politics

WASHINGTON - The idea that Minnesota could 'opt out' of the controversial government insurance program at the center of a proposed national health overhaul has received a push from no less a figure than Gov. Tim Pawlenty.

But it will be up to a future Minnesota governor, and a future legislature, to decide whether the 519,000 Minnesotans who lack insurance will be able to sign up for the so-called public option.

As congressional debate intensifies, with meetings over the weekend and a closed-door pep talk from President Obama on Sunday, Republican opponents in Minnesota are already planning to fight on against what they see as a government takeover of health care.

Along with legislators in at least a dozen other states, they have introduced measures to limit or oppose parts of the federal health care package, from universal insurance mandates to the public option.

The stakes are high. According to federal estimates, 875,000 Minnesotans could be directly affected: the 519,000 uninsured, plus another 356,000 with nongroup coverage who could be eligible for health insurance through a federal exchange that includes the public option.

Should it pass, the health care overhaul would not be fully phased in until 2014. That would give state politicians the 2010 gubernatorial race and beyond to shape Minnesota's response to the landmark legislation that will emerge from Congress in the coming weeks or months.

Pawlenty and other Republicans have suggested that the public option -- as currently written in the U.S. Senate -- may be an offer they can't refuse.

That's because Pawlenty and other state Republicans consider the opt-out choice a "sham," saying that Minnesota would still have to pay its share of the federal tab to set up the program, bail it out if it goes in the red, and fund the taxpayer subsidies for states that opt in.

"Regardless of whether states can 'opt-out,' including that option is just a smoke-and-mirrors way to buy votes and push through government-run health care," said Dave Dziok, spokesman for U.S. Rep. Michele Bachmann, the Minnesota Republican who inspired last month's Washington rally against the House Democrats' reform package.

U.S. Sen. Al Franken, a Minnesota Democrat who has championed a national insurance program, disputes the notion that opt-out states would still be on the hook to cover the program's expenses.

"The public option has to stand on its own," Franken said in an interview with the Star Tribune. "There is no federal money going into it other than the seed money that has to be paid back after five years."

Senate Democratic Majority Leader Harry Reid of Nevada, who included the state opt-out provision to win over wavering centrist Democrats in the Senate, calls it "the fairest way to go."

'Shot across the bow'

The opt-out provision has yet to produce the filibuster-proof 60 votes needed for the $848 billion package that Senate Democrats hope to pass by Christmas.

Whatever the final deal in Congress, Minnesota lawmakers are girding themselves for the political battle coming their way.

"We're going to have to get our bills ready in time," said Duluth DFLer Thomas Huntley, chairman of the Minnesota Senate Health Care Finance Committee. Huntley, who supports a public option with negotiated rates, anticipates a full-throttle debate in upcoming legislative sessions.

"It ought to be an issue," he said. "This is the biggest thing that's happened in health and human services since 1965," when Medicare was created.

Minnesota Democrats, like their counterparts in Washington, are of varying minds on the public option, depending on the final version.

"Depending on what it looks like, I might not be in favor of it either," said Sen. Linda Berglin, the DFL's leading voice on health care issues and chairwoman of the Senate's Health and Human Services Budget Committee.

Republicans, while a minority in the Legislature, expect to present unified opposition to the public option.

"I think it's something we could all stand behind," said Fairmont Republican Julie Rosen, assistant Republican leader in the Minnesota Senate. "It would be a long shot that you would find any Republican support."

But DFLers control both chambers in the Legislature. Unless that changes, chances are slim that lawmakers would grant Pawlenty's wish and send a future governor a bill opting out of a national insurance program set up by Congress.

That has not stopped some Republican lawmakers from pushing initiatives that could limit the reach of the Democrats' health reform plans, or at least put the state on record in opposition.

One, authored by former House Minority Leader Marty Seifert, is a resolution inspired by the states' rights movement. Though it has no force of law, it would "affirm Minnesota's sovereignty under the Tenth Amendment" and urge Congress not to impose any unfunded mandates. Presumably that would include future health care costs.

"It's meant more as a broad-based shot across the bow," said Seifert, who said he could see making opposition to the public option an issue in his run for governor next year.

Another GOP gubernatorial candidate, state Rep. Tom Emmer of Delano, recently renewed his push for the Health Care Freedom Act, a proposed constitutional amendment guaranteeing people's rights to make decisions about their own health care.

The proposal, inspired by similar measures in Arizona and Michigan, would not head off the public option, but it would make it hard to enforce the proposed federal mandate requiring nearly everybody to carry health insurance.

As for the public option, Emmer said, "It is an issue for the next election, because people are seriously concerned at the grass-roots level. It's not just a federal issue. It's a state issue."

Kevin Diaz • 202-408-2753