Faces and dollar signs: The human impact of General Assistance Medical Care cuts


On Wednesday night, the line for dinner outside of St. Stephen’s Shelter in south Minneapolis is just beginning to grow as the sun goes down and the temperature drops.

In the human rights office at St. Stephen’s, a smaller group gathers, not to eat, but to discuss the impact of cuts to General Assistance Medical Care (GAMC). They are not policy makers or city council members; they are not hospital administrators or economists. Despite their lack of political credentials, the members of St. Stephen’s General Assistance Medical Care Advisory Board may know more about the impact of the governor’s recent health care cuts than anybody else. Everyone on this advisory board has been or is currently on General Assistance Medical Care. Many have also been homeless or applied for low-income housing. They all understand what a stepping-stone GAMC can be for those in need.

Story Behind the Story

Last Sunday I had the opportunity to join Richard Johnson and Chuck from St. Stephen’s as they drove to various spots in Minneapolis and St. Paul trying to recruit people to give their video testimonies. This is a harder job than it may seem. We went to many places that are spots where homeless or very low-income populations come for services or simply a place to go. Many are suspicious immediately of the clipboards and pamphlets in our hands. Some warm up after explaining our intentions. Most know about GAMC, while some are finding out for the first time that they will now longer receive health care in the spring. Even fewer are willing to be filmed. A strong feeling of hopelessness can be felt throughout this community. I often heard sentiments of defeatism from those who feel that this community is constantly the target for budget and program cuts. It is hard to argue with this sentiment, but it intensified the respect I have for St. Stephen’s work in giving a voice to the often voiceless.

In conjunction with the advisory board, St. Stephen’s Human Rights Group is currently compiling video testimonies of people on GAMC and how the loss of GAMC will impact their lives. They already have over 200 videos, working toward a goal of 1,000. The videos aim to put a human face on the loss of General Assistance Medical Care. Many of those featured in the videos are homeless and depend on GAMC for all types of health care, from basic needs to cancer treatment.

“If I can’t get the medical services I need, I can’t be productive in society” said Elaine, a GAMC enrollee who suffers from depression, in one video testimony. Many of the videos focus on mental health patients who make up an estimated 70 percent of GAMC enrollees. St. Stephen’s will be sending some of the videos to legislators including Linda Berglin, and others on the Health and Human Services Budget Committee.

Richard Johnson from St. Stephen’s emphasized that the cuts not only take away a social service but a stepping stone that can be used by homeless or low-income adults while applying for more permanent services, like Medicare or Social Security. When you take away the enrollees’ ability to get health care, their health deteriorates and their ability to apply for other forms of aid is much lower, explained Johnson.

GAMC facts

On May 14, 2009 Governor Pawlenty cut General Assistance Medical Care from the state budget, effectively eliminating the program in its entirety. It is estimated that 30,000 Minnesota residents will lose their health care.

• The program will end this spring. The official date to no longer receive treatment is set at April 1, 2010, but many believe the program will run out of funding much sooner.

• The legislative session begins February 4, 2010.

• Many of those who are receiving General Assistance Medical Care (GAMC) are living on $203 a month, and are homeless, in precarious housing, or low-income housing.

• An estimated 70 percent of those who receive GAMC deal with a mental illness or substance abuse.

• GAMC covers those who are at or below 75 percent of the federal poverty guidelines. GAMC covers adults who have no dependent children who make less than $8,123/year.

What you can do

The coalition of organizations that are fighting to reinstate General Assistance Medical Care has one resounding call to action: call your legislator. Stressing the power of constituency, St. Stephen’s, SafetyNet, Catholic Charities, and others are calling for all those concerned about the loss of General Assistance Medical Care to inform their representatives that they find the loss of GAMC unacceptable. If you would like to support the reinstatement of GAMC, find your legislator’s contact information here.

In a recent Homeless Against Homelessness newsletter, Chuck expressed similar feelings: “Without GAMC, it’s like taking out the bottom two rungs on a ladder,” he wrote. “Without the bottom rungs, the ladder is useless.”

Health care providers see the human impact of GAMC everyday and understand the consequences of ending these programs.

“We’ve been hearing the word catastrophic a lot,” said Michael Scandrett from SafetyNet Coalition, a group of health care and non-profit organizations that serve uninsured and low-income patients, in response to how the cuts will impact patients and providers. Despite SafetyNet Coalition’s focus on providers, Scandrett said, “The heart of the issue is about how we take care of ourselves and the community.”

“Without GAMC, it’s like taking out the bottom two rungs on a ladder. Without the bottom rungs, the ladder is useless.”

SafetyNet, St. Stephens and other organizations have formed a coalition in order to present a unified front when proposing the reinstatement of GAMC to legislators. The coalition is looking to reinstate the full program. The organizations also understand that cuts will probably still be made and hope to be consulted when those decisions are made. However the immediate goal is to reinstate GAMC before any enrollees lose their coverage.

Commenting on the need for reinstatement and the possibility of cuts, Patrick Ness, the public policy manager from Catholic Charities Office for Social Justice said, “There is no margin for error for these communities, and it is not exaggerating to say that this is an issue of life and death for many Minnesotans already struggling to hang on.”

One of the ways St. Stephen’s and other organizations are trying to reinstate GAMC is to appeal to Republican legislators for support when the session opens February 4. Many of these legislators are from suburban areas and believe that GAMC is an urban problem that doesn’t affect their constituents. GAMC supporters are struggling to gain support from those legislators serving greater Minnesota.

In response to her legislator, Keith Downey (R) and his lack of support for GAMC, Gabriella Raspa, a GAMC enrollee and member of the St. Stephen’s advisory board, said “I wonder what he would think if I went up to him and said ‘I live in Eden Prairie and I am on GAMC.'”

Despite widespread support from health care providers and human service organizations, the reinstatement of GAMC before the programs end on April 1 would be, in the words of Michael Scandrett, “unprecedented.” It would have to be one of the first issues addressed and have widespread support in the legislature. Although Governor Pawlenty believes that those on General Assistance Medical Care can apply for MinnesotaCare, advocates of GAMC believe most won’t be able to pay MinnesotaCare copays and those who can will fall through the cracks while waiting up to four months to be eligible for MinnesotaCare.