Pawlenty’s 2006 Flirtation With Universal Coverage: ‘Intrigued’ By Mandate, Supported Medicaid Expansion

Last week, Ben Smith reported that likely presidential candidate and former Minnesota Gov. Tim Pawlenty expressed interest in the individual mandate in 2006, calling the provision a “potentially helpful,” if incomplete, solution to covering the uninsured. “Pawlenty described a Massachusetts-style mandate in his speech as ‘a worthy goal and one that we’re intrigued by and I think at least open to,’ but suggested that the central health care problem was not forcing people to buy insurance but helping them afford it.”

A review of Pawlenty’s 2006 remarks, however, betray much broader support for expanding access to universal coverage and reforming the health care system. For instance, during the same November 11, 2006 health care forum, Pawlenty — fresh off a close election victory for his second term — said his administration has been “studying very diligently the Massachusetts model about how that would apply to Minnesota” and pledged to “move in stages” toward “universal coverage.” “Everyone should be in a health plan of some sort…but I think as a goal we should start with covering all kids,” he said.

His statements were met with surprise from reporters and Democrats in the state. At the time, the Star Tribune described Pawlenty’s endorsement of covering all children as “a sweeping policy departure that aligns with a top agenda item of the newly elected DFL legislative majorities”:

Senate Health and Family Security Committee Chairwoman Becky Lourey, DFL-Kerrick, who is retiring from the Legislature after an unsuccessful run for governor and what she said was 20 years of advocacy for universal health care, praised Pawlenty’s shift.

“It’s very exciting to hear the governor talk like this,” she said. “If he wants to be a leader, Minnesota is the state to move forward with universal health coverage. And this coming year will be the year to do it.” […]

Pawlenty said his administration is studying health care reforms in Massachusetts, Utah and elsewhere for guidance on how to proceed in Minnesota. But he emphasized that “giving more access to a broken system does not ultimately fix the problem”…He also warned that the greatest challenge of establishing universal health coverage will be managing “a modest and affordable benefit set” in a political environment.

But Pawlenty went further, proposing to expand the state’s Medicaid program — a critical element of the Affordable Care Act:

Pawlenty didn’t outline specifics for expanded children’s coverage, but said options include extending the MinnesotaCare health plan for the working poor or creating a children’s insurance program with fewer services than those required for adults.

His flirtation with universal coverage did not go over well with conservatives, however. Star Tribune columnist Katherine Kersten interpreted Pawlenty’s comments as a push to “use the machinery of government — and a ‘surplus’ of taxpayer money — to ‘start moving toward universal health coverage.’” “He proposes either to expand MinnesotaCare, the state’s publicly subsidized health coverage program, or create a brand new state program,” she warned.

As he pursues the GOP nomination, Pawlenty no longer calls for establishing universal coverage or expanding Medicaid. Instead, he now supports repealing the near-universal Affordable Care Act and replacing it with a yet-to-be-announced proposal.