TPawSurgeonBy Casey Selix | Thursday, Oct. 15, 2009

Sam Joyner expected state Rep. Jim Abeler, R-Anoka, and other lawmakers to listen to his testimony last session about how the General Assistance Medical Care (GAMC) program for impoverished residents had covered his treatment for painful degenerative disk disease.

What Joyner didn’t expect was that Abeler would invite him to his office after a February committee hearing. “He told me he was a chiropractor and he said, ‘Would you do me a favor and stand there for a minute,’ ” Joyner, age 62, recalled.

Within a few minutes, Abeler showed Joyner how his right shoulder was three inches higher than his left and advised him that “any good chiropractor” could help restore balance. Joyner found a chiropractor close to his Minneapolis apartment and reports: “I still can’t work, I can’t lift weights … but I can walk and I can function without being in total agonizing pain around the clock.”

A cynic might ask: Could lawmakers moonlighting as chiropractors and medical professionals be the Republican approach to cutting health-care costs for the poor?

The ‘softie Republican’
An optimist might respond: Republicans have a heart. Even Abeler describes himself as the “softie Republican” in the House.

Rep. Jim Abeler

Rep. Jim Abeler

Since that behind-the-scenes moment in February, a whole lot has happened to threaten the future of GAMC benefits for Joyner and nearly 35,000 Minnesotans and the hospitals and providers who care for them.

Three days before the session ended, Gov. Tim Pawlenty used his line-item veto to strike $381 million in second-year funding for GAMC, stunning Republicans and Democrats alike. The DFL-controlled House of Representatives failed to reach a two-thirds majority to override the veto in a straight party line vote. Then the Republican governor unallotted another $15 million, in effect speeding up the demise of the program on March 1 — unless legislators can come up with a veto-proof and unallotment-proof compromise to restore some form of GAMC.

The other BIG question hanging over the future of GAMC is the passage of federal health-care reform legislation. Each of the major bills before Congress, including the one just passed this week by the Senate Finance Committee, contains language to extend Medicaid coverage to anyone under age 65 with income up to either 133 percent (in one bill) or 150 percent (in other bills) of Federal Poverty Guidelines (FPG). Right now, Medicaid (called Medical Assistance in Minnesota) does not cover poor adults with no children under 18 unless they receive Social Security disability.

Has filled gap for 35 years
For 35 years, GAMC has helped fill the gap in coverage for childless adults making up to about $8,000 per year or 75 percent of FPG. Minnesota is one of the few states in the nation to offer a state-funded program for this subset, though counties in other states find ways to cover health care for the poor.

“What we really need is a bridge,” said Patrick Ness, public policy manager for Catholic Charities’ Office of Social Justice. “We need to find a solution in the first two weeks of the Legislature to bridge to federal health-care reform. They’re saying it will be three years before we see the fruits of this (federal reform). All we need is to find a short-term solution to bridge the health-care needs of this most-vulnerable population.”

The governor’s veto and the House’s failure to override him ignited a firestorm among communities ranging from homeless shelters to hospitals required by federal law to treat and stabilize anyone who shows up in their emergency rooms. And the situation has galvanized livid social-justice advocates and hospital CEOs, the nurses who may lose their jobs because of hospital cutbacks, DFL legislators and Hennepin County commissioners.

“It was one of the most stark and heart-wrenching debates I’d ever seen,” Ness recalls of the floor debate over the veto override. “Veteran lawmakers were breaking down in tears about what this says about Minnesota.”

Advocates ready to make their case
GAMC advocates are organized and ready to make their case when the Legislature convenes on Feb. 4. They’ve met with legislators to brainstorm solutions on how to restore some GAMC funding. A GAMC Alliance of 50 interest groups has formed within the Safety Net Coalition.

Lobbying is occurring across the spectrum: from the St. Stephen’s Human Services’ YouTube videos of GAMC enrollees to Regions Hospital’s weekly email detailing how much treatment of GAMC patients cost at the St. Paul hospital that week, a case study of a patient and a countdown to Feb. 4.

“There’s interest in moving forward,” said House Assistant Majority Leader Erin Murphy, DFL-St. Paul, “but it’s going to be like threading a really small needle to find something we can afford that provides the care for people who are sick and to make sure there’s a financial cushion for providers who care for them.”

Senate Health Finance Division Chair Linda Berglin, DFL-Minneapolis, has held a few work sessions with affected parties and legislators. “We’re working very hard to try to figure something out,” she said. “The question is whether the governor is going to be interested in having GAMC get fixed or not because no matter how many ideas we have about reform we don’t get enough savings to buy back a program that would be even half of the size.”

