As Congress works to hammer out a nearly trillion dollar health reform overhaul, state lawmakers are urging the federal government not to place the burden on states already hit hard by the recession.
At a meeting of the National Conference of State Legislatures, state legislators called on Congress and the Obama administration to fully fund any expansion of Medicaid. Several of the health reform bills Congress is considering would increase the number of people served and expand the types of services states would have to provide. President Barack Obama and others have said this would increase access to healthcare for some Americans.
"The truth of the matter is states are battling budget shortfalls and face increased demand for services," said Rep. Joe Hackney, North Carolina's Speaker of the House and president of the NCSL. "We just can't enroll more people on Medicaid when we can't pay for the ones we currently have."
At the Thursday meeting, NCSL members passed an internal policy position that urges that any reform of federal healthcare should respect states' interests and ensure people will be able to keep their insurance. NCSL policies on state-federal issues guide the group's lobbying efforts on Capitol Hill.
"We support covering all Americans, but we want to ensure that a state-federal partnership includes respect for state law, avoiding cost shifts and unfunded mandates," Hackney said. "States lead the way in healthcare reform initiatives and many already have passed reform efforts."
According to the NCSL, Medicaid absorbs about 15 percent of state general fund budgets. As unemployment rates increase, causing the loss of employer-based insurance, state Medicaid programs are picking up the slack.
State lawmakers urged Congress to pass federal health reform that would:
- Not require unfunded mandates that would shift costs to states;
- Preserve states' regulation of insurance;
- Not expand mandatory benefits unless fully funded by the federal government;
- Protect so-called legacy states that already have enacted health reform;
- Urge Congress and the Obama administration to build on state-reform efforts;
- Provide a trigger mechanism that guarantees enhanced federal Medicaid funding when economic indicators decline;
- Endorse a public option for those for whom private insurance is not a choice.