Bush To Discuss Medicaid Proposal With Governors Association Today
President Bush on Monday is scheduled to meet with the nation's governors and push for an "early agreement" on his plans to restructure Medicaid, the Washington Post reports. Medicaid will "dominate" the annual winter meeting of the National Governors Association this week. The governors also are scheduled to have a private lunch with members of Congress on Monday and to meet with HHS Secretary Mike Leavitt on Tuesday. Bush has urged governors to support his Medicaid plans or "risk steep" funding reductions, the Post reports (Connolly/Balz, Washington Post, 2/28).
The president has proposed a $60 billion reduction in Medicaid spending, including $40.5 billion by eliminating "accounting gimmicks" used by states, $15.1 billion by lowering payments to pharmacists and $4.5 billion by implementing more stringent restrictions on nursing home eligibility. Bush also has proposed $11.3 billion to expand children's health coverage, $1.8 billion to care for more nursing home residents at home and $1.9 billion to extend coverage. If Bush's proposals are approved in Congress, governors likely will be forced to reduce benefits for certain beneficiaries, tighten eligibility requirements and proactively control costs in other ways, CQ Today reports (Carey, CQ Today, 2/25).
Negotiations over Medicaid "could take months," and governors "have moved in the last six weeks to rein in Medicaid costs" before any of Bush's proposals are debated in Congress, according to the New York Times (Pear, New York Times, 2/27). The governors are sending a "mixed message" to Bush, according to the AP/Albany Times Union.
Leavitt over the weekend attempted to persuade governors to support the entire Bush plan, "[b]ut consensus was elusive" and "governors agreed only to oppose the cuts and tentatively embrace elements of the budget plan" intended to "drive down drug prices" and decrease the number of middle-class people enrolled in Medicaid for nursing home care, the AP/Times Union reports (Tanner, AP/Albany Times Union, 2/28).
Many governors said they want more freedom to reconfigure Medicaid based on their own states' needs, and they voiced support for Bush's proposal to give governors "vast new discretion to decide who gets what benefits," according to the New York Times (New York Times, 2/27).
Gov. Mark Warner (D-Va.), current NGA chair, said his Democratic colleagues should not rush into any agreements with the president, and he recommended they focus on cost-saving measures.
Gov. Bill Richardson (D-N.M.), chair of the Democratic Governors Association, said, "The administration wants a deal by the end of the week. We're going to resist that. It just shouldn't be 'our way or the highway.'"
Gov. Jennifer Granholm (D-Mich.) said she and other governors "will not stand for" more cuts in "a whole array of services." She added, "We have all cut and cut and cut" (Washington Post, 2/28).
Gov. Bob Taft (R-Ohio) said, "I don't think there are any divisions among governors" when it comes to losing federal funding, adding, "The real issue is it's governors against the White House and Congress" (AP/Albany Times Union, 2/28).
Gov. Linda Lingle (R-Hawaii) said, "It's not a solution to eliminate people from Medicaid coverage" (Wallsten, Los Angeles Times, 2/27).
Some governors also worry that even if they agree to Bush's plans, the Bush administration "will continue to insist on deeper cuts in the upcoming budget," the Post reports (Washington Post, 2/28).
APM's "Marketplace" on Friday reported on potential cuts to Medicaid funding for states. The segment includes comments from Joan Alker, a senior researcher at the Health Policy Institute at Georgetown University, and Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured (Tong, "Marketplace," APM, 2/25). The complete segment is available online in RealPlayer.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.