Sen. Linda Berglin

Sen. Linda Berglin

So, what is the governor’s stance?

MinnPost asked about Pawlenty’s parameters for a new GAMC proposal. Spokesman Brian McClung responded in an email: “Health and human services spending is on an unsustainable path, compared to growth in the economy and the rest of the state budget.”

Asked if the governor is taking a wait-and-see approach on GAMC funding, given the pending federal legislation, McClung wrote: “The federal health care reform legislation will likely be passed in advance of the 2010 legislative session, so the features contained in the federal bill will certainly inform actions that might be taken during the 2010 session. The vast majority of people now in GAMC are eligible for MinnesotaCare” (the health-insurance program for low-income residents).

Revenue forecast due next month
Looming on the horizon is the November tax-revenue forecast, when the state should know how big of a budget deficit is expected. Sales-tax receipts for the quarter ending Sept. 30 were down 13.5 percent and individual income tax receipts were down 7 percent from the same period a year ago. Corporate tax income is down, too.

Any resolution of the GAMC issue may come down to three Republican votes, the number needed for the two-thirds majority to override another veto. Abeler’s could be one of them. He has crossed party lines in the past, he said.

Could the DFL majority in the House rally three Republicans to override a veto if necessary?

“It’s a little more complex than that,” said Murphy, the House assistant majority leader and a nurse who serves with Abeler on the Health Care Finance Division. “Because Gov. Pawlenty has chosen to use unallotment in a much expanded way, from my perspective we could come up with legislation to reform and rebuild GAMC, and we could get the support of three Republicans, and the governor could still choose to use unallotment to undermine that. It’s imperative we work in a bipartisan fashion, and I think it’s absolutely imperative that we address this issue this session.”

As vice chair for the House Health Finance Division and a broker of sorts between the administration and lawmakers, Abeler said he was “just as astonished” as other lawmakers and the public when Pawlenty signed the Health and Human Services Omnibus bill but struck the funding for GAMC.

“When I heard about the line-item veto I thought, ‘this will create some dialogue’ and it didn’t — it just created more rock-throwing,” Abeler said. “Then it became political, and the politics of GAMC are very urban in nature. Even though the GAMC population is scattered about the state, it’s heavily concentrated in the urban area and the Democrats rule the urban world 100 percent. I live in Anoka. Do you know how many calls I’ve gotten in the suburbs about GAMC? Two — and that’s counting the activists.”

That gap between urban and suburban-outstate interests is part of the problem, advocates for the poor say. As they try to spread the word about what’s at risk for the poorest of the poor and the health providers who care for them, they find many Minnesotans are unfamiliar with the program.

“Most Minnesotans think GAMC makes really nice cars, so that’s the barrier we have,” said Ness of Catholic Charities. “But when you talk about people who are sleeping under bridges and in shelters, who are really at what people say is the bottom of society, they say, ‘Yes, the state should play a role in their health care. … There’s a broad understanding that not only is it morally correct but it’s also fiscally wise to respond to this with state funding.”

Who receives GAMC?
To become eligible for GAMC, recipients can’t earn more than 75 percent of federal poverty guidelines, which is about $8,000 for a single adult. Many earn less than $2,500 a year, said Ness, explaining that’s about the annual amount of a welfare payment called General Assistance.

More than 41 percent of GAMC enrollees live in Hennepin County, according to demographic data [PDF] from the state Department of Human Services. Ramsey County has the next-largest share of GAMC recipients: 12.6 percent.

Overall, nearly 28 percent of recipients say they are homeless. Nearly 56 percent of all recipients are white, and African-Americans account for 31 percent of the population. Nearly 66 percent of recipients are male.

Mental-health issues and/or chemical dependency are prevalent among the population: 31 percent of recipients are diagnosed with both problems; 16.1 percent with chemical dependency only and 13.3 percent mental health only. Otherwise, 39 percent are free of those problems.

From six-figure income to no work
Inconsolable after his wife’s death from cancer, Sam Joyner says he took his savings and traveled the country on a Greyhound bus. Eventually he ran out of money and spent time among the homeless in Minneapolis, picking up any odd job he could — from janitor to mailroom sorter. It was a long way from his six-figure job as a salesman while his wife was alive. Eventually, his degenerative disk disease caught up with him and he couldn’t work at all.

