Governors Cite Cost Concerns in Resistance to Medicaid Expansion
A proposed expansion of Medicaid has many governors, who already have had to reduce the program's benefits and make other cuts to offset the effects of the recession, on edge, the Washington Post reports.
Current health reform legislation would make anyone whose income is lower than $14,404 annually eligible for the program, potentially adding 11 million new beneficiaries (Murray, Washington Post, 10/5).
The proposal would have the federal government pick up between 77% and 95% of the cost of the expansion, with states contributing the difference. Under a deal reached between Senate Finance Committee Chair Max Baucus (D-Mont.) and Senate Majority Leader Harry Reid (D-Nev.), the federal government would contribute 100% of the cost of the expansion in Michigan, Nevada, Oregon and Rhode Island for the first five years.
A survey released last week by the Kaiser Family Foundation showed that Medicaid enrollment increased by 5.4% in fiscal year 2009 -- the highest growth in six years. In addition, the survey showed that state Medicaid spending grew by 7.9% in FY 2009 -- the highest growth in five years -- compared with the 5.8% growth rate that was predicted at the beginning of the year (California Healthline, 10/1).
Concerns About Cost, Access and Enrollment Numbers
Governors in Southern and rural Western states -- which offer the minimum-allowed Medicaid benefits and would be less able to handle new beneficiaries -- have been some of the most vocal opponents of the proposed Medicaid expansion, according to the Post.
States are not certain how many people would be eligible for the expansion, nor how many of those currently eligible but not enrolled would sign up for Medicaid. States also are concerned about whether there will be enough care providers to accommodate new Medicaid beneficiaries.
Gov. Arnold Schwarzenegger (R) said the proposed Medicaid expansion could cost California $8 billion a year, and Sen. Dianne Feinstein (D-Calif.) said she would not support legislation that "pushes additional costs on California state government or its counties."
Congressional lawmakers are unlikely to make further concessions on funding, and House Democrats recently have been considering reducing the Medicaid funding in their bill (HR 3200), the Post reports.
Twenty-two members of the Democratic Governors Association last week sent a letter to congressional lawmakers to support the broader health reform effort; the letter did not address Medicaid specifically (Washington Post, 10/5). 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.