The move is a dramatic shift for Gov. Pawlenty, who cut health insurance coverage and eligibility during his first term in office. Now, Pawlenty says the state should move toward covering every Minnesotan. He says the first step should be to provide health insurance to every Minnesota child. Pawlenty says the state is projecting a budget surplus and thinks a portion of that money should be used to cover the 70,000 uninsured children in Minnesota.
"We now have the resources to provide coverage for those children," Pawlenty said. "I think that's a logical next step in this progression towards universal coverage in Minnesota."
The governor didn't offer specifics or the price-tag for his proposal. He said one option is creating a children's health insurance program with fewer services than those required by adults. Another would extend the MinnesotaCare plan for the working poor. A spokesman says Pawlenty's announcement should not be confused with a single-payer, government-funded health care system which he does not support.
Pawlenty's goal can be seen as good public policy, but it may also be a sign that he intends to work with the DFL-controlled Legislature.
Senate DFLers have introduced bills over the past two years that would provide health insurance coverage to every child. House DFLers, who retook the majority in last week's election, also made covering every child an election-year priority.
DFLer Linda Berglin of Minneapolis, the leading health care expert in the Minnesota Senate, says she's pleased with Pawlenty's announcement, but questions the timing.
"(It is) Absolutely a post-election conversion. We couldn't even get the discussion off of first base on part of our proposal last year," Berglin said.
Berglin's plan, which was defeated in the Legislature last session, would extend coverage through the MinnesotaCare program. She says children in low-income families would have free coverage. The costs of the program would increase as a family's income grows higher.
The House DFL plan would make the MinnesotaCare program more accessible to every Minnesota child. The current plan requires people to live in the state for four months before they're eligible for MinnesotaCare. Health care groups are pleased that Pawlenty and the majority caucuses in the House and Senate have all signed on.
"We've now moved to where everybody wants to do it. It's just now a matter of how you do it and how you do it in a way we can afford and is effective," according to Marc Kimball of the Children's Defense Fund of Minnesota.
Kimball says he's pleased to see a renewed focus on moving to universal health coverage. In recent years, Kimball says, Minnesota has seen an increase in the rate of uninsured children, while other states decreased their number of uninsured. He says 52,000 children didn't have health insurance in Minnesota in 2001. In 2004, that number jumped to 68,000.
"Sixty-eight thousand kds is equal to the same number of kids in Moorhead, St. Cloud, Duluth, Stillwater and Rochester combined, and we think we can do better than that," Kimball said.
During his comments to the Midwest States Health Reform Summit, Pawlenty talked about higher health care costs. In addition, he questioned the effectiveness of HMOs. He said health care costs have increased dramatically over the years even though HMO executives promised to control costs. The governor said the focus should not only be on insuring more children but making sure that the health care system is providing the best care to everyone.
"More access is a worthy goal, but without some improvement in the system, all we're doing then is creating access to a system that is broken and is unsustainable," Pawlenty said.
Pawlenty's plan may have smoother sailing with the Republican caucus than it would have in past years. The biggest critics of MinnesotaCare have either retired or lost their seats. He received a nod of support from one House Republican. Steve Smith of Mound said he's willing to work with the governor on his proposal. He said his two main questions are the details and how much the program would cost.
Lawmakers and public policy experts will begin debating those issues when the Legislative session begins in January.