Despite Minnesota Gov. Tim Pawlenty's (R) recent executive order intended to stop the implementation of federal health care reform in Minnesota, millions of dollars from the Patient Protection and Affordable Care Act will still be flowing into the state, with the governor's blessing. The Huffington Post has learned that the state Department of Health is considering 10 federal grants worth more than $10 million in total and the governor's office is allowing all but two of those grants to go forward, highlighting the fact that Pawlenty is more than willing to take advantage of federal money when it fits his agenda.
Pawlenty has been a vocal critic of federal health care reform, and as spokesman Bruce Gordon explained to the Huffington Post, the governor is "striving to find ways to stop its implementation in Minnesota." But the executive order left the door open to allowing some money from federal health reform to flow into Minnesota, as long as it is required by law or authorized by Pawlenty:
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.
In other words, Pawlenty's executive order isn't really keeping the Affordable Care Act out of Minnesota; millions of dollars from the federal law can still flow into the state. The Huffington Post spoke with John Stieger, spokesman for the Minnesota Department of Health, who identified 10 existing grants worth more than $10 million that come from the federal health care law. He said that Pawlenty's office had authorized all but two of them to go forward: the Personal Responsibility Education Program grant that provides funding for comprehensive sex education and the Health Insurance Exchange. Below is a full list (view large file here):
As HuffPost previously reported, Pawlenty is largely picking and choosing federal money based on his ideological preferences. While he is refusing to let the Department of Health apply for comprehensive sex education funds, he is allowing the agency to go forward on an abstinence-only education grant, even though it requires the state to spend its own money on a matching grant.
Minnesota state Rep. Erin Murphy (D) pointed to political motivations for Pawlenty's order, saying that in the past, he embraced some of the concepts -- like insurance exchanges -- that he is now rejecting. She said that although some Affordable Care Act money may still come in, the order will nevertheless affect the state. "We're exploring the opportunity of an exchange in Minnesota," she said. "The grants that we passed by would have provided for working groups -- the actuarial analysis how an exchange impacts our insurance market, and we have a lot of expertise around the table, but we don't have that expertise."
Dr. Lynn Blewett, a University of Minnesota health policy expert who is part of the health insurance exchange working group referenced by Murphy, said that, ironically, Pawlenty's order may have the effect of bringing more federal authority into Minnesota. Blocking the grant will not prevent the state from moving forward with exchanges, but rather, according to Blewett, force the working group to make decisions with the existing data it has. In the case that it won't be able to agree on a state exchange, Minnesota would default to a federal exchange. "It's interesting because it's exactly what he doesn't want to happen," said Blewett. "But by saying no, we're not going to do this, most of the stuff defaults to the federal government."
Pawlenty has been a sharp critic of the federal government's "reckless spending," but in addition to these selected funds from the Affordable Care Act, the governor has accepted $263 million in Medicaid funds, even though they were part of a federal spending package he previously bashed. The Huffington Post contacted Pawlenty's office but did not receive a response.
Medical associations, including the Minnesota Hospital Association, Minnesota Council of Health Plans, and Minnesota Medical Association, have publicly condemned Pawlenty's order, saying, "In the past, the Governor signed comprehensive health reform legislation in Minnesota with many of the same objectives as this federal legislation. We supported these objectives for the state and we support them federally. Gov. Pawlenty's decision leaves Minnesota at an enormous disadvantage."
Sen. Al Franken (D-Minn.) also called walking away from hundreds of millions of dollars in federal funding a "huge mistake." "By rejecting these funds, Minnesotans won't be getting their fair share of benefits," said Franken in a statement . "Even the Mayo Clinic, the state's largest private employer and a national health care leader, has said that this decision jeopardizes Minnesota as a national standard-bearer for care and could seriously hurt the state's economy. There are going to be more opportunities to receive federal funding, and we can't afford to miss out next time. Minnesota has been a leader in health care for decades and it would be a real shame to fall behind the curve."