Fraying Medicaid system, fraying stockings worry some U.S. governors — MedCity Morning Read, Aug. 7, 2009

Washington State Gov. Christine Gregoire is an outspoken supporter of most of President Obama's health care reforms.

SEATTLE, Washington — The fraying of the Medicaid system has many indicators, and one of them is Connie Baugh’s stockings, according to the New York Times.

Baugh recently received a letter from Washington State saying as a result of budget cuts, Medicaid could no longer pay for the compression stockings that support her circulation and keep her aching leg ulcers from flaring, the Times said. At $239 a pair, the stockings take up more than one-third of the Social Security check Baugh lives on.

Some governors fear such cutbacks — produced by a recession that eroded state budgets and swelled Medicaid ranks — will be worsened by health care reform being crafted in Washington, D.C., the Times said. The governors worry Congress will give the states expensive new Medicaid responsibilities without providing the money to pay for them.

“We can’t afford to have Congress raise the eligibility for Medicaid coverage without paying for it,” said Christine Gregoire, Washington State’s Democratic governor, during an interview with the Times. States’ fears were stoked last week as House lawmakers drafting reform legislation reached a compromise with conservative “Blue Dog” Democrats that would force states to shoulder a greater Medicaid burden than an earlier version of the bill, the Time said.

In most cases, Gregoire is an outspoken supporter of President Obama’s efforts to overhaul health care. But she knows her state’s Medicaid program already is under strain. Doug Porter, Washington State’s Medicaid director, warns that an increasingly thin safety net could break if Congress makes more people eligible for Medicaid, according to the Times.

The Congressional Budget Office has projected that federal Medicaid spending under the house bill could increase (pdf) by more than $430 billion over 10 years, the Times said. The question is, how much of that increase would be borne by the states?

On Thursday, senior members of the Senate Finance Committee, which is at the forefront of crafting bipartisan reform legislation, heard from governers and Democratic senators that their proposals might be unaffordable to states and to many low-income people, the New York Times said in a separate story.

More stories worth a read:

• Democrats say no to cost cap for drug makers (New York Times)
• Former MetroHealth executive John J. Carroll accused of taking lavish bribes to fake overruns on construction projects (Cleveland Plain Dealer)
• Clinic, University Hospitals get stable bond ratings from Standard & Poor’s (Cleveland Plain Dealer)
• FDA chief: ‘Violations have gone unaddressed for far too long’ (Wall Street Journal Health blog)
• RAC audits are imminent (FierceHealthCare)
• Stereotaxis reports 19 percent second quarter revenue growth (PRNewswire)
• Michigan legislature to duke it out over stem cell regulations (Detroit News)
• Nine months after end of stem cell ban, donation process not in place (Detroit News)
• Improving chronic care: the “guided care” model(pdf) (Johns Hopkins Bloomberg School of Public Health)
• Biotech startup Acetylon Pharma catches $7.25 million in A Round from backers such as New England Patriots owner (Xconomy | Boston)
• Vertex drug could be ’man walking on the moon’ for cystic fibrosis treatment, says Seattle researcher Bonnie Ramsey (Xconomy)
• Swine flu vaccine on track for September, WHO says (Los Angeles Times)
• Merck’s AIDS triumph (Forbes)
• Elan launches court fight over drug row with Biogen (Financial Times)
• Blue Cross Blue Shield of Michigan, Michigan attorney general and Michigan office of Financial and Insurance Regulation near agreement on rate increases on under age 65 individual products (PRNewswire)
• Cleveland, paramedics reach pact to curb inappropriate sick time use (Cleveland Plain Dealer)
• Idenix to raise $21.2 million in secondary public offering (Xconomy | Boston)
• Stanford experiments with drive-through emergency room (Wall Street Journal Health blog)
• Pfizer agrees to cut price of tuberculosis drug (Financial Times)
• Biotechnology Industry Organization urges Supreme Court to reject rigid Bilski Rule (BIO)