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St. Paul, Minn. — Fifteen months ago, Tim Sullivan returned from the doctor's office, diagnosed with small-cell lung cancer. His treatment involved regular chemotherapy. The bills could easily have run into the hundreds of thousands of dollars each year. But Sullivan and his wife, Valerie, say that wasn't an issue as long as they remained enrolled in MinnesotaCare.
Until last month.
I don't want this to become a political football. This isn't Democrats. This isn't Republicans. This is Tim's life.
With the new spending cap in place, Tim Sullivan says he reached his coverage limit within days.
"I try not to think about it a lot," he says. "But I do. I worry about having to sell the farm, having to sell what little bit of equipment I do have. I don't have much, but I worry about what's going to happen to my wife, Valerie. I worry about what's going to happen to her when I pass on. Especially if we lose everything. So it's been stressful."
Sullivan isn't alone. As part of this year's budget-balancing, MinnesotaCare enrollees without children -- and who earn more than 75 percent of federal poverty guidelines -- are subject to the $5,000 cap on outpatient services.
The state Health Department estimates 20,000 Minnesotans meet those criteria, and that as many as 3,000 of them will exhaust their spending limits this year.
Valerie Sullivan says she appreciates the difficulty of balancing a state budget. But she says there must have been a better way.
"I just want to say I don't want this to become a political football. This isn't Democrats. This isn't Republicans. This is Tim's life. This is 3,000 other people's lives, maybe, that are right now in the balance. How would you like that to happen to you?"
Human Services Commissioner Kevin Goodno issued a written statement, saying this year's budget cuts were targeted to spare the most vulnerable Minnesotans. Because the Sullivans were at a relatively high-income level compared to other MinnesotaCare enrollees, Goodno suggests they're "more likely to be affected."
But Goodno, and Gov. Tim Pawlenty, say there may be other state programs that can help. Pawlenty says he's willing to examine the issue.
"We don't want to see people going without medical care. In this particular family, I don't know enough about their situation to say what other options they may have in terms of Medicare, Medicaid, or other state programs. So we'll certainly look into that as a first step," Pawlenty said.
In fact, Tim Sullivan has already made the transition to Medical Assistance, the state's version of Medicaid. The program has enabled him to continue his chemo treatments.
But House Democrats, who held a press conference to introduce the Sullivans, say the strict asset and income limits for that program could impoversish the family and eventually result in the loss of their farm in rural Aldrich.
Rep. Tom Huntley, DFL-Duluth, the lead Democrat on the House Health and Human Services Finance Committee, says the state has essentially abandoned the affected MinnesotaCare enrollees.
"They paid their premiums for four years. And now, when they need the money for their treatment, they're told, 'Oh, we changed the rules. Forget about your premiums you've paid for four years. We've changed the rules.' We would never allow a private insurance company to do that. Yet we've done it with MinnesotaCare," he said.
Huntley and other Democrats are urging Pawlenty to restore the MinnesotaCare benefits to previous levels. Pawlenty says he'd like to be responsive, but he says the state already provides significant assistance.
"Minnesota is, generally, a very generous state in terms of social services and publicly-assisted health care. And if there's a couple of pinch points in the system, we'll be happy to review those and see if we can't make it better," Pawlenty said.
But the prognosis may not be good. No one is currently projecting a significantly brighter budget picture when lawmakers return to St. Paul early next year.