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State was advised of court-challenge plans before today's GAMC extension

Two days before today's announcement that General Assistance Medical Care (GAMC) coverage for impoverished adults would be extended by a month, legal-aid attorneys contacted attorneys for the state advising that they planned to seek a temporary restraining order challenging the governor's unallotment of $15 million for the program.

They also advised they would use the same arguments that were posed in a separate lawsuit that led a Ramsey County judge to rule that Gov. Tim Pawlenty overstepped his authority when he unallotted money for a state nutrition program. That case is under appeal.

GAMC was due to run out of money by March 1 as a result of the $15 million unallotment and Pawlenty's line-item veto striking $381 million in second-year funding last year.

"We were seeking a temporary restraining order against the Department of Human Services [DHS] on the theory that irreparable harm would come to our clients if the program was terminated as planned on March 1," said Anne Quincy, a staff attorney for the Legal Aid Society of Minneapolis.


'Lower than projected'
This morning, the governor said in a press release that the "extra month of coverage is possible because program costs and new enrollment were lower than projected."

Regardless of what precipitated the decision, advocates for GAMC enrollees are ecstatic that the state decided to extend the coverage an additional month while legislators try to come up with a bipartisan solution to restore some vestige of GAMC.
 
"We're perfectly happy with the action, and we take absolutely no credit for it," Quincy said. "The governor has done a good thing; the department has done a good thing. If we brought to light enough information that they were already moving in that direction and decided to move in that direction this week instead of next week, we're very glad because the first of the month is always nerve-wracking for people on benefits. … So we're glad this action means they won't be faced with uncertainty on the first of February, and the administration can take all the credit for that."

Updated: DHS spokeswoman Karen Smigielski said in an email response that the department had been working on an extension of benefits before receiving word of the TRO.

"With a program of this magnitude, determining if it could continue an additional month required some amount of planning. We did give the plaintiffs’ attorneys a courtesy heads-up yesterday that we would have an announcement about the program today," Smigielski said.

Letters were to go out Friday
Letters were scheduled to be mailed this Friday to inform GAMC recipients that they would be enrolled in transitional MinnesotaCare, a program that requires them to pay more for prescriptions and share 10 percent of the costs of any hospitalization. MinnesotaCare also caps hospitalizations to $10,000 annually. Providers and advocates for the poor say the program is not a good fit for GAMC recipients because many make less than $2,700 a year.

DFL Sen. Linda Berglin, co-author of a bill to restore funding for GAMC, is curious where DHS Commissioner Cal Ludeman found the money to extend the program by a month. Berglin has received regular updates about the status of GAMC funds and the last one from 10 days ago said the program was short $4 million. She said she'll likely find out at a scheduled meeting with Ludeman this Friday.

"I would have no way to know for sure if that notice (of a lawsuit) had anything to do with this decision or not," said Berglin, chair of the Senate's Health and Human Services Division and co-author of legislation to restore some GAMC funding and reform some of its practices. "I can tell you I met with Cal a week ago and I asked if he could delay notices going out … and he said that the only way he could do that was if instructed by the governor to do so."

According to Smigielski, a November revenue forecast showed the department was $8 million short of the $34 million needed to extend GAMC coverage through March. The forecast was based on data received through Sept. 30.

"With lower than expected expenditures and fewer enrollees in three more months of actual data through December, we now expect to have sufficient funding to pay for March coverage," she said.

Berglin and others said they wanted to avoid the costs of auto-enrolling 28,000 or more people in MinnesotaCare only to de-enroll them if lawmakers are able to restore GAMC. 

Quincy said her office had planned to seek a temporary restraining order to stop the state from ending the GAMC program on March 1 because the Minnesota Supreme Court is due to hear the state's appeal of the earlier unallotment ruling on March 15.

"If the Minnesota Supreme Court were to decide in the middle of March that the unallotment was unconstitutional, it would be too late to undo the GAMC unallotment," she explained. "If the court were to decide the unallotments were constitutional, any action we got in getting a restraining order against ending the GAMC program would have ceased to be of effect. But we would not have thrown people into chaos. …You can't really undo having terminated everyone [from coverage] for half a month and put them back on."

DHS notified office on Tuesday
Today's news from the administration ends the need for an injunction on GAMC, Quincy said. She said the DHS notified her office on Tuesday that an announcement about the extension would be made this morning.

"I think everyone agrees there need to be reforms in GAMC, but there are very bright minds working on what those reforms need to be, and our thought … was they needed time to figure that out without having to deal with the chaos of the program ending prematurely," Quincy said.

Patrick Ness, public policy manager for Catholic Charities' Office for Social Justice, said the extension is good news but doesn't change the population's need for long-term relief.

"My initial reaction is this is very good for enrollees if it keeps notifications from going out, but that we can't allow this to undercut the sense of urgency in finding a solution immediately," said Ness, who is part of the Save GAMC Coalition. "Things are coming together. There is a growing sense of momentum and we can't afford to take a break now. We still need to enter the session with a bipartisan agreement and a bill that the governor will sign."

Casey Selix, who covers health reform and other issues for MinnPost, can be reached at cselix[at]minnpost[dot]com. Follow her on Twitter.

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Comments (2)

But GAMC wasn't unalloted. It was vetoed. So the unallotment lawsuit has nothing to do with GAMC and has no bearing on it.

I've been informed a small amount was unalloted. I was wrong. I'm an idiot. Sorry.