Minnesota and Wisconsin share a border but, after today, they won't share a policy on implementing healthcare reform

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January 3, 2011

By Eileen McGuire-Mahony

Both states will see new Governors sworn in today, and each man has a different vision for crafting healthcare policy

Now that President Obama's contentious healthcare plan is already partially implemented, it's facing a fresh set of challenges in the states, characterized in many instances by the attitudes Governors are taking. Lawsuits from states aren't new, but a fresh crop of Governors who may back policies that differ from their state's past trajectory are. On top of that, in 48 hours, a Republican controlled Congress, whose leadership has been explicit about a determination to repeal Obama's signature accomplishment of 2010, takes power on the Hill. Scattered across the next two weeks, the winners of more than three dozen gubernatorial contests will also begins their terms. Some have been very candid about their intentions for healthcare in the states they will govern.

In two Midwestern states, both of which saw a change of executive power and both of which were among 2010's most bitter electoral fights, the incoming Governors are taking strikingly different tones to the entire issue of healthcare. Minnesota Democrat Mark Dayton and Wisconsin Republican Scott Walker will both be inaugurated today. Both men have already discussed their intentions for handling healthcare.

Mark Dayton, a left leaning Democrat in a state known for its generous social programs and liberal politics, has already announced his first legislative act. Tomorrow morning, the new Governor will sign an executive order expanding Minnesota's Medicaid rolls. The move amounts to early enrollment in Barack Obama's healthcare agenda for 95,000 Minnesotans, along with the commensurate volume of medical and political jobs to oversee the augmented rolls. $1.2 billion in federal funding is set to flow into the state as a result of the early adoption.[1]

Dayton has the authority to sign such an order due to a 2010 compromise between the state legislature, controlled by the Democratic Farm Labor Party, and outgoing Governor Tim Pawlenty, a Republican. Faced with ongoing controversy over adopting the healthcare reform, both sides agreed to a plan that gave the new Governor sole power to accept or reject the plan by January 15, 2011. Had 2010 Republican gubernatorial candidate Tom Emmer won, he almost certainly would have made a different choice. The direction Dayton is moving may also have been part of Tim Pawlenty's recent comments that he regrets not having run for another term in office.[2]

In neighboring Wisconsin, Scott Walker, a former Milwaukee County Executive, first revealed his hand in early December, when he wrote to President Obama to request the maximum flexibility for Wisconsin in following the new law.[3][4] Walker went further in ordering the state's government to freeze implementing aspects of the healthcare law even before he took office, through he later ratcheted down his rhetoric and indicated he would look for ways to work with the U.S. Department of Health and Human Services, itself headed by a former Governor, Kathleen Sibelius.

More recently, Walker announced he would order the Attorney General of Wisconsin, J.B. Van Hollen, to sue the Federal Government.[5] According, to Walker, Hollen has long been eager to take such action but it is known that outgoing Democratic Governor Jim Doyle barred him from doing so. In fact, under Governor Doyle, who worked with a Democratically controlled State Assembly, Wisconsin had been on track to take the same early adopter route as Minnesota, and was in the process of applying for Federal grants to do so when the 2010 midterms replaced one party's trifecta with another. Walker has indicated he will seek to join an existing multi-state lawsuit against the Federal government rather than starting fresh.

While the two states have both seen substantial political changes, each one also faces the same situation it was in, albeit in a mirror. Minnesota went from a Republican governor and a DFL controlled legislature to having the same power sharing, with its potential for both tension and compromise, only with a GOP dominated assembly and a Democrat in the governor's seat. Wisconsin voters ousted the Dems who controlled the state's House and Senate as well as the Governorship and put Republicans in power in all three seats.

Both states may now try to apply lessons learned to a familiar picture. While Minnesota's compromise may have avoided making a decision that would have rankled some voters, it also only pushed the choice into the New Year. By guaranteeing a partisan elected official would have sole discretion to make such an important choice, it also almost certainly upped the ante of the gubernatorial race, which ultimately went into a protracted recount and led to legal action. In Wisconsin, a new crop of lawmakers may seek to sidestep behavior that cost the Democrats their control of state politics.

While states hash out their strategies for implementing the new healthcare law and, in some cases, simultaneously work to legally defeat the mandate, Congressional members are set to clash over whether or not the law will even stand. In the event that Republicans, led by presumptive Speaker John Boehner, succeed, Minnesota and Wisconsin will be only two states seeing their various attempts to work with the new law made superfluous. Should the U.S. House let the law stand or itself make some compromise, then America's Governors will see no small part of their own legacies crafted by their response to the Federal dictates.