Court fight ahead for governor’s GAMC plan?

DFL House speaker says legal action is probably imminent

It was clear that Maureen O’Connell was repeating herself.

“We are analyzing our clients’ options in light of the failure of the [GAMC] veto override,” O’Connell, director of Minnesota Legal Aid’s Legal Services Advocacy Project, said this week in response to yet another question about potential litigation stemming from the elimination of the state’s General Assistance Medical Care program. “At this moment, that’s all I can tell you.

“We’re still in the analysis phase. In order to have a lawsuit, you have to have clients, you have to have harm — there are so many elements of a lawsuit that one would have to prove, it’s premature for me to say anything other than that we’re doing our analysis.”

Despite O’Connell’s reluctance to be more specific about potential litigation stemming from the pending disappearance of GAMC, a program that pays for health care for Minnesota’s poorest adults, her name was invoked repeatedly this week after the House failed to override Gov. Tim Pawlenty’s veto of a bill that would have extended GAMC for 16 more months, until the end of fiscal year 2011.

“Our coalition has been discussing the broader topic,” Greta Bergstrom, a spokeswoman for the Save GAMC Coalition, said. “We have for the moment no detailed information [about possible litigation]; we’re not part of any lawsuit, and we’ve been referring people to Maureen O’Connell. She’s the single source.”

Unless legislators can come up with a GAMC plan that Pawlenty approves, a lawsuit — or multiple lawsuits — seem inevitable, especially after a judge granted a temporary injunction in December that called into question the governor’s use of his unallotment authority to eliminate a $5.3 million low-income nutrition program.

TakeAction Minnesota, a progressive statewide coalition of organizations that works for economic and social justice, released a list of 73 groups that supported the GAMC extension legislation and urged a “yes” vote on the bill. Those organizations, which range from the Minnesota Hospital Association to the Minnesota AFL-CIO to St. John Neuman Catholic Church in Eagan, are potential parties to a class-action lawsuit challenging the elimination of GAMC.

This week, immediately after the House failed on a straight party-line vote to override Pawlenty’s veto of the GAMC extension, House Speaker Margaret Anderson Kelliher told the Pioneer Press that she expected a court challenge “in the next 24 hours” to halt the auto-enrollment process of GAMC participants into MinnesotaCare. (This issue of Capitol Report went to press at midday Wednesday; for coverage updates, please visit politicsinmn.com.)

Last summer, the governor line-item vetoed GAMC and decreed that approximately 21,000 of the 30,000-38,000 Minnesotans who use the program in an average month would be automatically enrolled in MinnesotaCare as of April 1. GAMC supporters said he added insult to injury by subsequently unallotting part of GAMC funding for fiscal year 2010; a pending lawsuit, which questioned his unallotment authority, will be heard later this month by the state Supreme Court.

As it stands now, MinnesotaCare provides subsidized health care coverage to low- and moderate-income families and individuals in Minnesota. GAMC is a state-funded program for low-income adults, ages 21 to 64, who have no dependent children and who do not qualify for federally funded health care programs.

But under the revamped MinnesotaCare plan, the eligibility rules for single adults on MinnesotaCare will be severely restricted: Currently, to be eligible for MinnesotaCare, a single adult must earn no more than 250 percent of the federal poverty guideline, or $27,084 a year.

After GAMC participants are rolled into MinnesotaCare, the single-adult threshold will be no more than 75 percent of the federal poverty guideline, meaning that any single adult Minnesotan who earns more than $8,000 a year will no longer be eligible for the program.

Because a large proportion of GAMC recipients are transients, appearing on the radar only when they are very ill, the program experiences a high rate of turnover.

This week, Sen. Linda Berglin, DFL-Minneapolis, who chairs the Senate Health and Human Services Budget Division, estimated that the number of people served over the course of a year by GAMC ranges from 75,000 to 80,000, and that the new eligibility guidelines will knock 20,000 to 30,000 people off of the MinnesotaCare rolls.

As Berglin parses the numbers, subtracting the 21,000 GAMC participants who will be rolled over to MinnesotaCare leaves 59,000 residents without health care coverage. Adding the 20,000 to 30,000 who will be knocked out of MinnesotaCare to make room for the former GAMC enrollees means that between 80,000 to 90,000 Minnesotans overall will lose health care coverage entirely.

Last week, anticipating Pawlenty’s veto of the GAMC extension, Senate Majority Leader Larry Pogemiller, DFL-Minneapolis, and Kelliher, DFL-Minneapolis, ordered Department of Human Services Commissioner Cal Ludeman, a Pawlenty appointee, not to spend state money on the automatic transition of GAMC participants into MinnesotaCare, saying that the funds had not been authorized and that any such transition would be contrary to state law.

In a letter to Ludeman, Pogemiller and Kelliher also warned that any administrative action relating to Pawlenty’s GAMC unallotment would be “premature pending a resolution by the Minnesota Supreme Court” in the unallotment lawsuit.

Ludeman countered with a letter of his own, telling the legislative leaders that while he appreciated their opinion, he “respectfully” disagreed with it.

“It is clear this administrative action is fully compliant” with Minnesota law, Ludeman wrote. “As a result, we will proceed with the transition to MinnesotaCare beginning April 1 in order to ensure current GAMC enrollees maintain health care coverage.”

Ludeman cited a portion of state law governing enrollment in MinnesotaCare and GAMC — the statute on which Pawlenty relied in his decision to automatically enroll GAMC participants in MinnesotaCare after GAMC is eliminated.

Berglin called the Pawlenty administration’s use of the statute “illegal.”

“The law says — and I’m the author — that once you’re enrolled in GAMC for two months, you may be enrolled in transitional MinnesotaCare for the next four months, except if you’re HIV positive, homeless or applying for Social Security disability benefits,” Berglin said.

“A complete transfer of GAMC recipients to MinnesotaCare is not within the law. For one thing, some of them won’t have been in GAMC for two months, and some, as I said, are in populations that are not supposed to be transferred to MinnesotaCare at all.”