Dayton Medicaid order turns into Minn. town hall

ST. PAUL, Minn. — Gov. Mark Dayton shared the podium with tea party protesters on Wednesday as he completed his first official act — deepening Minnesota’s participation in the federal health care overhaul by expanding Medicaid coverage for the poor.

The Democratic governor turned his first news conference into an impromptu town hall meeting, but laid down ground rules before giving equal time to opponents of the Medicaid expansion who jammed into the Capitol reception room.

“This is a public room that belongs to the people of Minnesota, where all points of view are honored,” Dayton said.

The mood was charged and security was heavy as Dayton signed an executive order extending Medicaid coverage to 12,000 uninsured vulnerable adults and 83,000 others who currently get less generous coverage under other state health care programs.

Minnesota is among a small group of states allowed to draw federal money to cover childless adults now because they already had state health care programs for that population. Most states don’t. So far, only Connecticut and the District of Columbia have opted for the early Medicaid expansion. Starting in 2014, the federal government is slated to extend Medicaid to vulnerable adults nationwide.

Former Gov. Tim Pawlenty, a Republican, had refused the Medicaid expansion as he took steps to limit the reach of the health care overhaul in Minnesota. But Pawlenty and the previous Democratic-led Legislature passed a law last year allowing the next governor to opt in through executive order, and Dayton had promised during his campaign to do so.

The move is expected to bring in $1.2 billion in federal money for hospitals, clinics and health care providers.

Dayton said the state is projected to save $32 million through mid-2013, even as it spends nearly $400 million in general-fund dollars on the expansion. That’s because even more money will be saved in a separate fund tied to the MinnesotaCare health care program for the working poor. Republicans who now control the Legislature are wary of the additional general-fund spending as the state faces a $6.2 billion deficit.

“This is the step that benefits all the people of our state at no, and I repeat, no net cost to the state of Minnesota,” Dayton said.

Dayton also signed an order rescinding a Pawlenty directive that prevented state agencies from seeking discretionary grants under the health care law.

Rep. Jim Abeler, who heads a House health care spending panel, warned against banking on the federal money coming in.

“Our state has been victimized by promised federal dollars in the past,” said Abeler, R-Anoka.

The new governor was both booed by protesters and cheered by supporters at his news conference. He entered the room wearing a stern expression, warning those there that they would be ejected if they interrupted the speakers.

One of the supporters who spoke was Sarah Anderson, a social worker from St. Paul who said her brother was denied state coverage while he faced a rare cancer. Dayton stepped forward to quiet the room as she talked. She thanked Dayton for signing the order.

“The health care in Minnesota is far more safe and secure because of Governor Dayton’s actions today, leaving this citizen, this social worker and this sister very humbly grateful,” Anderson said.

Opponents cheered and applauded when Jake McMillian, 31, of Annandale, got up to respond.

“Where is the church to help these people because that is the church’s job and duty in social causes? I don’t find in the constitution where the government’s job is to do that. It’s for nonprofit organizations. It’s for the church to do what it rightfully should do,” he said.

Dayton stood by, listening. Then he signed the order.

19 Replies to “Dayton Medicaid order turns into Minn. town hall”

  1. So thanks to Dayton we are giving more money to people that want handouts and do not deserve a cent from hard working Americans. Let people pay for their own medicine and health bills. Medicare and Medicaid should be declared unconstitutional. These systems are nothing more than government sanctioned ponsi schemes.

  2. So you guys like paying higher taxes to care for people who don’t earn enough money to pay their own bills?

  3. I, too, question the constitutionality of both Medicare and Medicaid (due to their not-really-federalist structure and questionable Section I authorization). However, the question of whether these programs are *constitutional* and whether public medical welfare programs in general are *good public policy* are very different questions. Please do not conflate them.

  4. The U.S. Department of Justice has examined the constitutionality of federal health care programs before and concluded that they do not violate the constitution. See, for example, this 1993 Department of Justice memo regarding the constitutionality of health care reform:

  5. The government is examining whether the government’s own decision is constitutional? That doesn’t make any sense.

  6. Matthew, one responsibility of the U.S. Department of Justice, the Office of Legal Council specifically, is to provide legal advice to the President and all other Executive Branch agencies. This includes, but is not limited to, providing legal advice on constitutional matters: “The Office [of Legal Council] is responsible for providing legal advice to the Executive Branch on all constitutional questions and reviewing pending legislation for constitutionality” (see the Department of Justice-Office of Legal Council website,

  7. OLC’s analyses can be, and often are, dead wrong. For an example of one highly controversial OLC constitutional analyses, see John Yoo’s memos supporting the Bush Administration’s constitutional authority to waterboard terrorist suspects and to hold them in Guantanamo Bay.

