Dayton set to expand state's Medicaid enrollment

Mark Dayton
Gov. Mark Dayton gives his inaugural address at the Landmark Center in St. Paul on January 3, 2011.
MPR Photo/Nikki Tundel

Gov. Mark Dayton is expected today to put an end to an eight-month discussion over whether the state should enroll thousands of low- and middle-income Minnesotans into an expanded federal health care program.

Dayton is scheduled to sign an executive order that would expand Medicaid coverage in Minnesota -- a move Republicans in the Legislature oppose. Dayton's decision won't put an end to the debate.

At the end of the 2010 legislative session, a budget deal allowed former Gov. Tim Pawlenty and whoever was elected to succeed him to decide whether to enroll in an expanded federal Medicaid program.

The move was allowed under the new federal health care law, and Pawlenty quickly rejected the option.

Dayton will make good on his campaign promise of enrolling in the program at a signing ceremony this morning.

"This to me is the easiest, most straightforward decision that any governor can make," he said.

Dayton's action means as many as 100,000 low- and middle-income Minnesotans will be shifted from two state-based health care programs into the more generous federal Medicaid program. It also means upwards of $1.4 billion in federal money will start flowing to the state's hospitals and clinics.

"This is about how we can provide health care to the poorest 100,000 Minnesotans and allow our hospitals and clinics and health care providers to provide the best possible health care to all of us," Dayton said. "It is such an obvious decision that I'm astounded that anybody other than the political attack squads even think this is something to be debated or considered at all."

But Democrats and Republicans disagree over where the federal health care law will lead the state, and the program's price-tag. The dispute centers on the best way to cover low-income childless adults but also highlights the partisan divide over the federal health care law.

Republicans won control of the U.S. House of Representatives in part because they campaigned heavily against the law, which they derisively call "Obamacare." The new Republican leaders of the House have pledged to repeal the measure -- a difficult task as Democrats still control the Senate and the White House.

State Rep. Jim Abeler, R-Anoka, said the uncertainty of the future of the health care law, expanding Medicaid in Minnesota is too risky.

"It may provide some better services, but I'm afraid that the whole reform is based on mythical money that Washington will fund ... as they go deeper in debt to pay for all of our programs," Abeler said. "For all of the niceties that it may bring, it's a deep concern of mine."

But Minnesota hospital officials are applauding the move. According to the state Department of Human Services, 12,000 currently uninsured Minnesotans will receive health care coverage under the expansion. It also means another 83,000 people currently enrolled in state-based programs will receive better benefits, including dental services.

Pawlenty administration officials said it would take until October to enroll people in the new program, but Dayton said he wants to do before then.

Mike Harristhal, a vice president at Hennepin County Medical Center, said HCMC will see an additional $42 million a year under the Medicaid expansion.

"This is a good thing for those of us that believe a healthier population that has access to services can be a more productive population long-term," Harristhal said.

Democrats and Republicans disagree about how much expanding Medicaid will cost the state. Finance officials say extending benefits will cost Minnesota's general fund $384 million over the next two years -- a number they say is already factored into the state's projected $6.2 billion budget deficit.

But Democrats point out that the state's Health Care Access Fund will see a savings of $416 million over the same time period. That's because people who were scheduled to enroll in the MinnesotaCare insurance program will shift to Medicaid.