Federal health law becoming an issue in governor's race

The race for governor usually focuses on state-based issues like K-12 schools, the budget and taxes.

But already in this campaign, federal issues, in particular federal health care, are generating attention.

The main issue is a plan that would shift about 100,000 low-income Minnesotans from two state health programs into a federal program.

"These are Minnesota taxpayer dollars that need to come home. They need to come home to help Minnesotans," said Minnesota House Speaker Margaret Anderson Kelliher, the DFL-endorsed candidate for governor, speaking in Rochester on Monday. During the legislative session, Kelliher pushed to include the Medicaid expansion in the budget deal.

The shift, which requires $188 million more in state funds, would mean roughly $1.4 billion more in federal funds. Republicans balked at the idea and the two sides agreed to allow the next governor to decide the matter.

By raising the issue in Rochester and in other cities, Kelliher is gambling that voters will want federal money to help the state's bottom line and local hospitals, which are some of the largest employers in rural Minnesota.

"They're going to wonder why Tom Emmer does not want to bring Minnesota's tax dollars back to Minnesota, why he wants to be give them to Florida, why he wants to give to Arizona, why he wants to give them to every other states," Kelliher said. "We are one of the lowest states in the country for bringing back our federal tax dollars."

While Kelliher is working to make the issue about Minnesota's share of the federal budget pie, Rep. Emmer, the Republican-endorsed candidate, is working to make it a referendum on the entire federal health care law.

"Folks, the very expansion that they're talking about, the dollars that they want to access is authorized by the federal health care legislation known as ObamaCare, so it's opting into to Obamacare," Emmer said last week at a campaign stop in Moorhead.

By highlighting his opposition to the Medical Assistance option, Emmer is hoping to consolidate support among voters who are opposed to the recently enacted federal health care law. Emmer argues that by opting in to MA, the state would give up the standards it set through the state-based health care programs, General Assistance Medical Care and MinnesotaCare.

"We don't need a federal program destroying the quality and making promises that it simply can't deliver on," Emmer said. "What's the other side? The other side believes that government makes those choices better than we do."

Emmer is correct that the program would shift some low-income Minnesotans from those two state health care programs into a federal program that has stricter standards, and it would mean GAMC would be eliminated and the state funds that pay for it would be directed for the MA enrollment.

But MA isn't a new federal program. Medical Assistance, also known as Medicaid, has been in existence since 1965 and currently covers more than 500,000 Minnesotans. More than half are families; the remaining are seniors and people with disabilities.

Tom Horner, the Independence Party's endorsed candidate for governor, said he'd choose to opt in to the program. He argues it would better suit the state's budget to opt in to Medicaid and then work to change the bad parts of it.

"Not only because it returns $7 in federal money for every $1 in state [money], but it allows us to do a better job of reforming health care, of addressing the unsustainability of public health programs," Horner said.

The other two Democrats in the race, former U.S. Sen. Mark Dayton and former state Rep. Matt Entenza both say they'll enroll in MA if they're elected.

While the issue could be flash point in the current election, it could become less of an issue in the coming years as the state would have to pay for the program only through 2014. The federal government would pick up the entire cost of MA after that.

(MPR News reporters Elizabeth Baier and Dan Gunderson contributed to this report.)