This is an archived article that was published on sltrib.com in 2011, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
States need more flexibility to find their own solutions for Medicaid costs and health care reform, Utah and Mississippi Republican governors told a field hearing of the U.S. Senate Finance Committee in Salt Lake City on Thursday.
Utah Gov. Gary Herbert painted the low-income public health insurance as a budget-buster and said states urgently need more independence to run their programs.
"This is where true health reform will rise from, from the 'laboratories of democracy' that we call states," said Herbert, invited to testify by Sen. Orrin Hatch, R-Utah, the committee's ranking member.
Mississippi Gov. Haley Barbour joined Herbert in calling for the federal government to seek more input from states on ideas for reform, and to allow local innovation.
"Don't make us have Massachusetts-care in Mississippi in the name of Obama-care," he said. "We don't want to have forced on us what happens to work somewhere else."
Advocates defend Utah's Medicaid program, arguing its share of state spending hasn't budged.
Utah's Medicaid rolls exploded during the recession; the state had 176,000 beneficiaries in 2006 and serves 244,000 today.
Budget summaries for 2011 show Utah investing 6.4 percent of its sales and income tax revenue in the state Department of Health, with the lion's share going to Medicaid. That compares to 8 percent prior to the downturn in 2006.
"We're not committing any more toward Medicaid, and we're treating more people," said Lincoln Nehring, senior health analyst at Voices for Utah Children.
Health officials don't dispute those figures but suggest the state would have been on the hook for more money had lawmakers not approved a hospital bed tax to draw more federal funds for Medicaid. States also propped up health programs with billions in stimulus dollars, which expired this month, said state Medicaid director Michael Hales.
And lawmakers trimmed costs by reducing how much providers are paid and cutting optional services, such as dental and vision for adults, Hales said.
Governors complain that states are now running out of penny-pinching options. Obama's health overhaul will significantly expand Medicaid, adding scores of childless, poor adults to the program in 2014.
The feds will foot most of the bill for new enrollees, with states picking up, at most, 10 percent. But to get that money, states are barred until 2014 from cutting provider pay further or changing eligibility rules.
Herbert cited Medicaid's "strain" on Utah's budget, noting that the program was 18 percent of the state's general fund last year, which is more than double its portion from the 1990s.