“My back was so bad,” he said. “For the last couple of years I’ve spent most of my time bedridden or sitting in chair because moving aggravated everything.” All that started changing in February, when he took Rep. Abeler’s advice and started seeing a chiropractor. GAMC allows 24 chiropractic treatments annually.

GAMC recipient Robin Simpson’s last job was as a live-in nanny, but for many years she waited tables at restaurants. Now, she’s a live-in caregiver for her 79-year-old mother, who is recovering from breast cancer and dealing with ulcerated sores on her feet.

Simpson, 50, and her mom, Estelle Elledge, live in a trailer court in Oakdale and scrape by on Elledge’s food stamps and Social Security as well as Simpson’s $203 a month from General Assistance. Simpson is in the process of applying for Social Security disability because of a herniated disk and a foot problem that makes it difficult for her to stand or work.

While the federal Medicare program has covered Elledge’s health care since she turned 65, only recently did her daughter become eligible for the state program.

Long-neglected ailments
Like many previously uninsured adults, Simpson is playing catch-up on her long-neglected ailments including decaying teeth and depression. Also like many of the estimated GAMC enrollees, she’s worried about the safety-net program going away March 1 and about sliding back into despair about her ailments.

“I just think Gov. Pawlenty should look out for people who are trying to take care of our families in difficult situations and can’t go out there and get work because of medical problems and the situation at home,” Simpson said. “If it wasn’t for this medical care, who’s to say we can be around for the people who have taken care of us all our lives?”

Simpson and Joyner don’t necessarily fit some of the stereotypes of GAMC recipients, and that’s part of the issue in crafting a solution to resurrect the program after March 1.

“Because there are different groups, the solution for each group does not necessarily work for other groups,” said Sen. Berglin. “If you have people who are applying for disability (through Social Security), that’s one group of people and what you do for that group of people isn’t going to work for people who are chronically mentally ill and showing up in the hospital emergency room eight times a year. … It is smart to look at categories and solutions that work best” for them.

Though the governor has said that GAMC recipients would be eligible for MinnesotaCare, Berglin and others say it’s not that simple. Legislators will need to work quickly at the start of the 2010 session to create a solution for GAMC.

“If you throw 35,000 people off a program and a month later you fix it, then what? You have all these costs of notifying and dis-enrolling them and notifying and re-enrolling,” Berglin said. “If we miss that date, I think the chances of getting solution for it become much less likely.”

Premiums and co-pays too much for poor
Another problem with MinnesotaCare is that it charges premiums and co-pays to low-income residents.

What if you don’t have an address or a checking account from which to deduct the premiums? Twenty-eight percent of current GAMC enrollees are homeless. Even if they’re receiving $203 a month in General Assistance, a co-pay is unaffordable, their advocates say.

“I don’t think people realize that a $10 co-pay for someone who gets $203 a month equals a $1,500 co-pay for someone making $30,000 a year,” said Monica Nilsson, director of street outreach for St. Stephen’s Human Services in Minneapolis. “Are you willing to pay a $1,500 co-pay? Of course not.”

MinnesotaCare also has a four-month lag before it starts paying for services, which is a problem for poor people dependent on prescription medications.

Nilsson said St. Stephen’s is hearing from homeless clients who are worried about where they’ll get their meds once GAMC expires. Some have said they’re trying to wean themselves or stockpile their meds, she said.

She’s also warning the downtown Minneapolis community, the police department and businesses about what’s to come if GAMC goes away and there’s a four-month wait to qualify for MinnesotaCare.

“They’re always complaining about panhandling and people causing disturbances,” Nilsson said, “and I’ve been saying that if you think we have an economic development issue now, just wait until our folks can’t get their anti-psychotic meds. There will be a lot more people talking to themselves” on March 1.

The other question is whether there will be enough money generated by a health-access fee paid by providers to fund MinnesotaCare to cover 35,000 more people.

“DHS is assessing and analyzing options that exist under current law for GAMC enrollees, and that we can administratively implement, to assist and provide health care services for current GAMC enrollees and future applicants,” DHS communications manager Karen Smigielski wrote in an email. “We are also providing information and technical assistance to legislators and others interested in GAMC alternatives. Because any transition would be handled administratively, no specific funding has been set aside.”

Which institutions are hit the hardest?
About 55 percent of GAMC funding goes to hospitals, where the poor and uninsured typically show up in emergency rooms, according to the DHS. The rest goes to outpatient clinics and health-care providers.

