Policy

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

Some governers fear coverage 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. “We can’t afford to have Congress raise the eligibility for Medicaid coverage without paying for it,” said Christine Gregoire, Washington State’s Democratic governer.

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.

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