State governors on Saturday said they were frustrated with the federal government's now-stalled effort to overhaul the U.S. healthcare system, saying the process has been more about bluster than action and pledging to press forward with reform efforts at the state level.
Governors frustrated by stalled federal health reform
“In the states, we educate, mitigate, incarcerate,” Montana Gov. Brian Schweitzer said, adding that the requirement to have a balanced budget often means tough decisions between education, law enforcement and healthcare. “In Congress, they talk about it.”
A year-long effort by the federal government to change the way care is delivered and paid for has been at an impasse since January, when Democrats lost a pivotal Senate seat that stripped them of their 60-vote majority—the number needed to break a filibuster.
Even though both the House and Senate have passed comprehensive bills, the inability to meld them together and then break a Republican-led effort to shelve the legislation has handcuffed the process.
The delay, however, has had a direct impact on states, Vermont Gov. Jim Douglas said in his opening remarks of the National Governors Association's annual meeting in Washington.
Douglas, the Republican chair of the NGA, set health reform as the top priority for this year's conference. He said he had expected the congressional effort to overhaul the $2.5 trillion per year healthcare sector to have been completed by now, but instead has shifted his focus to how states can work ahead of their federal counterparts.
“Here we are (and) it is hasn't happened,” he said. “We have to get in front of it. We can't wait for the federal government.”
The reason is simple: money. State revenues have experienced double-digit declines over the past three quarters, which translate into a total of $31.3 billion in budget cuts across 43 states so far.
While state revenues have nosedived, healthcare costs have continued to grow, Douglas said. State spending on Medicaid last year increased 7.8% over spending in 2008, with enrollment expected to grow some 6.6% this year, according to an economic snapshot of state fiscal spending.
“What we're finding out is, from a fiscal standpoint, the worse probably is yet to come,” Douglas said.
In March, the NGA is expected to hold a summit on state based health reforms, with other meetings on delivery system reforms and implementation expected later in the year.
“When the federal government comes along, we'll see how we integrate their reforms,” Douglas said. “But we're going to do what we can as governors to provide leadership with or without a federal bill.”
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