On this point most legislators can agree: Hennepin County Medical Center in Minneapolis, the state’s primary public safety-net hospital and trauma center, will feel the most pain if GAMC goes away. It stands to lose $43 million in funding in 2010-11. Regions Hospital in St. Paul is next in line, anticipating a loss of $23 million in the first year.

“We understand there’s a budget problem at the state of Minnesota, however the patient population doesn’t go away” if GAMC is cut, said Mike Harristhal, HCMC’s vice president for public policy. “Those patients will still be here, and the institutions that serve them are vitally important to the community. So, we really need the creativity and statesmanship of policymakers to figure out a way to get through this crisis or else we will suffer longer-term consequences that would include a state with not quite as healthy a population and ultimately fewer health professionals.”

One way or another, even Minnesotans with health insurance will suffer the loss of GAMC.

“It’s about cost-shifting,” said Regions CEO Brock Nelson. “These patients will continue to get care but it will be cost-shifted to (insurers) and those who pay the bill including employers, employees, etc.”

Regions has called attention to the plight of its GAMC recipients with a weekly email distributed to lawmakers, the governor and the media about that week’s costs and a story of the week about a GAMC patient. “I was amazed at the first report that was sent out,” Nelson said. “My email was barraged with the number of responses about it. That alone shows it’s very impactful.” Here’s the report from June 22.

Across the river, HCMC’s patient population breaks down this way: 45 percent of patients receive either Medical Assistance/Medicaid or GAMC; about 22 percent receive Medicare; between 23 and 25 percent are commercially insured and 8 percent are uninsured.

What kind of cost-shifting occurs at HCMC?

“As much as I can get away with in that small 23-25 percent (insured) population,” said Chief Financial Officer Larry Kryzaniak. To cover a $43 million loss on its own, HCMC would have to raise rates to insurers by 33 percent.

Could he get it? Kryzaniak laughs. “I happen to be friends with some of the people at the health plans and I can hear the laughter already.”

Cuts and delays
HCMC executives and Hennepin County commissioners have been busy trying to figure out what services the hospital can cut and which capital projects they can delay. Hennepin County taxpayers provide 5 percent of HCMC’s $550 million annual budget, and the county in effect is the hospital’s “banking backstop and line of credit,” said Kryzaniak.

County commissioners are considering a 3 percent property tax increase to support HCMC, which would bring in about $18 million but still leaves “a big hole” in the budget, Board Chairman Mike Opat said. For an owner of a $250,000 home, the annual bill would be $30 higher.

Commissioner Mike Opat

Commissioner Mike Opat

Among the extreme measures under consideration: restricting access to Hennepin County residents, closing outpatient clinics, shutting down some programs such as statewide poison control, and training fewer doctors, nurses and others from the area’s medical schools.

HCMC also recently announced that it would form a private foundation to help raise money for the hospital. Many hospitals, including Regions, already have fund-raising foundations to help support their services and expansion plans.

“I’m disappointed in the governor,” Opat said. “This is breaking faith with state policy in terms of providing health care for the poor. … I don’t get the sense that the governor and DHS commissioner (Cal Ludeman) are willing to help. It’s particularly disheartening to have the result of a meeting with the DHS commissioner to be a shrug of the shoulders and say, ‘We feel for you.’ “

MinnPost tried to get a response from Ludeman. Smigielski of DHS wrote in an email that Ludeman would not be available for an interview with MinnPost about GAMC. Communications staff also would not make an administrator available to answer questions.

Why can’t Minnesota’s nonprofit tax-exempt hospitals simply absorb the costs of uninsured patients? Isn’t there a tacit understanding, at least in Minnesota, that taking care of the poor and uninsured needs to be built into hospital budgets?

Pressure all around
“There’s no question, our No. 1 mission is we are here for the community, we’re nonprofit and we do everything in our power to serve the community,” said Ken Paulus, CEO of Allina Hospitals & Clinics, who estimates that Allina’s various entities could lose up to $40 million in GAMC funding over a two-year period. “Our goals and motives aren’t profitability or financial gain, if you will. One of our major problems is that if all of our different sources of reimbursement continue to be under pressure, then we just can’t run a viable business.”

Part of the problem is that reserves are dwindling because of stock-market losses in 2008, said Lawrence Massa, president and CEO of the Minnesota Hospital Association.

