In the end, the patient didn't die. But she's not looking well, either.

Last week the Legislature compromised on General Assistance Medical Care (GAMC), a program that helps the poorest and sickest among us, cutting its budget from $400 million to $132 million, perhaps just enough to make it look like we still care.

Meanwhile, the message to strapped clinics and hospitals across the state was clear: Poor people are your responsibility.

Gov. Tim Pawlenty vetoed GAMC last year to help balance the state budget, but relented after an onslaught by the institutional forces of the medical community. If you are disenfranchised and voiceless, it's always nice to have some doctors and lawyers on your side -- you know, people with political juice.

Brian McClung, Pawlenty's spokesman, told me that no one will be cut out of health care, and that in fact they'll get better care for less money and the partisan complaints are pure rhetoric. If he's right, the governor just solved the health care problem, so consider me skeptical.

The ink was barely dry on the compromise bill, however, when many of these same people, and a few others, found themselves the target of more cuts. This time, however, they are pretty much alone.

Pawlenty is proposing to eliminate the General Assistance program and to cut state assistance to low-income families with disabled parents or children, substituting one-time emergency assistance, a program he originally unallotted, according to Deborah Schlick, executive director of the Affirmative Options Coalition.

General Assistance offers about 19,000 destitute adults with disabilities or serious illnesses $203 a month, some spare change to cover medical co-pays, bus rides and food. Instead, they could apply for emergency funds once a year.

Another 4,500 families with children will be stripped of their income under the governor's proposal to trim state-funded assistance to families with disabled parents and children who are on the state's welfare-to-work program, the Minnesota Family Investment Program (MFIP).

That includes people such as Wanda Ard, a Duluth single mother whose 11-year-old son, Jacob, was born with hereditary chronic pancreatitis. Ard works part time at an elementary school, does community work and just gets by on MFIP and Jacob's Social Security. It is almost certain she would lose money under the proposal.

Any cuts, she said, "would put us behind again. We're just trying to grow and trying to get ahead. Most people spend more in a trip to the store than we get in a month."

Her son is "a normal kid when he's not under attack [from the disease]," said Ard. But when the affliction hits, Jacob has to be hospitalized for a week at a time.

Another woman, Lucy, has a teenage son with cardiomyopathy. A combination of $700 monthly in Social Security and MFIP allows Lucy to make ends meet. Elimination of her $350 MFIP would break her.

"This is the worst possible group of people to take this hit," said Schlick. "Under the governor's proposal, most people would lose all their MFIP money."

Brian Rusche of the Joint Religious Legislative Coalition said a further travesty is that federal stimulus dollars were earmarked to protect these people in the shadows of the recession from more cuts, but the administration shifted that money into the general fund. "That is in my opinion a violation of what the federal government wanted," he said.

McClung disagrees. "It's not accurate to say the money has been rolled into the general fund to cut the budget," McClung said. "The federal funds were used for state programs. Someone might make the argument that they wouldn't recommend cutting those particular programs to help solve the budget deficit, but it's not a case of 'rolling'money from one account to another, it's about what programs would you reduce to solve a $1 billion deficit."

McClung said the state still has a large social safety net, but Rusche is not so sure.

"If you are willing to put balancing the budget on these folks, that's a sign you have to look at revenue, or we're not a humane people anymore," said Rusche, who moved to the state because of that reputation for compassion. "This is not the Minnesota I remember." • 612-673-1702