Obama Promise on Medicaid Leaves Republicans Christie, Brownback Doubtful

Republican governors said President Barack Obama may not move fast enough to ease the burden of soaring health-care costs that are driving the $125 billion in projected deficits facing U.S. states.

After meeting with Obama at the White House, Republicans including New Jersey’s Chris Christie and Sam Brownback of Kansas said they doubted the president’s pledge to give them greater flexibility to run Medicaid, the health-care program for the poor. The meeting came at the end of the National Governors Association’s session in Washington yesterday.

Maine’s Paul LePage said he’s asking the federal government to let his state scale back eligibility rules for Medicaid, which now covers residents with income double the poverty rate.

“We can’t afford it anymore, but we’re stuck,” the New England Republican said in an interview. “We have to have a budget passed and in place by July 1, and I don’t see it happening. I don’t see the progress coming fast enough.”

Medicaid, whose costs are shared by the federal government and the states, has emerged as a battleground as governors are forced to balance their budgets. The health-care overhaul Obama signed last year limits states’ power to bump residents off Medicaid without federal permission, a provision Republicans have asked Obama to ease.

Photographer: Ramin Talaie/Bloomberg

New Jersey's Governor Chris Christie. Close

New Jersey's Governor Chris Christie.

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Photographer: Ramin Talaie/Bloomberg

New Jersey's Governor Chris Christie.

Recession’s Impact

“The president is committed to helping states address their fiscal challenges and has taken significant steps to help states,” Nick Papas, a White House spokesman, said in an e- mail. “At the same time, we need to address a set of long term economic challenges and make smart investments in innovation, education and our infrastructure to win the future.”

Republican governors are also fighting the health-care law in court, saying its requirement that residents buy insurance is unconstitutional.

States are still trying to recover from the 18-month recession that battered tax collections and swelled Medicaid rolls as residents lost their health insurance along with their jobs. Since 2009, the U.S. has provided additional cash to help run the program, though that money is set to disappear just as most states begin their budget years in July.

‘Trust Us’

Washington Governor Christine Gregoire, a Democrat who heads the NGA, also wants greater leeway over the program. On Feb. 26, she said states don’t expect any more stimulus money from the U.S. government. Gregoire urged Congress not to worsen states’ problems by cutting too deeply into the federal budget.

Photographer: Andrew Harrer/Bloomberg

Kansas Governor Sam Brownback. Close

Kansas Governor Sam Brownback.

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Photographer: Andrew Harrer/Bloomberg

Kansas Governor Sam Brownback.

After his meeting with the governors, Obama said he asked them to form a bipartisan commission to work with his administration to find ways to trim the cost of Medicaid and give states more room to run the program.

The president also said he supports a plan to let states opt out of the health-care law to set up their own systems, starting in 2014, that provide benefits and coverage equivalent to federal law.

“Governors just want flexibility to run our states,” Christie said. “I wish he’d trust us a little bit more. None of us want to do anything to harm the public. But we can’t print money. And we can’t run trillion-dollar deficits.”

Brownback said Obama isn’t in favor of handing over block grants to run the program as states see fit, an idea being backed by fellow Republicans.

“It’s just gobbling up everything coming out of the recession,” he said of Medicaid. “It’s still fuzzy what that help is and when it will come,” he added, referring to Obama’s pledge.

On Wisconsin

Mississippi Governor Haley Barbour, a former head of the Republican Governors Association and a potential presidential challenger for Obama next year, said after a Congressional hearing today he’d trade half of the annual increase his state Medicaid program gets from the federal government in exchange for more flexibility to spend the money.

Barbour said he would take steps such as moving more Medicaid patients into managed-care plans and require recipients to make co-payments and get annual exams.

“There’s example after example of managing the program better,” he said. “We can save money without people losing coverage.”

Other Republicans frequently at odds with Obama chose not to criticize the president, who also weighed in on a move by Wisconsin Governor Scott Walker, a Republican, to roll back the power of public-employee unions in the state. Obama said government workers shouldn’t be “vilified” or lose collective- bargaining rights as states seek to balance their budgets.

To contact the reporters on this story: William Selway in Washington at wselway@bloomberg.net; Mark Niquette in Washington at mniquette@bloomberg.net

To contact the editor responsible for this story: Mark Tannenbaum at mtannen@bloomberg.net

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