Comments on the Huntley-Berglin-Murphy Proposal for General Assistance Medical Care

Senate and House health committee leaders (Senator Berglin and Representatives Thissen, Huntley, and Murphy) have proposed the first real and viable means for preventing the elimination of the General Assistance Medical Care program. (Representative Dean has also proposed an alternative bill attempting to solve the GAMC crisis, and we will offer commentary on his proposal in the coming weeks.)

We greatly appreciate that this proposal would ensure that tens of thousands of the poorest adults in Minnesota maintain access to health care coverage.  This proposal makes very few changes in eligibility to the current GAMC program, and preserves the current program for GAMC enrollees transitioning onto Minnesota Care.  The proposal does eliminate reimbursement for those who show up at hospital emergency rooms without insurance and who are not poor enough to qualify for GAMC.  That loss is not insignificant, but we commend the authors of the proposal for avoiding deeper eligibility cuts in a very challenging environment.  We also recognize that the new bill proposes significant cuts to providers, and we remain committed to working with the provider community to preserve access to care for GAMC enrollees. 

We also greatly appreciate the decision of the bill’s authors to consider alternative care models for the GAMC population.  The Accountable Care Organization is a new and somewhat untested model, and as a result, several questions about it are not yet fully answered.  However, we look forward to exploring further the potential this model may have to provide more cost-effective care, improve health outcomes for GAMC enrollees, and achieve greater transparency for the GAMC program.  The shift to fee-for-service for counties unable to develop an Accountable Care Organization will also help to contain costs, create greater transparency within the program, and ease the transition forward from the current GAMC program.  An exploration of alternative care models should also consider increased investment in “on the ground” care management through organizations that have regular, face-to-face contact with GAMC enrollees.  Real investment in community clinics and direct service organizations to assist in care management would help to boost primary care utilization and reduce ER expenses, resulting in better health outcomes at lower costs.

Finally, we would also encourage the Legislature to consider – within the context of this program and other state budget expenditures – the need to raise greater revenues in Minnesota.  Over two dozen states passed significant revenue increases last year to mitigate budget cuts and boost economic growth.  We would urge Minnesota legislators to also consider real revenue increases – including requiring wealthy Minnesotans to pay their fair share – in order to create a sustainable funding source for GAMC and other critical state programs.

Our thanks to the Save GAMC Coalition for this valuable material.