State cuts take toll at Minnesota’s largest safety-net hospital


As Hennepin County Medical Center announced 200 more job cuts on Nov. 18, AFSCME members joined 200 protesters outside the hospital, urging the Legislature to rescue General Assistance Medical Care before Gov. Pawlenty eliminates the program. The protesters created what they called a never-ending emergency room line. Emergency care, they said, will be the only way for vulnerable residents to get medical treatment once the state throws them off GAMC. That happens on March 1 – sooner if existing money runs out before then.

Pawlenty vetoed funding for GAMC in May. The House failed to restore the funding because not one Republican voted to override the governor’s veto.

Three hospitals where AFSCME represents workers – HCMC, Regions Hospital in St. Paul and Fairview University Medical Center in Minneapolis – expect to take about 60 percent of the financial hit from Pawlenty’s GAMC veto.

AFSCME now is working in coalition to rescue GAMC once the Legislature goes back in session on Feb. 4. Wednesday’s actions were one piece in raising public awareness of the gravity of the situation.

protest against GAMC cuts

35,000 lose health care, hospitals lose millions of dollars

Eliminating GAMC will deny medical care to adults who earn less than $7,800 a year. Roughly 70,000 residents use GAMC over the course of a typical year; more than 33,000 are currently enrolled. The Department of Human Services intends to transition GAMC enrollees into the Minnesota Care program for working adults, with counties picking up the tab. But skeptics say many GAMC enrollees will not qualify for or not be able to afford the out-of-pocket costs of Minnesota Care.

Eliminating GAMC also will deny hundreds of millions of dollars in state reimbursements to hospitals, according to the Minnesota Hospital Association. But eliminating GAMC does not eliminate people’s need for medical care, advocates point out.

“There needs to be quick action by the Legislature next year to find a way to pay for health care provided to people currently on General Assistance Medical Care or to support the hospitals providing those services,” said Dr. Arthur Gonzalez, HCMC’s chief executive officer.

Hospital workers pay the price

HCMC, the state’s largest safety-net hospital, expects to lose $90 million over the next two years. Regions and Fairview, combined, expect similar losses.

As a consequence, HCMC’s board said Nov. 18 that the hospital will eliminate 200 more jobs in 2010, deny routine access to uninsured patients from outside Hennepin County, close a cardiac rehabilitation clinic, and close a senior care clinic. Those decisions still need to be approved by the county board in December.

HCMC laid off 200 workers earlier this year, and required other employees to take unpaid furloughs. Overall, Minnesota hospitals eliminated 2,282 jobs between November 2008 and June 2009, according to news reports compiled by the Minnesota Hospital Association

AFSCME members currently are in contract negotiations with HCMC, which is proposing wage freezes, no increases in longevity pay scales, and significant shifting of health insurance costs onto workers – including requiring workers to pay for individual coverage for the first time.

Uncompensated care skyrocket

Pawlenty’s elimination of GAMC piles on to the deteriorating financial conditions at Minnesota hospitals, which are being forced to provide more “free” care for more uninsured patients at the same time the state is slashing funding.

Last year, Pawlenty cut $234 million in other state funding to hospitals. Hospitals, meanwhile, provided $601 million worth of care in 2008 for which they were not paid. That “uncompensated care” is three times higher than it was five years ago, the hospital association says.

The number of Minnesotans without health insurance is climbing by about 10,000 a year, according to federal statistics. That number does not include the bulk of residents who lost insurance after losing their jobs in the past year