Health law ups the ante in state-federal Medicaid budget battle

As this health insurance program for low-income people continues to place a huge burden on state budgets, governors are pressing for more flexibility regarding Medicaid's eligibility standards. The health law's expansion of this program — scheduled to take effect in 2014 — adds a sense of imperative to the conversation, as do the spending cuts being considered by Congress.

NPR: Governors: Medicaid More A Budget Buster Than Ever
The federal government and the states have shared the cost of Medicaid, the health insurance program for some 60 million low-income Americans, since it was created in 1965. They've shared something else almost that long — arguments about who should foot how much of the ever-escalating bill. ... But what really makes this Medicaid fight different from ones that have come before is the impact of the health overhaul passed last year, which calls for a huge expansion of Medicaid in 2014 to low-income childless adults. States won't actually be on the hook for most of those costs; all but 10 percent will be paid by the federal government (Rovner, 2/28).

The Washington Post: Governors Differ On Extent Of Flexibility For Medicaid
Democratic and Republican governors, burdened by crushing budget pressures from Medicaid, said Sunday that federal officials should allow them more freedom to change eligibility rules and other aspects of the public health insurance program for the poor. But they displayed sharp ideological differences over how far such flexibility should go (Goldstein and Balz, 2/27).

The Wall Street Journal: Governors Scramble To Rein In Medicaid
More than half the states want permission to remove hundreds of thousands of people from the Medicaid insurance program, a move that would represent a rare cut to a national social program (Murray, Adamy and King, 2/28).

Related, earlier KHN stories: States May Face Showdown With Feds Over Cutting Medicaid Rolls (Werber Serafini and Appleby, 2/3) and Wisconsin Union Battle Masks Medicaid Tensions (Weaver, 2/25).

Politico: GOP Governors Want Medicaid Block Grants
Republican governors are pushing Medicaid block grants as the best path to more flexibility (Kliff, 2/27).

The Hill: Republican Governors To Government: Give Us Medicaid Grants
Republican governors, asking for greater flexibility to design Medicaid programs as their states face massive budget gaps, are pushing for the federal government to provide Medicaid block grants (Millman, 2/27).

Kaiser Health News: Governors' Wish List For Medicaid
Kaiser Health News staff writers Jessica Marcy and Aimee Miles surveyed some governors to ask, "If you were given flexibility from Washington to redesign your state's Medicaid program, what would you do?" (Marcy and Miles, 2/25).

The Washington Post: Obama Has Few Options To Aid Strapped States
Even those who say Obama needs to secure significant new federal spending to help states avoid cutting health care and education programs and laying off workers acknowledge the limits (Goldfarb, 2/27).

Los Angeles Times: Obama, Governors To Meet As States Face Cutoff Of Funds
Governors of both parties have proposed cuts in health care, one of the largest single expenses for states, as they struggle to balance their budgets. Many, including some Democrats, want the Obama administration to loosen a requirement in the new health care law that prevents them from dropping large numbers of low-income people from Medicaid. About 53 million poor children and adults are covered by the program, which is funded jointly by the state and federal governments (West, 2/28).

The Associated Press: Govs To Feds: Avoid Causing States Any More Pain
[National Governor's Association chair and Washington State Gov. Christine] Gregoire and the NGA's vice chairman, Gov. Dave Heineman, R-Neb., recently met with House and Senate leaders as well as Health and Human Services Secretary Kathleen Sebelius, and asked them to be mindful of how the loss of the money, as well as further spending cuts, could hurt states. The warnings come just as the Commerce Department reported that state and local responses to the fiscal crisis were undercutting the national recovery, slowing economic growth. Governors said the report only proved their point (2/27).