Just a week before the full Senate is scheduled to begin debating Medicare and Medicaid reform, GOP governors are attacking their own party's Medicaid plan, setting up a showdown with Senate moderates.
In a letter to Senate Majority Leader Robert Dole (R-Kan.), Republican governors said they opposed the Senate Medicaid plan because of what they called "a number of overly prescriptive and onerous provisions that will militate against the state's ability to implement reforms."
The governors objected to an amendment added to the plan that would require states to provide coverage for pregnant women and children under age 12 and the disabled.
The amendment was sponsored by moderate Republican Sen. John Chafee (R-R.I.) and was accepted by the Republican leadership because Chafee's vote was needed to pass the bill out of the Senate Finance Committee.
But last week, Chafee and several moderate Republicans vowed to keep the individual entitlements in the plan.
"What they have to understand is that what we put in the bill is very modest; it doesn't even say what they would be entitled to," Chafee said. "I don't understand all the complaints."
The governors said in the letter that they were worried that when the bill reached the Senate floor it would be amended with additional mandates that would shift costs to the states.
The Republican plan trims $182 billion from projected Medicaid spending over seven years.
The Congressional Budget Office estimates that without any changes by lawmakers, federal Medicaid spending will increase more than 10% a year from $89 billion this year to $178 billion by 2002.
The savings would come from limiting the amount of increase in each state's allotment to 4% a year. In return for the caps, the federal government would turn control over the program to the states.
The governors' objections put the future of the Medicaid plan in jeopardy. The Senate was expected to begin work on the plan this week but may be delayed as it seeks to find compromise on a number of issues, including Medicaid.