National Press Club

Governor Urges Congress to be Mindful of States in Health Care Reform

September 18, 2009 | By Ellyn Ferguson |

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Congress should focus on comprehensive health care reform that includes the states as partners and keeps spending in line, Gov. Jim Douglas, R-Vt., said Thursday.

“We need to make sure Congress gets it right from the stand point of the states,” Douglas, chairman of the bipartisan National Governors Association, told a Press Club luncheon crowd.

Any federal overhaul of the nation’s health care system will fail if it burdens states with unfunded and inflexible mandates, he said.

“States will be where the rubber meets the road. It’s critical from my standpoint that governors be given the time and the flexibility to implement those reforms if we’re going to be successful in carrying them out,” Douglas said.

But Congress must respect the states’ budget concerns and constraints, the Vermont governor added. States face a collective $200 billion shortfall over the next few years.

Those budget worries make fellow governors wary about a “massive” expansion of Medicaid, the federal-state health insurance program for low-income people. On average, Medicaid is 22 percent of a state’s budget.

“Governors remain most concerned about an expansion of Medicaid and the financial liability for the states,” Douglas said.

NGA has weighed House Speaker Nancy Pelosi, D-Calif., and Sen. Max Baucus, chairman of the Senate Finance Committee, about governors’ concerns. Baucus outlined a health reform proposal Wednesday that drew mixed reviews from governors who are still waiting to see the proposal’s language.

Douglas said governors believe the U.S. health system needs change, but that such change will take years to implement.

“True reform needs to get at the cost drivers (in the system). We can eliminate duplicative services,” Douglas said.

Whatever Congress produces on health care will take years to make reality, Douglas said. He noted that Vermont, considered a leader in state health reform efforts, has taken six years to phase in 60 different initiatives of the Vermont Blueprint for Health. The comprehensive plan includes subsidized coverage for low-income uninsured people, investments in health information technology and an emphasis on coordinated primary health care that focuses on preventive medicine, early detection and management of chronic illnesses.

Vermont has been able to reduce its share of uninsured people from 9.8 percent to 7.6 percent because it took a comprehensive approach, Douglas said.

Any national reform effort also must be comprehensive and cost-conscious. He does not think a public option – a government health insurance option that would compete with the private sector – would save money.

He offered Vermont’s experience with its children’s health program. Employers urged parents to move their children off their private insurance to the public alternative, he said. If the public option is attractive, many people would likely move from private insurance to the government-run program and there would be little competition, Douglas said.