Regions Hospital puts a face on proposed cutbacks

It's been almost a month since the legislative session ended in disarray, leaving the prospect of major cuts to the state's health care budget by Gov. Tim Pawlenty.

But hospitals are not letting it go.

On Thursday, Regions Hospital in St. Paul launched an unusually public campaign to make sure legislators understand the full impact of cutting one program for the poor, General Assistance Medical Care, or GAMC.

The program, which covers 34,000 Minnesotans earning less than $7,800 a year, will end after July 2010 as part of Pawlenty's plan to close the state's historic deficit without raising taxes.

For Regions alone, that will mean a loss of $36.3 million in reimbursement. GAMC now accounts for about five percent of the hospital's revenue. Regions, owned by HealthPartners, is the state's second-biggest safety-net hospital, after Hennepin County Medical Center.

"Numbers that large make it difficult to understand the day-to-day impact of the loss of GAMC," Regions Hospital chief executive Brock Nelson wrote in a letter to the state's 201 lawmakers Thursday. "To help show the real impact, Regions is sharing our weekly census of GAMC patients and the cost associated with treating our patients."

For the week starting May 18, the day the Legislature adjourned, Regions had 237 GAMC patient visits, including 80 in the emergency room and 28 for in-patient care. Two had same-day surgery, while 127 came in for outpatient services such as radiology, chemotherapy, chemical dependency, or diagnostic visits. The bill for that week: $348,630.

To put a human face to the numbers, the letter highlighted a 23-year-old auto mechanic with no health insurance. After he came into the emergency room with a headache, doctors diagnosed a brain tumor, which despite two surgeries, left him blind in the right eye. He can no longer work as a mechanic, but he doesn't qualify for state medical programs because he is not completely blind and is not considered disabled. His bill so far: $150,000.

The hospital will continue to send these weekly reports to legislators, with a goal of getting GAMC reinstated in next year's session, said Geoff Bartsh, director of government relations for Regions.

Pawlenty spokesman Brian McClung said Minnesota has among the most generous public health care programs in the country.

"The welfare, health care and social services portion of the state budget has been growing at an unsustainable rate of more than 20 percent," McClung said. "In this time of economic challenge, many programs, including health care for single adults without children, have to be reined in."

During the legislative session, lawmakers voted to continue funding GAMC, but Pawlenty vetoed that along with tax increases to pay for it. Later this month, the governor is expected to make further health care cuts in a process known as unallotment.

Children's Hospitals and Clinics of Minnesota, which treats a large number of children on Medicaid, is particularly worried.

"We aren't privy to the governor's plans," chief executive Dr. Alan Goldbloom said in an e-mail Wednesday, "but his Medicaid budget proposal before the Legislature would have taken a devastating $36 million from our budget for the 2010-11 biennium, including a $6.6 immediate unallotment last December."

A cut of that magnitude, Goldbloom said, "would be terribly unfair to sick children, who unfortunately don't have much political clout."