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May 1, 2005
St. Paul, Minn. — Geraldine Differding is a 63-year-old diabetic who lives in Duluth. Two years ago, the state told her and other diabetics that MinnesotaCare would no longer pay for the test strips they use to monitor their blood sugar levels each day.
Differding panicked.
"If it gets too high I can go into a coma and if it gets too low it's the same thing," she says. "So you have to check it to figure what you're supposed to eat."
The test strips cost $100 a month. Differding says she didn't have the money because she lives on a limited social security income. So her family doctor came up with an idea. He knew that Differding's husband had health coverage through Medicare. And like her, he's a diabetic, too.
"His doctor just told him to say that he took his one more time a day," says Differding. "So I could have the one for myself."
Differding got her test strips. Still, she says her medical problems are far from solved. MinnesotaCare also stopped paying for the oxygen canisters she uses to run errands. So she decided to go without. And she's been homebound since November of last year.
"It's been one of the most difficult times of our life," says Differding. "I can't understand why they make cuts on the things that are so important like the Chem-Strips and the oxygen. How are people supposed to survive if they can't have the things that keep them alive?"
Kathy Auringer feels the same way. She lives in Eagle Lake, a small town in southern Minnesota located just east of Mankato. Auringer was dumped from MinnesotaCare after it was scaled back two years ago because she exceeded the program's income limits. She briefly signed up for another state sponsored health plan called Minnesota Comprehensive. But she had to drop it after a few months because she couldn't afford it.
She now has no health coverage. Auringer says it was a hard decision to make because she's a cancer survivor.
"I'm really taking a chance. Yeah, there's no question about that," says Auringer. "I should really have my preventive visits and stuff, but I'm not even gonna do that."
Auringer is 58. She figures she probably will go without health insurance for seven more years until she can qualify for Medicare at age 65. Like Differding, Auringer doesn't understand the logic behind cuts to MinnesotaCare.
"I think it is just absolutely disgusting," she says. "These guys just sit there and cut and cut and cut. They have no clue what people are living in down here."
Unlike Auringer, 44-year-old Amy Barankovich still has her MinnesotaCare coverage. But if lawmakers approve more cuts to the program she's sure she will be among the first to go. Barankovich doesn't have children. Under Gov. Pawlenty's proposal, adults without children would be dropped from the program.
"There's almost a prejudice going on," says Barankovich. "I don't understand why me being someone who has chosen not to have a child, why I should lose health insurance over someone who has a child. It's almost like this slant of encouragement to go ahead and have kids just so you can have some kind of coverage. And I know that's not the intention of it but it seems like something that could possibly come out of that."
Barankovich owns a small start-up business and isn't making much money yet. Recently, she found out that she has an adrenal gland problem. The discovery explains the chronic fatigue she says she has experienced the past few years. Barankovich says her MinnesotaCare coverage has never been more important to her than it is now.
"If I don't have that health care out there what does that mean for me? Is it something I'm just going to have to ignore and hope goes away? I know that's not going to happen," says Barankovich. "And so it's a frightening place to be."
These stories are not lost on Minnesota Human Services Commissioner Kevin Goodno. His department manages MinnesotaCare and other state-funded health care programs. "The decisions we're making aren't easy decisions," says Goodno. "They're difficult decisions and we don't take any of these decisions lightly."
According to Goodno, health care costs are projected to rise so much, that it's irresponsible for the state to try to keep up.
"We're the only agency that saw a projected double digit increase in our spending and we're at the high double digits at 18 percent," says Goodno. "We cannot continue to sustain that kind of growth in the human services area year after year and expect to be able to fund other things in the state that are important to people, be they natural resources or be it education."
Goodno says MinnesotaCare is a logical target for cuts because it serves a segment of the population that is typically healthier and less vulnerable compared to recipients in other government-subsidized health programs, like General Assistance Medical Care and Medical Assistance. He says in particular, the decision to drop adults without children was designed to do the least amount of harm. He says those recipients presumably have a better chance of earning enough money to pay for their own health care.
That theory annoys Amy Barankovich.
"You know, I'm not sitting around eating Bon-Bons and tweedling my thumbs," says Barankovich. "I'm an entrepreneur who's been working hard for the past three years in a struggling economy to make a lifestyle that is something that's valuable to me and something that I can contribute to society. And so I am making an attempt to bring in income, but it's not everyone is blessed with a large enough income in this day and age to pay for their medical expenses."
Barankovich is pinning her hopes on a bill in the Senate that takes the opposite approach to Gov. Pawlenty's plan. The bill would repeal many of the MinnesotaCare cuts made in 2003. That includes the $5000 dollar per-patient annual cap on benefits. It would also expand the program by increasing eligibility for MinnesotaCare.
Sen. Linda Berglin, DFL-Minneapolis, says no one disputes that health care costs are soaring. Even so, she says restoring the cuts makes financial sense.
"Throwing people off doesn't save money," says Berglin. "It costs you more money in the long-run when people end up in the emergency room."
Berglin predicts a tough fight in these last few weeks of the legislative session if the Senate approves its MinnesotaCare bill. She says it won't be easy reconciling it with the vastly different plans proposed by Gov. Pawlenty and the Republican-controlled House.