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 PawlentyâÄôs stance on what the former governor called âÄúObamacare.âÄù
One signature reversed an executive order Pawlenty signed in August restricting the stateâÄôs use of federal health care funding. PawlentyâÄôs 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 DaytonâÄôs office.
And Thursday, Dayton announced that expansion of MinnesotaâÄôs Medicaid program, called Medical Assistance, will begin on March 1 âÄî seven months ahead of PawlentyâÄôs scheduled start date.
DaytonâÄôs decision, among his first actions as governor, opened the stateâÄôs doors to more than $1.2 billion in resources that Pawlenty had rejected.
âÄúThis 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,âÄù 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 PawlentyâÄôs decision to limit federal funding.
âÄúIt seemed a strange way to turn down federal money,âÄù Renner said. âÄúDoes that mean we support the government takeover of health care? No, absolutely not, and I donâÄôt think thatâÄôs the direction these grants are going to go.âÄù
DaytonâÄôs appointee to head the Minnesota Department of Health, Dr. Ed Ehlinger, said PawlentyâÄôs stance slowed the implementation of reform but didnâÄôt cause any permanent losses in funding.
âÄúWeâÄôre just going to have to work faster and harder to get back to where we should be.âÄù
Among the funding that Pawlenty turned away was a $1 million grant to aid states in establishing insurance exchange programs. These exchanges âÄî made necessary by the federal mandate that all citizens must have health insurance âÄî are meant to extend coverage to employees of small businesses that donâÄôt 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 doesnâÄôt establish its own exchange, the federal government will instate one. MinnesotaâÄôs health care system makes it a good candidate to build its own exchange, said professor Lynn Blewett from the University of MinnesotaâÄôs 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.
âÄúThis is bad policy, and I think it is very destructive of the idea that we are an independent, self-governing nation,âÄù 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.
âÄúI think itâÄôs unfortunate that the governor is not wise enough to see that,âÄù 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.
âÄúMany states are moving ahead as planned,âÄù Blewett said.
âÄúSo until thereâÄôs 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.âÄù