“The balance sheets of all of our members have really been ravaged by the stock market decline,” Massa said. “They’ve all shown losses from investment earnings and hospitals need to maintain fund balances. Systems like a Fairview or a Mayo are big systems with lots of capital needs. That fund balance is there to ensure that they continue to go on long into the future — and that’s the beauty of a nonprofit delivery system like we have here in Minnesota. We’re able to plow those any kinds of gains we make into reserves that can create additional benefit in the future.”

For example, Allina’s portfolio lost $129.3 million between 2007 and 2008, according to its financial report. At the end of 2008, the portfolio was $698.4 million.

What was the governor thinking?
Observers believe that Pawlenty, faced with a $4.8 billion budget deficit during the last session and refusing to increase taxes, went in search of general fund expenses he could slash.

In his veto letter of May 14, Pawlenty said the rate of growth in health and human services spending was “unsustainable,” citing that it is forecast to grow 15 percent in this biennium and 30 percent in the next. He also said legislators have enough time in the session beginning Feb. 4 to come up with a compromise before March 1.

“By doing that, he makes it look like legislators have the opportunity to fix it,” Sen. Berglin says. “But in reality — we’re actually tracking the money on a monthly basis — it’s not the date that GAMC expires, it’s based on the amount of money available. So the program could end sooner than March 1. We know we’re running 3.2 percent higher than projected. At that rate, we won’t have enough money to take the program into March.”

Going forward, some advocates believe Pawlenty is “receptive” to ideas, said Michael Scandrett, who is heading up the GAMC Alliance, which consists of about 50 advocacy groups seeking to keep the program. “He’s got these basic bottom-line principles, which are no new taxes or increases and no major increases in state spending. There are other ways to accomplish this so it’s consistent with his principles but he’s not giving advance guidance.”

Others believe politics and constituencies played a role and continue to do so.

“I think it was an easy cut for the governor to make because it falls on one hospital or two and it’s a nuisance to other hospitals,” said Opat, the Hennepin County commissioner. “I think it was done in a rather cavalier fashion and an irresponsible fashion.”

Was it political? “It’s reasonably political,” Opat said. “It certainly isn’t his core constituency that’s hurt.” Did it have anything to do with Pawlenty’s national ambitions? “I’m not going to touch that one.”

MinnPost posed this question to Pawlenty: What do you say to critics who think you are turning a cold shoulder to the poor during a deep recession, and that you are more focused on running for national office than on helping vulnerable Minnesotans?

McClung, his spokesman, responded in email:

“The generosity of Minnesota’s government-subsidized health care programs far surpasses that found in virtually any other state. We have expanded programs in recent years that other states don’t even have. We have the second-lowest level of people without health insurance in the nation. However, it would be irresponsible for state government to allow these programs to grow at a rate that far exceeds inflation year-after-year.

“The explosive growth in health and human services is jeopardizing the state’s ability to fund education, public safety and other important programs. State government is on the brink of becoming nothing more than a giant welfare and social services provider. Dealing with this issue will be an important part of the policy debate in Minnesota for years to come.”

Rep. Abeler joined fellow Republicans in opposing the veto override on May 17. He defends Pawlenty’s unallotment decision, saying the governor is required by the state Constitution to balance the budget.

“Something has to happen or we’re going to ‘humanitarian’ ourselves out of business,” Abeler says. “Democrats will argue ‘but we can’t leave anyone behind.’ Republicans will argue that ‘the lifeboat will sink; we’re trying to rescue all we can.’ [In other words] there’s a fiscal capacity of the lifeboat. You can bring in the last three people but we’ll all drown.”

Joyner, the GAMC recipient, was there for the emotional override vote and he says he’ll be there when the Legislature convenes.

“I was hoping to get Rep. Abeler to swing his vote,” Joyner said. “He’s a Republican but he’s also a chiropractor and he knows what eliminating medical insurance means. … If I get a chance I’m going to confront him in front of everybody: ‘You’re a chiropractor. Are you saying it’s OK to just suffer and not have any medical insurance?’ I’d like to see what he says to that.”

A matter of pragmatism
So, how does Abeler explain his kindness to a GAMC recipient and a vote against an override? “It’s not a matter of kindness — it’s a matter of [being] pragmatic,” he tells MinnPost.

“The irony in all of this,” the six-term lawmaker said, “was here’s a guy (Joyner) who had a ton of GAMC treatment. He had injections, X-rays and therapy … and he didn’t even know about the option of a chiropractor. So, he did all the medical mainstream things first but it’s the less-expensive treatment that worked for him.”

And, he and others concede, it’s a matter of context and politics. After the governor’s veto, Abeler says, no one from the DFL sought his assistance in trying to craft a solution that would be acceptable to both major parties and the governor. “When he vetoed the bill, they quit talking even to me.”

