The Shape of Things to Come

Federal Health Care Reform was signed into law this spring.  But how that law will be enacted remains a hotly contested issue.  Many of the provisions do not go into full effect until 2014.  In the mean time, states are being offered a variety of grants to study, plan, and implement these changes.

Last week, Gov. Pawlenty ordered state agencies to halt applications for these grants unless given specific permission by his office.  There is some question concerning his authority to do so, because the Legislature had specifically directed that some of these grants be sought in a bill that Pawlenty signed into law.

Sadly, this appears to be a case in which potential avenues of compromise have been shut off.  The idea of insurance exchanges is not new.  Versions of the concept have been promoted by members of the House Republican Caucus as a potential solution to health care access.  Pawlenty, in fact, supported a similar concept a few years ago.

A wide range of groups has called on Pawlenty to reconsider this decision, including the Minnesota Budget Project (an initiative of the Minnesota Council of Non-Profits), the Minnesota Council of Health Plans, the Minnesota Hospital Association and the Minnesota Medical Association, as well as the Minnesota Chamber of Commerce.

We know that many Minnesota counties are doing what they can to help those without health insurance, trying to move as many people as possible on to other programs if they are eligible.  Some counties have paid premiums so that former GAMC patients can participate in Minnesota Care.  But these are stopgap measures.  Eventually, we will need to expand the MA system to cover more low-income single adults.  Eventually, we will need to set up an insurance exchange for individuals and small businesses buying their own coverage.

The question is: how much control will we take over the shape of things to come?  One of these grants in particular would have given the state greater control over how our insurance exchange would operate.  Delaying these programs hurts Minnesotans who lack health care coverage, and we know that many of those individuals have significant mental health concerns.

Meanwhile, the “compromise” GAMC program is straining to meet the needs of the metro area, and has let down individuals across the state that cannot travel to seek medical care.

As Minnesotans decide how to address these issue, we will continue to call for long-term solutions that provide equitable access to care.  Right now, there are two great opportunities for shaping that future.  You can contact Gov. Pawlenty’s office to let him know why health care access is important to you.  You can also participate in the Federal rulemaking process that helps determine how specific parts of the new law will take effect.  You can submit your comments at, by searching for “health care” and looking for rules that might impact you.

We think that it is vital for people with mental illnesses to be a part of creating new systems of care.  We know what services are missing from our communities, where the barriers have been, and what we need to do.  Please make it a priority to speak out and be heard.