The Minneapolis StarTribune’s piece on presidential hopeful Tim Pawlenty is the kind of story voters can expect to see at this stage in the presidential campaign. The story investigated the candidate’s health care stance, flip-flops and all. The ex-governor apparently is a chameleon changing colors whenever it suits his political purpose. Kudos to the StarTribune and reporter Kevin Diaz for telling the people of Minnesota and others the color du jour! It’s good to remember here that Obama’s cheering crowds did not realize that he would not support a single payer, national health insurance program until way into the campaign. Many of his supporters thought he was going to make that happen because he had backed such an approach earlier in his political career.
The paper dragged out none other than former Minnesota senator David Durenberger, who had a lot to say about health reform during the Clinton years. Durenberger chaired Pawlenty’s 2004 Citizens Forum on Health Care Costs. Pawlenty, he told the StarTribune, was a “guy who didn’t ignore the problem” and championed incentives for low cost insurance and quality measures for hospitals and doctors. Durenberger may now be disenchanted with him, saying that his new talking points are “unworthy of a governor of a state that has been working hard to create many of the care system and access innovations that the Affordable Care Act will help to fund with federal dollars as an example to the rest of the country.”
Former state Human Services Commissioner Cal Ludeman, who worked closely with the governor, said Pawlenty was a free market guy all along. And by free market, he didn’t mean the individual mandate requiring everyone to carry insurance, the approach Mitt Romney took in Massachusetts. In mid-July, Pawlenty ran ads in Iowa saying that he “did health care reform the fight way. No mandates. No takeovers.” To review: there is no takeover of anything in Massachusetts. There is a requirement that people have insurance, but they buy it from private insurance companies. Although the state might check on what private carriers are offering to see if they conform to state regs, the government does not sponsor or create the policies offered through its state shopping service called the Connector—the state’s insurance plans do that. The paper compared and contrasted an important statistic in both states. The number of uninsured dropped in Massachusetts after reform; in Minnesota under Pawlenty, the number of uninsured rose from 6.6 percent in 2000 to nine percent by 2009.
In 2006, the paper noted Pawlenty had good things to say about what he now derisively calls Obamneycare. He said he was “open” to an insurance mandate and said said “everybody should be in a health plan of some sort.”
“He didn’t want to close off the discussion about the mandate,” Ludeman recalled. Then the governor moved toward covering more kids—always a safe political move, because who can argue against children getting vaccinations and inhalers? Besides, covering kids is cheap compared to insuring sixty-year-olds with a zillion ailments. A year later, Pawlenty proposed a state-regulated insurance exchange for individual policies. Call it Romney lite, since there was no mandate that people buy coverage. The legislature said “no” anyway.
After the reform law passed and Pawlenty began dreaming of the White House, he seemed to have other ideas about health coverage, the StarTribune reported. He joined twenty-six governors and state attorneys general in suing to overturn the law, and rejected $1 million in federal funds that could be used to set up an insurance exchange, similar to the one he championed a few years earlier. He said an earlier state study showed the exchange would have a minimal impact on costs. One can only assume that the governor believes moving way to the right is the ticket to winning votes. The staff director of Pawlenty’s health care citizens’ forum said he saw a notable change in the governor’s perspective as he came close to a presidential run. Michael Scandrett said the governor who had introduced model reforms had turned into a fiscal hawk bent on slashing and burning costly programs.
The cost of insurance in the state keeps going up, and the would-be president touts his reforms of a state employee health program that controlled premiums by giving price breaks to those who bought the cheapest plan—presumably those that don’t cover much. Health care “needs to look more like a cash bar than an open bar,” he says. The cute phrase packs a lot of meaning for the direction his health proposals might go. Consumers who want better insurance—you know, the comprehensive kind that is rapidly joining the dinosaurs—will have to pay for it themselves. Is the governor’s health care strategy one that reduces health care costs by shifting them to those who get sick without dealing with the root causes of the problem? It would be good for the paper to articulate that in its next piece on Pawlenty’s health program.
The individual mandate was a free market approach to reform. Advocates and politicians embraced it when it was clear that the alternatives—government-provided insurance a la single payer and an employer mandate requiring all employers to cover their workers—weren’t going to fly for obvious reasons which we don’t have to rehash in this post. Now, it seems, there is yet another way with the ex-Minnesota governor leading the way. Between the StarTribune and Minnesota Public Radio, we are learning a lot about the candidate’s health care thinking.
PS: A Pawlenty spokesman told Politico it took strong exception to the StarTribune story. Alex Conant said that the governor rejected individual mandates every time they were proposed in the state. As for the insurance exchanges, he said a state study showed they didn’t work. Boy, if that’s the case, health reform is headed for real trouble.
Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.