Medicaid should not be turned over to the states without maintaining some federal guidelines, American Hospital Association Chairman Gail Warden told a congressional panel last week.
Warden, president and chief executive officer of Henry Ford Health System in Detroit, also said the $182 billion over seven years in Medicaid savings called for in the GOP budget could not be reached by managed-care alone.
Meanwhile, at the National Governors' Association meeting in Vermont, Senate Majority Leader Robert Dole (R-Kan.) said that Congress will likely not act on Medicaid reforms until the governors reach an agreement on how federal funds should be distributed between states.
However, according to NGA Chairman and Wisconsin Gov. Tommy Thompson, several meetings among governors did not produce such an agreement. States that have low per-capita Medicaid spending are calling for a larger slice of the pie as are states that have high growth rates.
One thing the GOP governors did agree on was that under a block-grant plan, no state's federal funding should be less than it receives now.
That is an apparent victory for New York and other states that spend the most per beneficiary. Last month, representatives from a coalition of states that have high per-capita Medicaid spending met with House GOP leaders in an effort to convince them that redistributing Medicaid funds would severely disrupt their programs.
Last year New York spent an average of $7,200 per Medicaid beneficiary compared with Mississippi's average of just $2,600, according to government figures.
Speaking before the House Commerce health subcommittee, Warden argued that the federal government should require states to continue to spend as much money on Medicaid in the future as they do now. He added that the future increases should be based in part on how fast each state's Medicaid population rises. That would shield states with high growth rates from funding shortages.
He also called for the continuation of some federal eligibility standards, such as requiring that states cover pregnant women and children.