In his first official action since taking office, Gov. Mark Dayton on Wednesday signed an executive order that would expand the federal Medicaid program to cover 95,000 more Minnesotans.
Dayton's action was expected, as it fulfilled a campaign promise. What was surprising was how the governor handled a rowdy group of people who showed up to protest.
Hundreds of people packed into the governor's reception room to watch Dayton sign the two executive orders, in a scene that looked more like a contentious political rally than a signing ceremony.
Protesters arrived with signs challenging Dayton's action and criticizing the federal health care law that Republicans deride as "Obamacare." It was a tense scene as security personnel removed protest signs from the room.
How the event would unfold was uncertain, as some protesters exchanged angry looks with Dayton supporters. The tension mounted when a baby started crying as the governor's news conference started. Then Dayton took the microphone.
"The ground rule is I'm going to speak and then a designated representative or whoever would like to speak against the executive order will have the opportunity to do so next," he said.
Dayton's gesture was stunning. It's rare that protesters are allowed to attend a gubernatorial press conference. It's unheard of that a governor allows them to speak at the podium.
"This is a democracy," Dayton said to applause. "The great thing about a democracy is we can have different points of view and this is an office where all points of view are honored and respected."
Dayton then explained why he thought his action was necessary. His order makes 95,000 more Minnesotans eligible for Medicaid. Most of them are currently covered by other state-based programs, but 12,000 have no insurance at all.
"This is a step that benefits all of the people of our state at no net cost to the state of Minnesota according to the Department of Management and Budget," he said.
State finance officials say the expansion will cost Minnesota $384 million over the next two years, a figure already included in the state's $6.2 billion projected budget deficit. But it means a separate fund used to pay for the state-based MinnesotaCare program will see an increase of $416 million.
One of the critics Dayton allowed to speak said the expansion is too risky. Twila Brase, president of the Citizens Council on Health Care, said the state can't afford the plan's long-term costs.
"It really puts the state in peril when it comes to costs," Brase said. "There is something called tails which means once all of these people are on it will be difficult to get them off and it will be expensive to the state in the long haul."
The debate over the Medicaid expansion reflects disagreement nationwide over the federal health care law. Critics argue the expansion is government overreach. But supporters say those who go without insurance make the health care system more expensive for everyone else.
Sarah Anderson, of St. Paul, said her brother scrambled for cancer treatment after he was denied coverage.
"It is because Governor Dayton's commitment to sign the executive order opting Minnesota into Medicaid that there will not be another sister forced to watch her brother wait days then weeks then months for necessary information and treatment," she said from the podium.
But Ann Marie Ashton said she doesn't think it's the role of the government to ensure health care for its citizens. She spoke to reporters after attending the event with her three children.
"It's the government's responsibility to provide safety for the people but it's not their responsibility to provide welfare or health care," Ashton said. "That's the community's responsibility."
Republican lawmakers complained that Dayton didn't heed their call to study the long-term implications and constitutionality of the expansion. But they say there's little they could do to stop his action.
Officials in the administration of former Gov. Tim Pawlenty have said it could take until October to enroll people in the expanded program, a timeline Dayton called unacceptable.