GOP governors submit ideas for Medicaid

The country's Republican governors on Tuesday offered 31 ideas about how to fix the Medicaid program.

Released by the Republican Governors Public Policy Committee, the report—titled A New Medicaid: A Flexible, Innovative and Accountable Future (PDF)—follows a June letter to House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) and Senate Finance Committee ranking member Orrin Hatch (R-Utah) from 29 Republican governors that endorsed block grants for Medicaid and outlined seven principles for building a better program. The recommendations in the report align with those seven guiding factors.

According to the report, annual state Medicaid rolls have increased to more than 69.5 million, or about 1 in 5 Americans. Medicaid enrollment now exceeds Medicare enrollment by more than 8.1 million people on an average monthly basis, the report states. The authors also cite Congressional Budget Office estimates that after the healthcare reform law's mandated eligibility takes effect in 2014, an additional 25.6 million people will enroll in Medicaid in the following decade—increasing state administrative costs by $12 billion, according to the report.

The governors' suggestions include repealing the maintenance-of-effort requirements established in the Patient Protection and Affordable Care Act, requiring the federal government to take full responsibility for uncompensated care costs related to treating illegal aliens and lowering the threshold for premium payments to 100% of the federal poverty level to encourage a "sense of shared beneficiary ownership in healthcare decisions."

"Policies handed down from Washington have significant consequences for states and local governments," Upton said in a news release. "Rather than imposing new federal mandates, we are building a new partnership with governors to listen to their concerns and solicit their input on how to protect taxpayers and improve essential programs," he continued. "The concepts included in this report add to the growing collection of views from governors of both parties, which will help inform our efforts to reform Medicaid for the future."