This New York Times article, Governor’s Balk Over Emerging Health Care Bill Over Because of Costs, leaves the impression that any health care reform that makes more people eligible for Medicaid will force states to pay more to cover them. But the House Tri-Committee summary says that’s not true.
First the NYT summary:
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.
But here’s the summary of the Medicaid expansion provisions from the Education and Labor Committee:
Expands Medicaid. Individuals and families with incomes at or below 133 percent of the federal poverty level will be eligible for an expanded and improved Medicaid program. Recognizing the budget challenges in many states, this expansion will be fully federally financed. To improve provider participation in this vital safety net – particularly for low-income children, individuals with disabilities and people with mental illnesses – reimbursement rates for primary care services will be increased with new federal funding.
So what are the governors talking about? Indeed, the Times goes on to explain the House full federal funding provision and also notes that the Senate HELP Committee version includes federal funding for at least five years. It also notes the stimulus bill included billions to fund higher Medicaid costs during the recession. But there’s no indication whether these details entered the governors’ conversations.
Unfunded federal mandates are a serious concern for states, so they’re right to be trying to nail this down. And it’s not because they’re indifferent; as an earlier Times story notes, several states are straining the budgets to provide increased state funding of SCHIP, even as other states are cutting back or freezing no enrollments. But there doesn’t seem to be any discussion of how the federal government funds the assurances they seek.
Why aren’t the governors announcing at least their conceptual support for one or more tax proposals, such as those in the House Bill, which would imposes a small surtax on those making over $280,000 per year ($350,000 for family of four) and up to 5.4 percent for those with incomes over $1 million? And if not that, then what?
We need more than carping from the nation’s governors.
And why isn’t the Times asking these questions, instead of replaying complaints on one side of the issue?
More:
Sam Stein/HuffPo, on Montana Gov. Schweitzer’s complaint
Yglesias, the logic of DeLong care.



1 Comment







I cringed when I saw the NTY article. Thanks so much for the info on the ELC provision. Alas, our governors don’t dare take a public position for the proposed increases for the wealthy; that would be political suicide by conventional wisdom.
Looking at California Reps issue positions on their “Courage” index and while some of them say they’re for universal health care, I don’t know where they are on how to fund it. But I wished there were lots of folks who had real courage and real integrity in this ignoble fight.
Keep on informing us about some of the ignobility of the administration and congress. Keep on holding up the possibilty of couarge and integrity.
On to calls….
Blessings