The polarization, he says, is a problem no matter which party controls the respective chambers.“The habits on both sides when they’re in charge are very poor — Republicans are no better than Democrats. They both get D-minuses in reaching across the aisle.… It gets so partisan. Everybody should take a breath.”

Abeler says he’s all for a bipartisan effort but has yet to receive an invitation to pre-session work groups.

“If there were Republicans interested in an override last session, I wish they would have stepped up, sent a note or some other signal,” said Murphy, assistant majority leader. “I am not gifted with the tools of Harry Potter. All I have is a continued openness to work together and even that has been tested in the last year.”

Casey Selix, a news editor and staff writer for MinnPost.com, can be reached at cselix[at]minnpost[dot]com.

180px-Social-Security-cardApplying for Social Security Disability can seem overwhelming at times. There are medical forms to fill out, health questions to answer and many other things to keep track of. Make a list of everything you need, and of the doctors that you have to contact. Check these items off the list as you gather them. Do not get overwhelmed, take it one step at a time. Get a folder to put the information in so it will not get lost. A good idea is to make a copy for yourself of everything you have in case the original gets misplaced along the way. The information in this article only applies to the United States.


  • Social security is a gigantic bureaucracy. Its employees often don’t have time to care about you personally. They handle a lot of cases and talk to a lot of people in the course of a day. Be sure to take down their names and when you talked to them and record your impression of the discussions.
  • Be sure to promptly fill out and return any forms sent to you.
  • According to the law, social security must’ consider your doctor’s medical record and opinion before they send you to their doctor.
  • Make sure to have money for parking!
  • Consider asking a friend or relative to write a letter with your application specifically describing your disabilities. This often helps in the determination phase.
  • If applying without a lawyer: Check out several books on disability. They will guide you through process more easily. There are also websites devoted just to supporting the disabled through the application process. Just remember, you do not necessarily have to pay for advice. Many non-profits provide free representations to disabled people trying to get onto social security.


  • If you are denied, you have 60 days to appeal.
  • This is a long process. In many cases, it can take as long as 18 to 24 months to have your appeal heard. Some have to appeal or reapply even then. Have alternative means to live off.
  • Make sure you take your social security card with you!

Things You’ll Need

  • SS number
  • Birth certificate
  • Social security card
  • Passport
  • Bank statement
  • current utility bill
  • Birth date
  • Place of birth
  • Mother’s maiden name
  • Dependents’ dates of birth, place of birth, and Social Security number
  • If married, partner’s date of birth, place of birth and social security number
  • Parent’s date of birth, birth place and social security numbers
  • Exact dates, including dates illness began; dates you went to a doctor; dates you had test; hospitalization dates
  • Complete work history. Know the dates (at least a year and approximately how long you worked at that place of employment)
  • Tax forms (w-2)
  • Bank account number and routing number – have these available
  • Schooling information can be relevant
  • Doctors’ names and addresses – have these available
  • All financial and income information

Sources and Citations

October 15, 2009

Payments to Social Security and Supplemental Security Income (SSI) beneficiaries will not increase in 2010, marking the first time since 1975 that payments will not automatically rise, Social Security Administration officials said Thursday.

By law, Social Security benefits are required to automatically increase with inflation in what’s termed the Cost-of-Living Adjustment (COLA). But inflation decreased this year, so benefits will remain steady, making 2010 the first year since COLA was put into effect in 1975 that benefits will not rise.

Accordingly, the maximum monthly payment an individual on SSI can receive is $674, while couples can claim up to $1,011 monthly.

In anticipation of this announcement, President Barack Obama asked Congress on Wednesday to provide seniors and people with disabilities a one-time $250 economic recovery payment in 2010. If approved, these payments would mimic a similar one-time payment provided to recipients of Social Security, SSI and a handful of other government benefit programs earlier this year.

“Social Security is doing its job helping Americans maintain their standard of living,” Social Security Commissioner Michael Astrue said in a statement Thursday. “Last year when consumer prices spiked, largely as a result of higher gas prices, beneficiaries received a 5.8 percent COLA, the largest increase since 1982. This year, in light of the human need, we need to support President Obama’s call for us to make another $250 recovery payment for 57 million Americans.”

Copyright © 2009 Disability Scoop, LLC. All Rights Reserved.



WASHINGTON — Many middle-class Americans would still struggle to pay for health insurance despite efforts by President Barack Obama and Democrats to make coverage more affordable.

