WASHINGTON - President Bush tried to reassure the nation's governors yesterday that he's ready to work with them to ensure that his plan to cut federal funding for Medicaid, which helps 53 million low-income Americans with health care - including more than a million Ohioans, won't bankrupt their states.
But many Republican and Democratic governors, meeting in Washington for the winter session of the National Governors Association, were unconvinced, although they are still hoping to come up with a plan of their own to control what Ohio Gov. Bob Taft, a Republican, has called "the Medicaid monster."
In a meeting in the State Dining Room of the White House, filled with cheery yellow tulips that contrasted with the falling snow outside, Mr. Bush told the governors he too is worried about saddling the states with more of the cost of mandatory spending programs such as Medicaid while also maintaining health care services for the poor.
"We also recognize that the system needs to be reformed, and we want to work with you to do so," he said.
"There's no better group of people to work with than the governors. The governors are on the front line of Medicaid, I know full well."
In his proposed budget for fiscal year 2006, Mr. Bush indicated that over 10 years he wants Congress to stop spending more each year for Medicaid and eliminate about $40 billion from the program, which is expected to cost about $330 billion this year.
Since Medicaid rolls are expected to keep growing, this would be a larger cut than it seems.
Also, Mr. Bush wants to cut reimbursements for new administrative duties the federal government is requiring of the states.
States are eager for changes in the program, which now accounts on average for more than one-fifth (21.9 percent) of their entire state budgets.
But they complain that without major changes they can live with, they'll end up paying the difference if the federal share is reduced.
Several governors have insisted that keeping up with a larger share of Medicaid could bankrupt states that, unlike the federal government, must balance their budgets every year.
Mr. Taft's budget proposal for fiscal year 2006 would cut Medicaid benefits to 25,000 low-income men and women, eliminate dental and vision coverage to 800,000 adults, and end prescription-drug coverage for many poor people with mental illness.
Mr. Taft also wants to cut fees to nursing homes by 3 percent, which would cost them millions of dollars.
Many Democratic governors this week are arguing that Mr. Bush's proposals merely shift the burden to the states and that the states will have no recourse but to raise taxes to pay for them.
Virginia Gov. Mark Warner, a Democrat who is the current chairman of the National Governors Association, said yesterday that he considers Medicaid much more of a crisis than Social Security.
Mr. Warner is working with Arkansas Gov. Mike Huckabee, a Republican and vice chairman of the governors' group, to come up with an alternative to cutting federal payments to the states by 2 percent.
But so far, a compromise has proved elusive.
Mr. Huckabee, who will become NGA chairman this summer, said that without making changes in health care delivery, simply cutting the federal budget for Medicaid is "unacceptable."
In a transcript provided by the White House, Mr. Bush told the governors he understands their plight and as a former governor is sympathetic.
But he also insisted something has to be done. The White House did not provide a transcript of what the governors told him, and reporters were shooed out of the room as they began a question-and-answer session with him.
Many governors said they already have had to cut poor people from Medicaid rolls and don't want to make more cuts. They said such cuts often end up making people sicker and driving up the health costs for everyone.
Michigan Gov. Jennifer Granholm, a Democrat, said if she has to, she'll organize busloads of people to come to Washington to protest more cuts.
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