GAMC patients, adding pressure on outstate legislators to consider shifting them to Medicaid.

A House-Senate conference committee hoped to complete work late Monday on a health and human services bill that would include that shift, despite a veto threat from Pawlenty because the state must match the richer federal benefit.

"We're not trying to pick a fight with the governor," said Dr. Robert Meiches, CEO of the Minnesota Medical Association. "It's just that GAMC is clearly not going to work, and Medicaid will. We're hoping that wisdom prevails."

Warren Wolfe • 612-673-7253

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