The legislation advancing in Congress would require all Americans to get insurance — through an employer, a government program or by buying it themselves. But new tax credits to help with premiums won’t go far enough for everyone. Some middle-class families purchasing their own coverage through new insurance exchanges could find it out of reach.

Lawmakers recognize the problem.

“For some people it’s going to be a heavy lift,” said Sen. Tom Carper, D-Del. “We’re doing our best to make sure it’s not an impossible lift.”

Added Sen. Olympia Snowe, R-Maine: “We have no certainty as to whether or not these plans are going to be affordable.” Both are on the Senate Finance Committee, which finished writing a health care bill on Friday.

A new online tool from the Kaiser Family Foundation illustrates the predicament.

The Health Reform Subsidy Calculator provides ballpark estimates of what households of varying incomes and ages would pay under the different Democratic health care bills. The legislation is still a work in progress and the calculator only a rough guide. Nonetheless, the results are revealing.



By Jennifer LaRue Huget |  October 2, 2009

The copy advertising new Cherry 7-Up Antioxidant says, “There’s never been a more delicious way to cherry pick your antioxidant.”

That’s antioxidant, singular.


The drink’s Web site calls the product a “healthy boost” whose “splash of antioxidant” will “help you through your day.”

The antioxidant at hand is Vitamin E, of which an 8-ounce serving of Cherry 7-Up provides 10 percent of the Daily Value. Like other antioxidants, Vitamin E is thought to help protect against heart disease and cancer by interfering with the activity of unfettered oxygen particles — free radicals — that roam your body, causing inflammation and other damage.

But not all Vitamin E is created equal. Studies have shown that Vitamin E in supplement form (as in this 7-Up; more on that in a moment) doesn’t offer protection against cardiovascular disease or cancer; one study in 2004 even showed that very high doses of Vitamin E supplements increased risk of death, though only by a tiny bit. And more recent research suggests that taking Vitamin E supplements may diminish the benefits of exercise.

So it’s generally recommended that we get the 20-odd daily milligrams (the Daily Value is 30 International Units) of Vitamin E we need from such food sources as almonds, wheat germ and leafy greens.

None of which are to be found in Cherry 7-Up Antioxidant. The product, though it is said to be naturally flavored, contains no juice, according to its label. And the ingredient list includes Vitamin E acetate, a man-made supplement.

It’s hard to figure why its makers cherry-picked Vitamin E — and why they didn’t toss in other popular antioxidants such as Vitamin C and Vitamin A while they were at it. At least then they could have touted antioxidants, plural.

In any case, whether you buy it sweetened with high fructose corn syrup or the artificial sweetener Splenda, 7-Up has no nutritional value. But I have to wonder whether adding the antioxidant is a move intended to sidestep a soda tax, should one materialize. Would highly sweetened sodas be exempt from such a tax if their makers could argue that because they contain an antioxidant, they were a source of nutrition and not just another cause of obesity?

Food for thought.

The LeVasseurs (from left): Sarah, Cathy, Paul and Chris

The LeVasseurs (from left): Sarah, Cathy, Paul and Chris

Fairfield Public School has made a few questionable calls to the Department of Children and Families over sick kids.

By Nick Keppler – October 1, 2009

Cathy and Paul LeVasseur thought Fairfield Public Schools understood: Their son Chris was out sick with Lyme disease and wouldn’t be back to school until he was better.

Though he was a bright kid who sailed his way through the Six to Six Magnet School, Chris’ first year at Tomlinson Middle School had been derailed. The seventh-grader came down with a sore throat and fever in September 2008 and was bedridden with joint and muscle pain by the end of October. He also developed serious cognitive problems, his parents say. He could no longer remember the names of household objects. He pointed at them and then huffed in frustration. Fairfield Public Schools sent a tutor to the LeVasseurs’ home, but she was dismissed after Chris banged his head on the table in anguish during lessons.

Cathy LeVasseur says she excused all of his absences. She exchanged e-mails regularly with Chris’ guidance counselor. She met with a “team,” a cluster of school officials put together to guide the education of a child in need of long-term special ed accommodations.

Everyone was on the same page, she assumed.

Cathy was shocked, she says, when she got a call from school social worker Vanessa Constanzo last April, saying she had reported the LeVasseurs to the Department of Children and Families for the suspected “educational neglect” of Chris.




