A ‘new’ GAMC or an imperfect substitute?


Last week Minnesota Democrats in the Legislature unveiled plans to temporarily save General Assistance Medical Care (GAMC) from the chopping block. If passed, the legislation would to continue access to basic care for current enrollees, shift the funding structure, save the Health Care Access Fund from premature bankruptcy, and move some program participants who qualify over to federal programs. 

More specifically, the “new” GAMC would be funded by an increased surcharge on hospitals, HMOs and health care networks. Additionally, the program would rely on federal and county funding paired with reduced provider reimbursement rates. To further trim costs, patients such as pregnant women and state prisoners who qualify for coverage under alternative programs will be dropped. These measures aim to keep GAMC alive till the end of the biennium, June 2011, when a possible federal health care reform would hopefully kick in.

Although not perfect or complete solution, it will ensure that GAMC recipients will keep their drug coverage, including no co-pay for anti-psychotic drugs, as well as reducing the burden on MinnesotaCare that a transfer of the 30,000-plus GAMC recipients would create.

It is still very much up in the air whether such a proposal will go through, in which case GAMC will likely be terminated in the spring. If that is to happen, those currently enrolled in GAMC will be automatically transferred to MinnesotaCare at the expense of their respective counties till the end of their eligibility period, or up to 6 months. After the initial few months on MinnesotaCare, the counties will no longer be responsible for paying the premiums and recipients will need to renew their enrollment as well pay the premium. It has been estimated that the structure and requirements of MinnesotaCare as well as the cost of premiums will likely lead to as many as 13,000 dropping out of the program in the first year.

In addition to providing a poor match for the GAMC population, a move to MinnesotaCare would also lead to the bankruptcy of the Health Care Access Fund which provides the funding for MinnesotaCare by July 2011.

So what are we to do, other than build a time machine and ensure that the unallotment never happened? It is painfully obvious that neither a trimmed-down version of GAMC nor a move to MinnesotaCare are ideal solutions and do more than serve as band-aids for a major hemorrhage. It may not be possible to recover GAMC as it currently exists, but we can still fight for improving the solutions offered to those in need of the program while continuing our struggle for meaningful health care reform that can ultimately make programs such as GAMC superfluous.