"We're seeing emerge a theme that governors and those who manage your Medicaid systems need to have the tools that are available to any other large health-care system manager, and that would be co-payments," the former Utah governor told the National Governors Association (NGA) on Tuesday.
Leavitt said while not every state would want to use such a plan, "the governors ought to have the capacity to do it, particularly among optional populations."
Organizations lobbying against the Bush administration's proposed $45 billion cutback in the federal-state health-care program say charging Medicaid co-payments would price the neediest people out of basic medical treatment and drive up the number of uninsured people.
"The only studies on the subject are absolutely clear that any significant co-payment for low-income families will preclude them from getting the health care they need," said Ron Pollack of Families USA. "The people who fit this so-called optional category are some of the sickest and most disabled parts of the population and to say these groups can afford to pay considerably more money out-of-pocket is not accurate."
With states' share of Medicaid expenses eclipsing public education spending in many cases, governors are clamoring for increased federal contributions and more regulatory flexibility in the health-care program that covers 52 million Americans, including approximately 200,000 Utahns. Of the $1.4 billion Utah will spend on Medicaid this year, the federal government contributes $1 billion.
Utah Gov. Jon Huntsman Jr. left the NGA's winter meeting Monday to return for the final days of the 2005 session of the Utah Legislature, which adjourns tonight at midnight.
Leavitt's appearance before the association he once led underscored the political tightrope he walks trying to rein in federal spending while expressing sympathy for the budget-crunch facing governors. Although Leavitt has claimed $60 billion could be cut from the federal share of Medicaid over the next decade, governors reminded him he's not too far removed from Utah's Capitol to understand their fears about the administration shifting expenses onto the states.
"We see you as a friend," Virginia Democratic Gov. Mark Warner, chairman of the NGA, told Leavitt. A short time later, many of the governors in the NGA meeting cheered and clapped in favor of a suggestion that the federal Medicare program, rather than the states, should cover long-term nursing home care. Warner chided: "I notice the secretary [Leavitt] did not join in that applause."
Leavitt said he has met with several governors individually and believes consensus is building around legislation that would address the high price of prescription drugs, create more state flexibility for benefit plans, improve long-term care coverage and promote innovative state approaches to managing health care.
"We'll now work to build on that and hopefully come up with a proposal that will be bipartisan and that we can take to Congress for the purpose of being able to substantially improve Medicaid and have it reach its promise," he said before joining governors, members of Congress and White House officials in a closed-door Medicaid negotiating session.
