Wednesday, January 19, 2005


Governors are sharpening their message to President Bush and Congress on Medicaid, urging the federal government not to cut the federal-state health care program for the poor and promising that states will come up with innovative ways to trim some of the $300 billion a year in costs.

More than a dozen governors gathered for nearly three hours of private talks yesterday in Washington, as Republican governors came to town for Mr. Bush’s inauguration.

Democrats joined in the discussions, and the two sides were united in their opposition to federal reforms that would cut spending or shift costs to states, those attending said.

“We’re certainly giving the message very clearly that whatever the [federal] budget proposal, that we would find that simply cutting the Medicaid budget is unacceptable,” said Arkansas Gov. Mike Huckabee, a Republican. “You couldn’t tell who the ‘R’s and who the ‘D’s were in the room. There’s a real sense of ‘Let’s tackle this problem.’”

The administration hasn’t said what it will propose, although with plans to reduce the deficit atop the agenda, Medicaid can’t help but be a target, governors said.

At a Senate Finance Committee hearing yesterday, Michael O. Leavitt, Mr. Bush’s nominee for secretary of the Department of Health and Human Services said that Medicaid is “vital” and that states need more flexibility to manage rising costs — a comment seemingly in line with governors’ hopes.

Mr. Bush might squeeze savings out of Medicaid by proposing caps on the amounts states could spend per recipient, according to congressional aides and lobbyists who spoke yesterday on the condition of anonymity. Such a plan could save money but also might force states to make difficult choices.

This year, states saw their combined spending on Medicaid overtake their spending on K-12 education for the first time. Governors said there must be a concerted, comprehensive look at making the program work more efficiently.

Mr. Leavitt’s nomination wasn’t voted on yesterday, because the Senate panel lacked a quorum at the end of its three-hour hearing. A vote should be held soon, perhaps next week, said Senate Finance Committee Chairman Charles E. Grassley, Iowa Republican. Mr. Leavitt’s nomination is expected to be approved.

• Cheryl Wetzstein contributed to this report.

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