Sam Stein contributed to this report.
Although Minnesota Gov. Tim Pawlenty (R) on Tuesday signed an executive order aimed at keeping the Patient Protection and Affordable Health Care Act out of the state, he has also approved a budget that encourages state agencies to apply for grants funded by that very same health care law.
Pawlenty's executive order explicitly states, "All executive branch departments and agencies are directed that no application shall be submitted to the federal government in connection with requests for grant funding for programs and demonstration projects deriving from the Patient Protection and Affordable Care Act ("PPACA" or "the Act") (Pub.L. 111-148) unless otherwise required by law, or approved by the office of the Governor."
But in Minnesota's Special Session Budget, signed by Pawlenty on May 21, the state health commissioner is directed to apply for grants from this exact law:
-- Sec. 19. [256B.0755] HEALTH CARE DELIVERY SYSTEMS DEMONSTRATION PROJECT. Subdivision 1. Implementation. (a) The commissioner shall develop and authorize a demonstration project to test alternative and innovative health care delivery systems, including accountable care organizations that provide services to a specified patient population for an agreed upon total cost of care or risk-gain sharing payment arrangement. The commissioner shall develop a request for proposals for participation in the demonstration project in consultation with hospitals, primary care providers, health plans, and other key stakeholders... Subd. 6. Federal approval. The commissioner shall apply for any federal waivers or other federal approval required to implement this section. The commissioner shall also apply for any applicable grant or demonstration under the Patient Protection and Affordable Health Care Act, Public Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law 111-152, that would further the purposes of or assist in the establishment of accountable care organizations.
-- Sec. 20. [256B.0756] HENNEPIN AND RAMSEY COUNTIES PILOT PROGRAM. (a) The commissioner, upon federal approval of a new waiver request or amendment of an existing demonstration, may establish a pilot program in Hennepin County or Ramsey County, or both, to test alternative and innovative integrated health care delivery networks...(g) The commissioner shall apply to the federal government for, or as appropriate, cooperate with counties, providers, or other entities that are applying for any applicable grant or demonstration under the Patient Protection and Affordable Health Care Act, Public Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law 111-152, that would further the purposes of or assist in the creation of an integrated health care delivery network for the purposes of this subdivision, including, but not limited to, a global payment demonstration or the community-based collaborative care network grants.
-- Sec. 3. FEDERAL HEALTH CARE REFORM DEMONSTRATION PROJECTS AND GRANTS. (a) The commissioner of human services shall seek to participate in the following demonstration projects, or apply for the following grants, as described in the federal Patient Protection and Affordable Care Act, Public Law 111-148.
--"Sec. 3. FEDERAL HEALTH CARE REFORM DEMONSTRATION PROJECTS AND GRANTS... (c) The commissioner of health shall apply for federal grants available under the federal Patient Protection and Affordable Care Act, Public Law 111-148, for purposes of funding wellness and prevention, and health improvement programs. To the extent possible under federal law, the commissioner of health must utilize the state health improvement program, established under Minnesota Statutes, section 145.986, to implement grant programs related to wellness and prevention, and health improvement, for which the state receives funding under the federal Patient Protection and Affordable Care Act, Public Law 111-148.
On May 17, Politico reported that Pawlenty's budget was passed "over the protests of angry Democrats" who did not get some of their top priorities included. "We have some pretty clear values and principles in mind that we adhere to and when it relates to those core values and principles we don't compromise on," Pawlenty said of his budget. The Minneapolis Star Tribune also noted that Pawlenty "boasted that the agreement was the culmination of a historic change of course for Minnesota on his watch."
As the Huffington Post reported yesterday, Pawlenty turned down federal funds for comprehensive sex education because he "opposes Obamacare and he is striving to find ways to stop its implementation in Minnesota," but he also applied for abstinence-only grants that also come out of the Affordable Care Act.
UPDATE: Pawlenty Communications Director Bruce Gordon responded to the Huffington Post in an e-mail, writing, "As addressed in the Governor's Executive order, the state will only apply for grants if they are required by law or are consistent with our policy direction."
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