Critics get a say as Dayton opts in on health law

With two orders, he undid the state's stance against more federal health care help.

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In an extraordinary Capitol ceremony where opponents and supporters were invited to speak, Gov. Mark Dayton Wednesday ushered in a new era of health care in Minnesota.

With his signatures on twin executive orders, Dayton, a Democrat who took over from Republican Tim Pawlenty this week welcomed federal funds for health coverage for the poor and reversed Pawlenty's anti-"Obamacare" stance.

Dayton said the actions were "essential for providing better health care for all Minnesotans."

For Minnesota, the signatures were a symbol of more than just policy change.

In an unprecedented move, Dayton welcomed protesters into the august Capitol room where he signed the orders and allowed his detractors to speak from the official governor's podium at his first official news conference, giving action to his promise to open the state to all.

"This is an office where all points of view are honored and respected," he told the hundreds who stuffed themselves into the reception room and spilled out into the hallway.

As two supporters and two opponents spoke from behind the wooden stand emblazoned with the massive state seal, their backers cheered and occasionally booed, while a baby's loud cries filled the stately room.

"It is the people's room. This is where democracy occurs," said Dayton, who told protesters they'd have to be quiet to hear him speak, "because I'm not going to talk any louder."

The move worked. Adults in the room hushed, interrupting with applause but no disruptions, and the new governor found fans even among the most vocal critics.

"I'd like to thank Governor Dayton for giving the opportunity to hear from the opposition. This is really phenomenal that you did it," said Twila Brase, president of the Citizens' Council for Health Care Freedom and a longtime opponent of government involvement in health care.

But Dayton's inclusiveness did not blunt criticism.

"Because it takes away our freedom, because it expands government-run health care, because it puts bureaucrats in charge of patient care, for those reasons we ask Governor Dayton not to sign the executive order," said Brase, who received a handshake from the governor after she spoke.

'Best interests of the state'

Dayton signed the two orders to an array of hoots, cheers and long applause.

One rescinds an executive order Pawlenty signed in August that banned any discretionary grants from the national health care overhaul.

Dayton's order said Pawlenty's order was "not in the best interests of the state."

The new order will allow Minnesota to apply for potentially several million dollars in federal grants to plan for coming changes in health care, educate adolescents on family planning programs and reform long-term care in the state.

The other order, which will have a bigger impact, enrolls Minnesota in an expanded Medicaid plan that uses $1.4 billion in federal money to cover 95,000 of the state's poorest adults.

Although the cost to the state is in some dispute, Dayton said the changes would end up costing Minnesota nothing.

Republicans say that expanding Medicaid, known in Minnesota as Medical Assistance, gives the federal government too much power and relies on funding that might disappear in years to come.

At a legislative House hearing Wednesday, Republicans raised concerns that Congress could pull the promised financing.

"What happens then?" asked newly elected Rep. Bob Barrett, R-Shafer, noting that new Republican majority members in the U.S. House have pledged to overturn the federal health care overhaul law. "Who is liable? Do we find out the $6.2 billion deficit has grown by another billion?"

Chuck Johnson, chief financial officer of the state Department of Human Services, said it's impossible to answer without knowing what action Congress might take.

"In my years of experience, Congress has not suddenly pulled back" from financial obligations, but has given states time to adjust before changing funding, Johnson said.

While Republican lawmakers, who now control the Legislature, complained Tuesday about Dayton's orders, they admitted their power to change them is limited.

State Sen. Warren Limmer, R-Maple Grove, wrote in a letter to Dayton last week that he planned to call a hearing to air his concerns that last year's legislation, which Pawlenty signed and which gave the governor sole authority to opt in to the expansion, was an unconstitutional "delegation of legislative authority to the executive branch."

But Limmer said that point is mostly moot since Dayton has signed the executive order. The time to sue, he said, would have been before the order was signed.

Still unclear is when the new program will kick in.

Under Pawlenty, the Human Services department said the expansion might take as long as 10 months.

Dayton said that long a lead time was irresponsible and unacceptable.

The governor said he would soon appoint a human services commissioner whose first "mandate will be to do everything humanly possible to escalate that timeable."

Staff writer Warren Wolfe contributed to this report. Rachel E. Stassen-Berger • 651-292-0164

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