Tim Pawlenty

Minnesota Gov. Tim Pawlenty has gone to great lengths to establish himself as a conservative leader on the issue of health care, at a time when he appears to have continued aspirations for national office. But his record potently illustrates the dangers of a conservative approach to the issue.

Pawlenty was born to Eugene and Ginny Pawlenty on Nov. 27, 1960. Growing up in South St. Paul, Minn., Tim Pawlenty was the only one of five children in his family to attend college. After graduating from the University of Minnesota in 1983 with his B.A. and from the university’s law school in 1986, Pawlenty practiced law both privately and as a criminal prosecutor. He later served as a city councilmember in Eagan before getting elected to the Minnesota House of Representatives in 1992. Although he was raised a Roman Catholic, Pawlenty became an evangelical Christian in 1987 when he married his wife, Mary. They have two daughters.

Tim Pawlenty rose to prominence in 1998 as House Majority Leader of the Minnesota Legislature. Pawlenty was unsatisfied with the session because he believed the budget surplus had been spent more on new services than on tax cuts. During the following session, he led the way on passing the largest tax relief package in any state in the country. Following the popularity of the tax cuts, the legislature slashed property taxes in 2001. As early as 2002, the state was facing a looming deficit as Pawlenty became governor.

Pawlenty’s approach to health care can best be understood by looking at his troubled past with the state’s Health Care Access Fund (HCAF), a fund established by the Legislature in 1992 to expand insurance coverage. His experience with this program is one of the central issues in his attempts to balance the state’s budget.

During his governorship, Pawlenty frequently raided the fund’s surplus to divert the extra money to other areas. The money in the HCAF comes from a 2 percent tax on health care providers and premiums paid by low-income Minnesotans insured through MinnesotaCare. During his first term, Pawlenty insisted that the fund’s surplus could be spent down without any noticeable effects until 2007. By 2005, eligibility guidelines and benefits for MinnesotaCare had to be drastically reduced. As a result, an estimated 47,000 Minnesotans lost their health insurance. By 2009, the fund had been depleted by $400 million. Pawlenty callously insisted that up to 10,000 of those now uninsured would be able to qualify for General Assistance Medical Care (GAMC) if they made sure not to fall below the poverty line. But Pawlenty used a line-item veto in 2009 to deny $381 million in funding for GAMC and later cut its funding entirely. The cuts coincided with a scarcity of doctors in rural areas and layoffs in hospitals and clinics.

The attack on the HCAF and funding for GAMC is the result of Pawlenty’s pledge to never raise taxes. To justify diverting funds to which low-income Minnesotans had contributed specifically to maintain their insurance, Pawlenty labeled health care programs he wanted to cut as "welfare health care."

"It is not fair to the rest of the obligations and responsibilities we have to stand by and say, ‘It’s OK to grow welfare health care at 27 percent, when we’re also trying to fund K-12 education and transportation," he said in 2005.

It was widely speculated by political opponents and local pundits that Pawlenty maintained such an obstinate position against raising taxes because he needed powerful conservative credentials to achieve a national profile. Indeed, the moves Pawlenty made were widely unpopular in his own state. According to a Minnesota Star Tribune poll from 2009, 54 percent of Minnesotans favored tax hikes to close the state’s deficit, 57 percent favored higher taxes on corporations, 67 percent favored higher taxes on the rich, and a staggering 70 percent favored higher taxes on alcohol. Even the Minnesota Hospital Association preferred a tax increase on health care providers to the draconian cuts to health care, although other medical associations merely preferred a broad-based tax increase.

Pawlenty consistently diverted money from the HCAF and other rainy day funds to one-time fixes that would allow him to proclaim he had balanced the state’s budget without raising taxes, a move that would inevitably leave the state in the same precarious position, only without a safety net.

Pawlenty’s pledge to never raise taxes was largely responsible for several stalemates with the legislature over the budget, allowing him to take unilateral action after the end of the legislative session on more than one occasion. Most recently, Pawlenty used the unallotment mechanism, a unique power in Minnesota that allows the governor to rescind money appropriated in the budget, to balance the budget in 2009. It was by using this mechanism that he cut $236 million in health and human services spending, including all of the funding for GAMC.

Pawlenty’s critics in the DFL Party said he was acting like a "monarch," enacting a mechanism that had only been used four times in Minnesota’s history (including two times by Pawlenty himself). The governor’s office provided no legal justification for the unprecedented use of unallotment, so it was not surprising when the Minnesota Supreme Court ruled the actions illegal earlier this month.

Last June, Pawlenty announced he was not running for re-election as governor of Minnesota. In recent months, Pawlenty’s rise to the national stage has been marked by a further shift to the right and a series of contradicting statements. He believed the Democrats’ health care bill would create death panels before changing his mind, calling them an "indirect concern." Despite stating that challenging the health care bill is neither legal nor practical, he wanted to invoke states’ rights to exempt Minnesota from the bill and he endorsed a candidate for governor who believes in nullifying all federal laws. His newfound distaste for federal health care dollars blatantly contradicts his pledge as a gubernatorial candidate to get higher federal payments for Medicare patients.

Even though Pawlenty believes states should serve as a model on health care, he has a poor model to show: Over 100,000 Minnesotans lost their insurance between 2007 and 2009 alone. Minnesota only allows non-profit health insurance providers and HMOs to operate in-state. It prioritizes maximizing coverage to citizens and providing aid to children, the elderly, and the poor even if they are above the poverty line and do not qualify for Medicare or Medicaid. This is a far cry from Pawlenty’s belief in market-driven models that emphasize containing costs over access.

On Fox News in March he proposed mitigating the financial impact of the uninsured by making access to care more difficult. "Well, for one thing you could do is change the federal law so that not every ER is required to treat everybody who comes in the door, even if they have a minor condition," he said. If Pawlenty is the face of the conservative approach to health care, progressives should welcome him to the national debate with open arms.

In His Own Words:

"President Obama’s a former community organizer. He needs to be reminded that our definition of community is not the federal government and the federal government is not our God. There are other ways to approach these issues and reach reasonable progress. We do not want the health care to continue the way it is. We should stand up against bad ideas."

–On Your World with Neil Cavuto, Aug 20, 2009

“The diagnosis of the problem for the healthcare delivery system in the country was supposed to be cost-containment. In other words, we need to make it more affordable for individuals and families, businesses, and governmental entities. But, instead, they are now focused substantially on expanding access.”

–In Politico, Oct 27, 2009

"This is also the state of Eugene McCarthy, Hubert Humphrey, Walter Mondale, Paul Wellstone, and now Sen. Al Franken. Minnesota has evolved and ebbed and flowed a little bit in its politics, but it is fair to say that, with few exceptions, it’s been one of the more liberal states in the country. It’s the history, the tradition, the culture here. I’m someone who has confronted that in a way that for some is refreshing and for some is quite dramatic, in a way that is viewed as quite a departure from the normal trajectory here. Most of the Republicans who have succeeded here have been mostly very moderate, Democrat lite. I’m somewhat an exception to that. I’m more of a mainstream conservative governing in a liberal state."

–In Esquire, Feb 12, 2010

"We don’t honor the Constitution when we elevate a vague idea that is the right to privacy over the right to life."

–In Politico, March 25, 2010

Related Stories

• White House: Recognizing Affordable Care Act Successes Two Years Later
• GRAPHIC: The Contraceptive Controversy
• Tenn. Senator: ‘AIDS Came from the Homosexual Community,’ and Anti-Gay Bullying is a ‘Lark’
• Study: Broad Support For Provisions In Affordable Care Act
• Young Americans To Join Michelle Obama for State of the Union