    Fact is, those who interpret the Constitution, everywhere in government, are frequently (quite simply) not correct. This is not only true of OLC, but also true of our Supreme Court, which has handed us such legal abominations as Dred Scott v. Sandford, Plessy v. Ferguson, Bradwell v. Illinois, Korematsu v. U.S, Lochner v. New York, Planned Parenthood v. Casey, and (most relevant to this conversation) Wickard v. Filburn, a decision which massively expanded the commerce clause largely due to political pressure from the FDR administration.

    I dissent from Janet Reno’s 1993 conclusions about the constitutionality of national health care programs. I dissent from the Congressional consensus that supports the constitutionality of Medicare/caid — as do many respected legal minds and states attorneys general. And I go one step further and predict with confidence that the current Supreme Court will agree with me when they rule on the “insurance mandate” of the PPACA. Plese is right about that, at least…

  8. Back to the main topic at hand, I think that this quotation which I happened to recently find sums up my view on this and similar matters:

    “Speaking of earning, the revered forty-hour week is for losers. Forty hours should be considered the minimum, not the maximum. You don’t see highly successful people clocking out of the office every afternoon at five. The losers are the ones caught up in that afternoon rush hour. The winners drive home in the dark” (Neal Boortz)

  9. That’s a very sad view of “very successful people.” Very successful people have friends, spouses, children, and leisure. Without these things, you do not have a culture. Without these things, you do not have humanity. We earn money *so as to support these things*, not for its own sake. That is, unless we have imploded in greed or insecurity or another perversion of values.

  10. James, I was not at all suggesting that OLC’s legal advice is conclusive on this or other matters. The constitutionality of federal health care reform is an open question in the legal field and, as you note, respected experts have come down on both sides of the debate (although I suspect much of the opposition from various state attorneys general is motivated by political aspirations rather than sound legal reasoning).

    However, I take it that the general public has vague or unjustified reasons for challenging the constitutionality of federal health care programs. The OLC memo, at the very least, explains the actual question of law and highlights the relevant precedent. The memo is simply one instance of an excellent and, I believe, sound legal defense of the constitutionality of federal health care reform.

  11. It’s funny how one’s view on an issue influences one’s opinion of the other side. Where you suspect the state attorneys general of playing politics rather than thinking seriously about constitutional law, I’ve harbored precisely the same suspicions towards the folks who drafted and passed the PPACA. In retrospect, my intuition leads me to suspect that both our instincts are wrong, and that those on both sides are sincere… if sometimes exasperating with their inexplicable beliefs.

    If you’re not presenting the ’93 OLC memo as conclusive proof of the PPACA’s (or, rather, HillaryCare’s) constitutionality, then I have no beef with it. Insofar as the position has merit, Ms. Reno presents a strong case for it in not-too-many words, so it’s good to have in the conversation. I misinterpreted your meaning in presenting it.

  12. James, very successful people have friends, spouses, children, and leisure only after years of hard work. To want all that and not work over 40 hours of hard work a week is selfish and distorted.

  13. Or they have friends and leisure straight out of college working an honest 40-a-week, and spouses and children a couple years later.  Really not that hard, especially if you don’t mind a few years of genteel poverty.  I see it quite often, actually.

    I mean, hey, if you work into the late night for years after college, when you finally come up for air you’ll discover the dating pool dramatically diminished and your fertile years already waning.  And you still have *years* of work ahead of you to find, date, propose to, and wed the right woman.  You’ve jeopardized the humanizing parts of life for financial security.  Still more importantly, you’ll have *lost* ten years of the very precious time given you to spend on this Earth.  I would argue that *that* is selfish.

    It is also distorted.  It is certain, that, while (for instance) medieval man worked more than 12 hours per day, he also only worked about a third of the year, and so worked no more than 8hrs/wkday than we do, and probably less.  The Industrial Revolution was the distortion, not the reaction against it.

    So, basically, I don’t know where you’re coming from, Sir Plese.  The only way your formula works, as far as I can tell, if you define “winners” to mean “rich people” above all else.

  14. Winners are happy people.

    Wealth can be a means to happiness, but more often than not, in my experience, it forms a prison and a curse — especially for those who lose sight of the fact that money is literally nothing more than a lot of small green pieces of paper. You might be able to trade it for a digital watch (which are pretty neat, I admit), but not for sanctity, nor virtue, nor salvation, nor any measure of happiness in this life or (if there is one) the next.

    Am I wrong?

  15. What a horrible world to live in if over 99.9% of it’s occupants are considered to be “losers”.

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