I Don’t Hate America!

On March 5th, an agreement was made between Gov. Tim Pawlenty and DFL leaders to extend the GAMC program that was set to end on March 31st, 2010 and would have transitioned tens of thousands of low-income Minnesotans to a more expensive MinnesotaCare plan. Although the plan will continue coverage for many, the payments are slim from the state, instead shifting much of the costs to hospitals.  According to MPR and Sen. Linda Berglin (DFL), 77% of the program’s funding from the state is being cut.  Hospitals such as HCMC will still need to deal with picking up the cost to ensure all their patients receive the appropriate care.  From an RN that works at HCMC, staff have already been facing cuts that affect patient care.  Patient to nurse ratios have now increased on medical/surgical units up to 8:1 on nights.  With less reimbursement to hospitals and a shifting of costs such as this GAMC deal, patient care will still negatively be affected until legislators pass safe patient handling bills, or increase funding to programs for the uninsured.  This will be an interesting topic to continue following in the coming months.

From Minnesota Public Radio (MPR):

GAMC deal shifts costs to hospitals, health providers

by Madeleine Baran, Minnesota Public Radio, Tom Scheck, Minnesota Public Radio

March 5, 2010

St. Paul, Minn. — Gov. Tim Pawlenty and DFL legislators have reached a deal over funding for a health insurance program for the poor.

The deal will preserve coverage for most current General Assistance Medical Care recipients, but will shift costs onto medical providers.

GAMC provides health insurance for more than 30,000 of the state’s poorest residents. The program was scheduled to end on March 31, after Pawlenty cut its funding last year to balance the state budget.

The new plan will extend GAMC for two months. Starting June 1, a new system, funded with block grants, will replace it.

Instead of paying providers for each service provided, the new plan will provide hospital-based coordinated care systems with capped block grants to provide health care to eligible residents. Most former GAMC recipients will be eligible under the new plan.

“The hope will be this will be a more efficient, comprehensive, and continuous care,” Pawlenty said in a press conference this afternoon.

DFL legislators said they’re glad to have reached an agreement, but said the plan will hurt medical providers. Sen. Linda Berglin, DFL-Minneapolis, said the plan cuts the program’s funding by 77 percent.

“The health care providers are taking a huge cut,” said Rep. Thomas Huntley, DFL-Duluth. “That makes the state budget look good, but some hospitals may collapse, and other hospitals may just raise their rates to everybody else to make up for the loss of this money, and that will be put on your insurance bill.”

The state’s General Fund will provide $71 million in capped block grants to hospital-based Coordinating Care Organizations in the current 2010-2011 budget, and $131 million in 2012-2013.

The plan also establishes a separate method to reimburse CCOs for prescription drug costs. The deal caps drug reimbursements at $45 million from the General Fund in the 2010-2011 fiscal years, and $83 million in the 2012-2013 fiscal years.

GAMC recipient Robert Fischer expressed relief that he won’t lose his coverage. Fischer, who is 51, has sleep apnea, depression, and a degenerative back condition. His only income is $203 a month from the state’s General Assistance program.

“From what I’ve heard, I’m very, very happy,” Fischer said.

Negotiators have been working on a solution for GAMC for about nine months. The plan was set to expire later this month.

“We knew when we began this endeavor nine months ago that we were going to be putting together legislation that was going to be less than lovely,” said Rep. Erin Murphy, DFL-St. Paul. “We were working very hard to protect the safety net for those who get their care in GAMC, and we’ve protected that commitment.”

Murphy added, “I think the safety net is a little thinner. It may be a little bit more like a lifeboat.”

The state had planned to transfer many current GAMC enrollees into another state health insurance program, called MinnesotaCare, once the program ended.

But many recipients say they would not be able to afford MinnesotaCare’s monthly premiums and higher co-payments.

Issue background:

The General Assistance Medical Care (GAMC) fund is a MN healthcare program run by our Minnesota Department of Human Services (MDHS, 2009) that covers “low-income adults, ages 21-64, who have no dependent children under age 18 and who do not qualify for federal healthcare programs” (para. 1). The services offered include a comprehensive benefits package focused on preventative care and one for those who want coverage in case of an emergency hospital visit with a specific co-pay amount. A recent veto and line-item cut from MN’s budget by Gov. Tim Pawlenty took away $381 million from the GAMC (Perry, 2009). According to Share (2009), these “cuts to GAMC will leave 33,000 low-income Minnesotans without healthcare” as the labor review editor quoted the MNA.

One of the major hospitals in the Twin Cities, the Hennepin County Medical Center (HCMC) is one of the most affected by the line-item cut to GAMC as they will lose “$43 million in 2010 and $50 million in 2011” (Newmarker, 2009, para. 5). This has forced the one in only four Level 1 trauma center’s in the state to face many program cuts as they deal with a $550 million budget compared to a $600 million one in 2009 (Newmarker, 2009). Protesting nurses do not want to be a part of potential cuts, or see vulnerable patients turned away especially as we already face issues regarding safe staffing. HCMC’s major cuts highlight how payment increases to insurers must happen in order for healthcare organizations to stay afloat. Payment increases to insurers means payment increases to their customers, the ones who pay for health insurance. This is one element of the greater healthcare reform issue that needs to be addressed as the national debate continues.

