Let’s see who we’re talking about: low income adults with no dependent children, about 70 percent of whom have mental health or chemical dependency challenges, 40 percent whom have chronic diseases that lead to frequent hospitalization, many are homeless and a large number are homeless veterans. If they saved all their annual income, it might buy a cheap used car.

They’re the people who’ve been called the poorest of the poor.

These are the people who will lose medical coverage when General Assistance Medical Care (GAMC) is gone.

Gov. Tim Pawlenty issued a line-item veto that wiped out all $381 million of that funding for fiscal year 2011, which starts in mid-2010. Then the Legislature failed to override the veto in a party-line vote.

State Rep. Maria Ruud (DFL-Minnetonka) voted to override.

“He chose to line-item veto this particular item,” Ruud said. “I can’t tell you why. It is heartbreaking to me. Out of all my time here, it’s just extremely disturbing to me as a legislator and as a human being.”

Ruud, a nurse practitioner, said this issue cuts to the core of Minnesota values. After the override vote, there was dead silence. She and some other legislators were moved to tears.

In researching this issue, I almost was too. 

But this session, Ruud hasn’t been focusing as much on the moral reasons our society should be taking care of the poor, but rather on why caring for the poor makes economic sense.

Pawlenty, in his letter announcing his plan to veto the funding item, stated that the rate of growth in spending on human services is unsustainable.

But if the poor don’t get health coverage now they’ll still access the system later, Ruud said, and those costs will be shifted to everyone. That means rising health care costs for all. 

“This action by the governor will not lower them, it will only increase them. Because people will continue to get sick and they will continue to go to the hospital and hospitals will have to continue the care,” Ruud said. 

Not only that, but the state stands to lose $100 million in federal matching funds because of the cut, she said. 

In his letter, Pawlenty stated that “many individuals now eligible for GAMC may be eligible under the MinnesotaCare Program.”

But Ruud said MinnesotaCare was meant to be affordable health care for working Minnesotans and added those served by GAMC funding would overburden it. And for the GAMC population, she said, filling out 20-some pages of application materials can be a challenge.

The GAMC population includes as many as 35,000 people, according to the Minnesota Medical Association.

Instead of simply cutting programs like GAMC, Ruud said there needs to be reform that leads to more preventative and educational care. Public policy debate on the economics of such reform has been lacking, she said.

“We don’t pay for things like prevention and education,” Ruud said.

Maybe on the way to the airport when heading to some future meeting with national Republican party leaders, Pawlenty could stop to look the poorest of the poor in the eyes and tell them how Minnesota’s human services spending is unsustainable. 

Or if he’s in too much of a rush to get to Washington, D.C. to make the detour, legislators who voted against the override could fill in for him.