Legislators agree sobering statistics problem for state

By Alicia Yager – Thursday, October 1, 2009

Advocates for Wisconsin Lyme disease groups canvassed the Wisconsin State Capitol Tuesday and Wednesday to meet with legislators and promote their cause.

Marina Andrews, Michele Feltz, Tory Gensichen and Sara Brenner said they were visiting Assembly and Senate members to inform them of state health statistics and promote a Lyme disease documentary, “Under Our Skin,” which will be showing at Sundance Cinemas Oct. 9 to 15.

“What we are trying to convey today is the seriousness of Lyme disease; what an issue it is in Wisconsin and how many people are suffering,” Andrews said.

According to Andrews, the health care costs associated with Lyme disease are a financial burden for many Wisconsin families, and some residents have to go out of state to receive treatment because there are only two specialists in Wisconsin.



KSTPMinnesotans who suffer from chronic Lyme disease have a difficult time finding a doctor to treat them. Two lawmakers proposed legislation they think will change that.

The bill, co-authored by state senators John Marty, DFL-Roseville, and Ray Vandeveer, R-Forest Lake, would protect doctors who prescribe a controversial and aggressive treatment for Lyme disease, a bacterial infection carried by deer ticks.

The treatment is a long-term course of antibiotics that most doctors in Minnesota will not prescribe. Many don’t think it works and others fear they’ll face disciplinary action by the state Board of Medical Practice.



Kim’s Note:  This legislation is desperately needed in Minnesota.  Three other states have recently passed similar bills.  For all those doctors who say there is no proof long-term antibiotics work.  I AM PROOF!  I do IV antibiotics twice a day and in the past two weeks, my tremor has calmed.  Co-incidence?  After shaking for two years, I think not!  Thank you KSTP for doing this story!  //Kim

mngraphNew bill would protect physicians who prescribe long-term therapy

by Debra Neutkens, Staff Writer – September 22, 2009

FOREST LAKE — Those who suffer chronic, debilitating Lyme disease have only a handful of doctors, maybe three in the state, willing to treat them.

There are probably more, but those physicians are forced to fly under the radar when it comes to aggressive treatment for the tick-bite malady.

Legislation introduced by Sen. John Marty, DFL-Roseville, and Sen. Ray Vandeveer, R-Forest Lake, hopes to change that.

Senate Bill No. 1631 allows a doctor to treat chronic Lyme disease without fear of disciplinary action by the state Board of Medical Practice. The legislation is based on a Connecticut law allowing physicians to use their best clinical judgment when treating Lyme disease.

Three states, Connecticut, Rhode Island and California, have passed similar bills to protect physicians.

Marty, who is chair of the Senate health committee, acknowledged a lack of consensus on Lyme treatment in a statement released last month. Even doctors in other states feel they will face severe repercussions for treating patients, he said after a lawmaker’s meeting with state and national Lyme health experts.



Kim’s note:  This is a bill I have been active in trying to get into the next legislative session.  Although there are many others more active than I have been, (and I thank you all), this bill will help people, just like me.  I do two IV treatments a day and have a home healthcare nurse.  At $200 a day!   Shouldn’t I have the right to this treatment if I feel it is benefiting me?  I believe I should.

It is sad that this disease has become so politicized that it has to come down to legislation, but that is how the game is played.  So, we will play hard.

Minnesota has the 8th most cases of Lyme in the United States.  This could effect you, too.  Although, I hope not, but Lyme can happen to anyone, and this legislation is needed for those of us with the disease to get proper treatment.  There is truly a shortage of doctors who will treat this in Minnesota, yet, the disease is so pervasive!  Please, contact your State Senator about MN Senate Bill 1631.  //Kim

insslideA Constitutional Debate Over a Health Care Mandate

By Katharine Q. Seelye, September 26, 2009

The requirement that everyone buy health insurance moved a step closer to reality last week — and possibly a step closer to being challenged in court.

Conservatives and libertarians, mostly, have been advancing the theory lately that the individual mandate, in which the government would compel everyone to buy insurance or pay a penalty, is unconstitutional.

“I think an individual mandate will pass, and I think it’s going to be very vulnerable because it exceeds Congress’s constitutional authority,” said David Rivkin, a lawyer who served in the Justice Department under Presidents Ronald Reagan and George Bush. Mr. Rivkin spelled out his argument in a recent op-ed article in The Wall Street Journal that he co-wrote.

“If you say the government can mandate your behavior as far as this type of insurance goes,” he said, “there will be nothing the government can’t do. They can control every single way in which you dispose of your income.”



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