Minnesota Department of Human Services. (2009). General assistance medical care. Retrieved
on October 15, 2009, from http://www.dhs.state.mn.us/main/idcplg?IdcService
=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_006257

Newmarker, C. (2009, September 25). HCMC lists programs facing cuts. American City
Business Journals, Inc. Retrieved on October 15, 2009, from http://twincities.bizjournals.com/twincities/stories/2009/09/28/story4.html?b=1254110400%5E2162231

Perry, S. (2009, October 1). Employment stimulus will dominate session, as well as bonding bill.
Finance & Commerce, Inc. Retrieved on October 15, 2009, from http://legal-ledger.com/item.cfm?recID=12318

Share, S. (2009, October 12). Nurses march on capitol, call on governor to restore general
assistance medical care. Workday Minnesota. Retrieved on October 15, 2009, from http://www.workdayminnesota.org/index.php?news_6_4205

From MyFox 9:

MINNEAPOLIS — Former Vice President Al Gore thinks Al Franken would be “a fantastic senator,” according to a letter sent to Democratic delegates.

Gore’s endorsement of Franken’s bid for the U.S. Senate comes days before Franken squares off against opponent Jack Nelson-Pallmeyer for the DFL endorsement at the state party convention in Rochester, Minn.

One reason Gore endorses Franken is their shared goals of an effort to slow global warming.

The big day is this Saturday where Franken and Jack Nelson-Pallmeyer will fight for the DFL party nomination.  It should also be mentioned that the Minnesota Nurses Association (MNA) and AFL-CIO have endorsed Franken.  I do wish that JNP would voice his concerns for nursing more, like Franken has done on his website.  I have contacted JNP twice about it with no answer.  However, I cannot endorse Franken for his poor universal healthcare plan that requires each state to enact their own.

With low numbers in the delegate count, including the latest Rasmussen Poll stating that Ciresi has a better chance of losing against Coleman (than Franken), Ciresi decides to drop out of the U.S Senate race today. This was reported on KSTP’s 5 Eyewitness news:

Mike Ciresi announced he would withdraw his candidacy for the U.S. Senate Monday afternoon.Ciresi said in a statement that he was retracting his bid to relieve unnecessary fights.

“We are at defining moment in our nation’s history, and we have the opportunity to reject the failed policies of the past and write a new chapter in the American story. I am confident we will do so because of the spirit, creativity, and optimism of our fellow citizens,” Ciresi said.

In the statement, Ciresi also thanked the state and his staff members.

“I firmly believe that America’s best days are still ahead of us. As we return to private life, I will continue my efforts, as I have my entire life, to work with others in contributing to the common good of our state and nation,” Ciresi said.

From my post on Feb. 29th, Franken leads Coleman, latest poll,

Today’s latest Rasmussen Report shows Al Franken leading Norm Coleman, 49% to 46% if Franken were to be the DFL candidate. If Ciresi were to get the DFL nod, Coleman would be ahead, 47% to 45%. There was no mention about Jack Nelson-Pallmeyer.

Mike Ciresi’s statement, from MinnPost:

From: Ciresi, Michael V.
Sent: Monday, March 10, 2008 4:28 PM
Subject: MIKE’S STATEMENT ON WITHDRAWING FROM SENATE RACE

I am announcing today my withdrawal from the contest for the DFL endorsement and the conclusion of my candidacy for the U.S. Senate. In my judgment, continuing the endorsement race would only lead to an unnecessary floor fight. It is time to step aside.

On entering the race, I expressed my passionate belief that our country had lost its direction and that the middle class was being crushed economically. We have a failed foreign policy that has led us into a war that, despite the extraordinary service of our armed forces and the sacrifices of their families, has served to further destabilize the Middle East and led to a less safe world. Middle class jobs are evaporating and quality educational opportunity is being denied to our children. College education is increasingly unaffordable, and graduates are saddled with enormous loans. We have a “sick care” system rather than a health care system that is affordable and accessible to all. The environment is not being nurtured and protected. We have a tax system that has created the greatest wealth gap since the early 1900s. Staggering debt is being passed on to future generations, and yet those who seek political office say little about the difficult economic choices we must make.

We are at defining moment in our nation’s history, and we have the opportunity to reject the failed policies of the past and write a new chapter in the American story. I am confident we will do so because of the spirit, creativity, and optimism of our fellow citizens.

Ann and I have traveled our entire state for the past year, and the desire and sense of urgency for change is palpable. We believe that the people will demand that the tough choices be presented and that the vast majority of Americans will reject self-interest in favor of the common good and shared sacrifice. I firmly believe that America’s best days are still ahead of us. As we return to private life, I will continue my efforts, as I have my entire life, to work with others in contributing to the common good of our state and nation.

Ann and I and our family wish to express our deep gratitude to all of our fellow Minnesotans who have so graciously welcomed us into their homes, businesses, and towns and engaged us in heartfelt discussions concerning the issues facing our nation. We are also deeply indebted to all of our supporters and staff who passionately believe in our message and have worked tirelessly on our behalf. The memories and friendships forged are timeless. We encourage all to remain committed to changing the direction of our nation and to support candidates of their choice.

Fondly –

Mike and Ann Ciresi

Does Jack Nelson-Pallmeyer have a chance to scoop up more delegates? More to come soon.

This post is coming to you live from the DFL State Central Committee meeting in at Prior Lake High School in Savage.

That last part was important because there was some confusion about where the meeting was going to be: some thought it was at the OLD high school (which is now a middle school) and some were initially unable to find it because it was not clear to everyone that the school was in Savage, but it appears everything is smooth sailing.

I will becoming to you later today with a liveblog of the debate between DFL candidates for US Senate.  Mike Ciresi and Jack Nelson-Pallmeyer have been working the crowds; no sign of Al Franken or Jim Cohen yet. Congressional candidates Jim Hovland and Ashwin Madia (Third District) and Steve Sarvi (Second District) have already spoken.

See you all at 4:00 p.m.