Minnesota Slides in Health Rankings and Headed for Worse
November 18th, 2009 at 2:12 pm By Nina Slupphaug
The America’s Health Rankings report from the United Health Foundation was just released, and they found [PDF] that Minnesota, once a leader in health care is now 6th in the country. Here is the kicker though, the way things are going, it is unlikely that we will be able to change our downward trajectory anytime soon.
The good news are that there are still many areas where we are slipping only slightly: Minnesota has a low premature death rate, a low rate of deaths from cardiovascular disease, low infant mortality, low rate of uninsured, and a low rate of occupational fatalities. As for the bad news, we have had a significant increase in the rate for children in poverty from 9.7% to 15.6% over the past five years, immunization coverage has declined from 84.7% to 77.4% since last year, we have seen an increase in obesity, there is insufficient prenatal care, and we struggle with comparably low public health funding.
Being number six is not bad, anytime one is in the top ten a pad on the back is warranted. Our problem though, is that we were number one for four consecutive years up until 2006, then we fell down one spot, which is still pretty darn good. Come 2008, and Minnesota is now ranked third in the country which is still great. Cue to today, suddenly we are sixth, in itself not horrible, not even particularly bad except for the fact that we keep slipping and it seems to be a trend rather than a once-off.
What is Minnesota doing to turn things around? From the looks of it, not that much.
The Governor’s cuts to GAMC will increase our number of uninsured come March 1, since not all GAMC recipients are qualified for the automatic transfer to MinnesotaCare. After the six month grace period is over, it is likely that many GAMC recipients will be unable to maintain their coverage through MinnesotaCare due to the procedural requirements and cost. The discontinuation of GAMC is part of a larger $1 billion cut to Health and Human Services and it remains to be seen just how these cuts will affect other programs.
“The Future Costs of Obesity” report [PDF] says obesity rates will grow to an estimated 36.7% in Minnesota by 2018, if we stay on the current course, with related health care spending at $5,798,000,000. Despite the legislature’s commitment to end poverty by 2020, the number and rate of children living in poverty is steadily increasing.
Most of what Minnesota does well: low premature death rate, a low rate of deaths from cardiovascular disease, low infant mortality comes from the fact that we have a low rate of uninsured people in the state, but if this changes with the end to GAMC and overall cuts to the Department of Human Services, it is a good chance that there will be negative consequences to our low premature death rate, low cardiovascular deaths, and low infant mortality.
Minnesota has been touted the shining star of the nation in terms of health care, we have presidents and aspiring presidents looking to Minnesota as a state that has done things right. But it is time we stop resting on our laurels and realize that health care is an ongoing concern that should not be put on the back-burner, nor should it be where we cut funding to balance the budget. I would hate to be one of those parents who tell my kids “when I was young, things were so much better” and actually be right.
LikeTags: GAMC, Health Rankings, MinnesotaCare, Unallotment, United Health Foundation
My understanding is that ALL GAMC enrollees will be transferred to Transitional MN Care for the remainder of their enrollment.
A good article on why Transitional MN Care and MN Care are not acceptable substitutes for GAMC is on MPR: http://minnesota.publicradio.org/display/web/2009/11/17/gamc-protest
The two plans have several key differences.
Minnesota Care has an annual $10,000 limit on inpatient hospital care, with a 10 percent co-payment. GAMC has no inpatient hospital care limit and no co-payments for inpatient stays.
Unlike GAMC, Minnesota Care also has a monthly premium, calculated on a sliding scale based on income, starting at $4 a month. Enrollees will be given a several month grace period, but will then need to make payments to keep their coverage.
Heying says she expects many people will lose coverage because of unpaid premiums.
“Many of the folks that we work with are transient because of being precariously housed or homeless,” she said. “So, if they miss the paperwork that could seriously jeopardize their coverage.”
Minnesota Care has a $3 co-payment for both generic and name brand medications. Under GAMC, enrollees pay $1 for generic medications and $3 for name brand medications. GAMC caps co-payments at $7 a month to keep costs down for people taking several medications. The plan also waives co-payments for several psychiatric medications.
Although the differences in premium expenses and co-payments might seem minimal, advocates say the costs could add up quickly for low-income adults.
Many GAMC enrollees are unemployed and survive on $203 in monthly welfare assistance. Under current GAMC coverage, a person who took 3 name brand medications and 2 generic medications would pay $7 a month.
If the same person enrolled in Minnesota Care, the medications would cost $15. The $4 monthly premium would bring costs to $19, or 9 percent of a single adult welfare recipient’s total income.
“There’s a reason they’re not on Minnesota Care to begin with,” said Liz Kuoppala, executive director of the Minnesota Coalition for the Homeless. “It’s because they don’t have the money to pay for these premiums. It’s just not a program designed to help this group of people.”
Hi Marissa,
you are correct that all the GAMC participants as of March 1, 2010 will be automatically transferred. Thanks for catching that.
When our Commissioner of Health, Sanni Magnan, was confronted with this survey she replied,”It’s helpful when we shine a light like this. We need to renew our efforts”. What? This news should not be new to her. Where has our number one health advocate for Minnesota’s most vulnerable been durring the budget fiasco with GAMC defunded and the resulting backlog waiting for Minnesota Care? What would it be like if we had a Health Commissioner that actually offered leadership on these issues instead of falling asleep at the wheel? Has our Health Commissioner offered one suggestion on how to deal with the adverse health risks inherent in the 50 percent increase in child poverty occurring in the last three years? Has she tackled the growing problem of inadequate immunization with nearly one quarter of our children under vaccinated? What if we had an activist Health Commissioner that met these problems head on? Or would that be too much reality for a Pawlenty Administration to acknowledge, perhaps reflecting on their cumulitive policy failures?