Governors Balk Over Emerging Health Bill Because of Cost

BILOXI, Miss. — The nation’s governors, Democrats as well as Republicans, voiced deep concern Sunday about the shape of the health care bill emerging from Congress, fearing that the federal government is about to hand them expensive new Medicaid obligations without providing the money to pay for them.

The role of the states in a restructured health care system dominated the National Governors Association’s summer meeting here this weekend — with bipartisan animosity voiced against the Obama administration’s plan during a closed-door luncheon on Saturday and in a private meeting on Sunday afternoon with the secretary of health and human services, Kathleen Sebelius.“I think the governors would all agree that what we don’t want from the federal government is unfunded mandates,” said Gov. Jim Douglas of Vermont, a Republican who is the group’s incoming chairman. “We can’t have the Congress impose requirements that we are forced to absorb beyond our capacity to do so.”

The governors’ backlash creates yet another health care headache for the Obama administration, which has tried to recruit state leaders to pressure members of Congress to wrap up their fitful negotiations.

The New York Times

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But the sentiment among those who were could not have been more consistent, regardless of political party. The governors said in interviews and public sessions that the bills being drafted in Congress would not do enough to curb the growth in health spending. And they said they were convinced that a major expansion of Medicaid will leave them with heavy costs.

They are already anticipating large gaps in Medicaid financing after 2010, when stimulus money will no longer be available. And they point out that Medicaid already suffers from low payment rates to health care providers, discouraging some doctors and hospitals from accepting beneficiaries. If Medicaid is expanded, states would almost surely have to increase payments to doctors to encourage more of them to participate.

Gov. Phil Bredesen, Democrat of Tennessee, said he feared Congress was about to bestow “the mother of all unfunded mandates.”

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The price of the four insurance plans offered under Commonwealth Care rose 9.4 percent in 2009, according to the report done for the Physicians for a National Health Program. The study's authors said that the law has done nothing to stem the overuse of high-tech care and the "underdevelopment" of primary care. "Indeed, one little-known provision of the reform actually shifted resources away from primary care by lowering Medicaid payment rates for such services, while raising them for high-tech, tertiary-care services," they said.

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