Concerns About Reform Efforts Rising Up Among Democratic Governors

Governors from both parties continue to express concerns that health reform legislation under consideration in Congress could saddle states with more debt at a time when they are already hurting, the New York Times' "The Caucus" reports.

In the past, most of the criticism has come from Republican governors, but now some Democrats also are questioning provisions of the bills.

Delaware Gov. Jack Markell, chair of the Democratic Governors Association, said, "We've got concerns, and we're doing our best to communicate them." He added, "We understand the need to get something done, and we're supportive of getting something done. But we want to make sure it's done in a way that state budgets are not negatively impacted."

Markell was elected chair of DGA Wednesday.

Republicans have complained that the Senate health bill (HR 3590) would force states to come up with millions of dollars to cover an expansion of Medicaid (Nagourney, "The Caucus," New York Times, 12/2).

State Budgets Still Hurting

Meanwhile, during a press briefing Wednesday, National Governors Association Chair and Vermont Gov. Jim Douglas (R) said that over the next two years, states could face a $300 billion shortfall and might not bounce back to their pre-recession revenue levels until 2014, CQ HealthBeat reports. That could make any Medicaid expansion particularly trying.

West Virginia Gov. Joe Manchin (D) also said he has concerns about a proposal in the House health reform bill (HR 3962) that would fold the Children's Health Insurance Program into Medicaid.

Manchin, vice chair of NGA, called CHIP a "godsend" and said he "would have great concerns" about eliminating the program or merging it with Medicaid.

The Senate bill would preserve CHIP as a separate program.

Douglas said NGA does not have a position on an amendment from Sen. Bob Casey (D-Pa.) that would fully fund CHIP until 2019.

On the whole, however, the Senate bill is better for states than the House version, Douglas said, citing its Medicaid provisions and the way it would establish insurance exchanges.

The Senate bill would require states to create insurance exchanges, while the House bill would create a federal health insurance exchange.

Under the Senate version, states would have more flexibility, Douglas said (Norman, CQ HealthBeat, 12/3).