New Deal for Health Care

Lawmakers hammered out a deal with Governor Pawlenty on Friday after months of negotiations about state-funded medical care for Minnesota’s poorest residents. Here are some of the details:

GAMC as we know it will go away. People won’t be able to simply go to a doctor or a crisis home and have GAMC cover their care starting in June. Instead, coordinated care delivery systems will be established meaning that the state will contract with hospitals that agree to provide this care (so there could be hospitals that won’t provide care) and who have met certain criteria: 1) GAMC fee for service payments greater than $1.5 million, or equal to or greater than 1.3% percent of net patient revenue or 2) it’s necessary to provide geographic access. It should be noted that as before, most people will transition to MinnesotaCare except for those who are homeless, have end stage renal disease or are waiting to be determined to be disabled.

The hospital only coverage for people with incomes above 75% of poverty is eliminated. And it makes ineligible for the program people who have private health insurance, are in jail, reside in sex offender program, do not cooperate with the county to become eligible for SSI or SSDI and people who are not permanent residents of Minnesota.

Those hospitals will provide a set of comprehensive health care services, including mental health services. Prescription drugs would be a seperate benefit. The hospitals can contract with essential community providers – but don’t have to. They are also supposed to coordinate with counties and coordinate health care services with homeless prevention, supportive housing, and rent subsidy programs. They are also supposed to work with county veteran service officers to try to find other programs for veterans.

GAMC was scheduled to end April 1st after Governor Pawlenty’s decision to unallot funding for the program last year. Since that time, legislators and advocates has worked tirelessly to save GAMC. The new agreement will allow GAMC to continue unchanged until June 1, then transition to the new program. As a result, the planned automatic conversion of GAMC enrollees to MinnesotaCare on April 1 will not occur. Click here to learn more.