Calling it their "top legislative priority," governors gathered here for their annual summer meeting reiterated a plea for the federal government to pick up the costly prescription drug tab for more than six million poor, elderly Americans.
This group of seniors, commonly referred to as "dually eligible," qualifies for both Medicare -- the federal health insurance program for people over 65 years old and Medicaid the state-federal health care program for the poor and disabled.
Medicare, which is currently being debated in Congress, does not include a prescription drug benefit. But both the U.S. House of Representatives and Senate on June 27 passed differing measures that would add such a benefit to the 38-year-old program.
On behalf of all their fellow governors, a bipartisan quartet -- