When the nation’s 28 Democratic governors were asked to send a letter to congressional leaders last month expressing their support for health care reform, seven refused to sign the letter and even some who did complained that the pending reform plans could hit them with budget-busting expenses.
The big concern among the holdouts is that the health care overhaul will leave them on the hook to pay for expansions in Medicaid programs for the poor while Washington reaps the political credit.
Tennessee Gov. Phil Bredesen, one of those who declined to sign the letter, has been perhaps the party’s sharpest critic in the funding debate, calling the potential expansion of Medicaid in health care reform “the mother of all unfunded mandates.”
“We can’t print money. We can’t borrow money. A lot of staffers in Congress really don’t understand this idea of a balanced budget,” Mr. Bredesen, a former HMO executive, told reporters in September.
Costs are also worrying moderate Democrats in the House, where party leaders Wednesday pushed for a quick debate and vote on the $1.2 trillion measure as soon as Saturday. Democrats were buoyed by reports that the giant seniors lobby AARP would endorse their bill Thursday.
The Senate remains a tougher call, with Majority Leader Harry Reid, Nevada Democrat, hinting this week that Congress may miss President Obama’s deadline for passage of a bill by the end of the year.
The Democratic governors who wrote in support of a reform bill said in their letter that they “realize that the status quo is no longer an option.”
“Sky-rocketing health care costs hurt families, force businesses to cut or drop health benefits and cause already strained state budget deficits to significantly grow. We believe reform can relieve these burdens by reining in costs and making coverage more affordable, both for our citizens and our state budgets,” the letter said.
But left out of the letter was any mention of the federal Medicaid health insurance program for the poor, whose shared cost with the states has been the governors’ biggest budget headaches.
The health care plans being considered in Congress are projected to move millions of new health care recipients into Medicaid and add nearly $40 billion to the states’ costs.
New Hampshire Gov. John Lynch, who did not sign the letter, is one of many governors who has been raising concerns that the bills taking shape in Washington will hit his fiscally-strapped state with costs it is unable to meet.
“We’re struggling with our current Medicaid program, which has seen a big increase in demand over the past year. We can’t afford new costs,” Pam Walsh, the Democratic governor’s deputy chief of staff, told the Concord Monitor.
The recession has already driven up Medicaid rolls over the past year, further straining state budgets. New Hampshire officials said 114,862 state residents used Medicaid to help pay health care bills in September, up 10 percent over last year.
According to estimates from the National Conference of State Legislatures, the reform bill approved by the Senate Finance Committee could cost Mr. Lynch’s state $177 million in the program’s first six years, beginning in 2014, as a result of about 83,000 more people who would be added to the state’s Medicaid rolls.
Maryland Gov. Martin O’Malley, who did sign the letter, remains one of the health care plan’s staunchest supporters, but told reporters on ABCNews.com’s “Top Line” program, “Really, a lot of this is about cost-avoidance.”