Dayton reversing Pawlenty's healthcare policies

Gov. Mark Dayton wasted no time setting himself apart from his predecessor.

On Jan. 5, two days after taking office, Dayton signed two executive orders that sharply contrasted Tim Pawlenty’s stance on what the former governor called “Obamacare.”

One signature reversed an executive order Pawlenty signed in August restricting the state’s use of federal health care funding. Pawlenty’s order funneled all funding applications through his office for approval.

The other order signed Minnesota up for early enrollment in Medicaid, the federal low-income health program. With that comes more than $1 billion in federal funding that will extend coverage to about 95,000 poor Minnesotans, according to Dayton’s office.

And Thursday, Dayton announced that expansion of Minnesota’s Medicaid program, called Medical Assistance, will begin on March 1 — seven months ahead of Pawlenty’s scheduled start date.

Dayton’s decision, among his first actions as governor, opened the state’s doors to more than $1.2 billion in resources that Pawlenty had rejected.

“This is a step that benefits all of the people of our state at no, and I repeat no, net cost to the state of Minnesota,” Dayton said in a press release.

The Minnesota Medical Association was pleased to see Dayton follow up on the promise of early MA expansion he made during his campaign, said Dave Renner, director of state and federal legislation.

MMA and other medical associations in the state criticized Pawlenty’s decision to limit federal funding.

“It seemed a strange way to turn down federal money,” Renner said. “Does that mean we support the government takeover of health care? No, absolutely not, and I don’t think that’s the direction these grants are going to go.”

Dayton’s appointee to head the Minnesota Department of Health, Dr. Ed Ehlinger, said Pawlenty’s stance slowed the implementation of reform but didn’t cause any permanent losses in funding.

“We’re just going to have to work faster and harder to get back to where we should be.”

Among the funding that Pawlenty turned away was a $1 million grant to aid states in establishing insurance exchange programs. These exchanges — made necessary by the federal mandate that all citizens must have health insurance — are meant to extend coverage to employees of small businesses that don’t currently offer health insurance and other consumers.

Dayton announced Thursday that Minnesota will re-apply for that grant. He said he had spoken with the U.S. Department of Health and Human Services, which told him that Minnesota will receive the funding March 1.

If a state doesn’t establish its own exchange, the federal government will instate one. Minnesota’s health care system makes it a good candidate to build its own exchange, said professor Lynn Blewett from the University of Minnesota’s School of Public Health.

State agencies like MDH are moving forward in their plans for health care reform, but the conversation about whether the federal government has overstepped its authority continues.

With Republicans gaining majorities in the U.S. House of Representatives and both branches of the state Legislature, that conversation has intensified.

State Sen. David Hann, R-Eden Prairie, introduced a bill earlier this month that would stop Medicaid funding in Minnesota.

“This is bad policy, and I think it is very destructive of the idea that we are an independent, self-governing nation,” Hann said.

Dayton has promised to veto any attempts to halt Medical Assistance expansion, but Hann hopes to convince the governor in the coming months that the state could craft better reform without involvement from Washington, D.C.

“I think it’s unfortunate that the governor is not wise enough to see that,” he said.

The U.S. House voted Jan. 9 to repeal the health care reform act across the country, but it was little more than a symbolic gesture. The measure would likely fail if brought to a vote in the U.S. Senate, in which Democrats still hold a majority.

Blewett and the rest of the School of Public Health have been monitoring the debate, but the heated struggle is unlikely to have any impact for the time being, she said.

“Many states are moving ahead as planned,” Blewett said.

“So until there’s actual legislation and change to any specific part of the bill, I think you have to keep moving in good faith [and assume] that things are going to be implemented.”