Critical Condition

The State Front Opens Up

I know it’s been mentioned a time or two already, but it’s worth emphasizing the significance of another front that opened up against ObamaCare over the weekend. At a National Governors Association meeting in Biloxi, chief executives of both parties expressed grave concern about the implications of federal health-care legislation for state budgets via Medicaid and other health programs. While governors and state legislatures have in the past been part of the problem, by gaming Medicaid to wring maximum federal dollars out of the system for both medical and non-medical expenditures, their worries about the fiscal effects of health-care reform are both justified and helpful.

Some examples from the Examiner coverage:

• Gov. Phil Bredesen, the Democratic governor of Tennessee, said he feared Congress was about to bestow “the mother of all unfunded mandates.” Health-care reform is not just dumping more participants and more money into Medicaid, he said.

• “As a governor, my concern is that if we try to cost-shift to the states we’re not going to be in a position to pick up the tab,” said Gov. Christine Gregoire of Washington, also a Democrat.

• And from Time:

Redefining who is eligible for Medicaid would be one of the major means by which lawmakers hope to achieve universal health coverage — which is one of the reasons that governors, whose budgets are already straining under the program’s growing costs, are so wary of the idea. “It depends on what’s being proposed,” says Pennsylvania’s Ed Rendell, a Democrat. “These could essentially be unfunded mandates, and would be enormously destructive to state budgets.”

Members of Congress don’t always do the bidding of their state governors and legislatures, but they often do. Those in competitive districts don’t want to expose themselves to the argument that they did something that hurt their own state’s finances, or that could be construed as leading to a state tax increase.