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Dayton’s medical aid ‘signing ceremony’ turns into a full-fledged political event

What had looked like a typical gubernatorial “signing ceremony” this morning turned into a political event that left Capitol veterans buzzing.

Gov. Mark Dayton made it official today, signing up for expanded federal medical assistance.
MinnPost photo by James Nord
Gov. Mark Dayton signs up for expanded federal medical assistance.

What had looked like a typical gubernatorial “signing ceremony” this morning turned into a political event that left Capitol veterans buzzing.

As promised, Gov. Mark Dayton formally signed the executive order left to him by last year’s Legislature that allows Minnesota’s early enrollment in expanded federal medical assistance. Dayton’s authorization brings Minnesota into the fold of the federal health care reform law passed in March before compliance becomes mandatory in 2014.

But for the event, the new governor ended up with a standing-room-only audience of both protesters and supporters who crowded into the Governor’s Reception Room. They clogged the doorway and even spilled into the hall. Signs poked toward the gilded ceiling with slogans like “what point of NObamacare don’t you GET?”

In a surprise move, Dayton even gave up the podium for a short time to let protesters voice their views, turning the event into more of a debate than a ceremony.

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“This is the people’s room,” Dayton explained of his unusual graciousness. “This is where democracy occurs.”

It quickly quieted the booing crowd, and three anti-“Obamacare” protesters eventually spoke at the podium, effectively cutting Dayton’s presentation short.

Not to be outdone, supporters ranging from health care advocates to such high-profile political figures as former Senate Majority leader Larry Pogemiller, DFL-Minneapolis, and ex-House Speaker Margaret Anderson Kelliher cheered as Dayton signed the order.

The scene’s give-and-take prompted comments of surprise from Capitol observers like this one from Star Tribune political reporter Rachel Stassen-Berger, who tweeted: “In nearly 10 years of covering the Capitol, I’ve never seen an event quite like this one.”

Sen. Larry Pogemiller, who helped push legislative authority for the expanded aid, was on hand for the ceremony.
MinnPost photo by James Nord
Sen. Larry Pogemiller, who helped push legislative authority for the expanded aid, was on hand for the ceremony.

Activists denounced the federal health care law’s constitutionality and questioned the legislation’s long-term costs. Their calls for limiting the government’s role in health care clashed with heartfelt pleas from advocates whom Dayton brought in for the ceremony.

Sarah Anderson, a clinical social worker from St. Paul, described the pain she felt as her brother Eric Halstenson couldn’t find medical assistance while struggling with rare central nervous system cancer. She praised Dayton’s decision.

Her pain was met with understanding, but also with a different sort of solution: God and the church.

“Let’s not trust in a government system, let’s trust the spirit of God in your hearts,” said one protester who didn’t identify himself.

Dayton’s action today is expected to attract roughly $1.2 billion in federal dollars. Following a state match for the next three years, the federal government is expected to start funding the entire program in 2014.

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Protesters -- and supporters -- crowded the room for the signing.
MinnPost photo by James Nord
Protesters — and supporters — crowded the room for the signing.

Under the order, single, childless adults at 75 percent of the poverty line (earning about $8,000 yearly) enrolled in GAMC and MinnesotaCare will be covered by Medicaid when the switch is made.

The opportunity for an executive order came as a compromise with Gov. Tim Pawlenty during the final moments of budget negotiations last session. Although Pawlenty declined to sign the order in July, the Legislature gave the next governor till mid-January to sign up for the federal aid.

Including the compromise in the legislation infuriated some on both sides of the line, said Rep. Tom Huntley, DFL-Duluth. Democrats viewed the move as capitulation to Pawlenty’s cuts, while the Republicans viewed it as a gamble on the state’s next governor.

After Pawlenty effectively “kneecapped” the state’s General Assistance Medical Care program last session, in the words of political commentator Larry Jacobs, a portion of the poorest Minnesotans it covered were dropped. They were forced into to a different state program designed to provide insurance for low income – but still employed – state residents called MinnesotaCare

Because of the expansion, Democrats project that MinnesotaCare’s funding source, previously expected to run a deficit in 2011, will remain solvent until 2013.

Minnesota is only the second state to enroll in the early Medicaid opt-in, said Sen. David Hann, R-Eden Prairie. It was one of roughly 10 states eligible for the option.

Supporters say the move could save up to 20,000 health care jobs in Minnesota because federal funds will give more compensation to providers. They also expect it to expand access for the poor while saving the state a net $32 million into 2013.

Pawlenty originally opposed the early enrollment because he said it would cost the state $430 million over three years. He didn’t account for savings in the Health Care Access fund, which props up MinnesotaCare.

Dayton signed the order today, but it could take up to nine months to begin working, he said.

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“I think there will be some people in human services being fired if they can’t get it done in less time than that,” Huntley said.

Although the first $188 million in state payments for the program are built into the current budget, a projected $6.2 billion deficit for the next biennium could make it difficult to fund the state match.

As Dayton signed the new executive order, he rescinded a Pawlenty mandate from August preventing state agencies from soliciting grants under the federal health care reform law.

Afterward, Senate Republicans at a news conference questioned the constitutionality of a previous Legislature giving a future governor the power to spend “unilaterally.”

“The power of the purse belongs to the Legislature — not last year’s Legislature, but this year’s Legislature,” said. Sen. Warren Limmer, R-Maple Grove.

Limmer wrote a letter to Dayton last week asking the governor to “pause” before signing the order.  He cautioned that the bill’s language authorizing the opt-in wasn’t scrutinized by either house’s judiciary committees.

Senate and House Republicans will not file a lawsuit attempting to repeal the order, Limmer said, although he was concerned a GOP-controlled Congress that’s pledged not to fund the health care bill could saddle Minnesota with further unfunded federal mandates.

There will be Republican initiatives like federal waivers to address the order’s “policy implications” this session, he said.

James Nord, a student at the University of Minnesota, is a MinnPost intern.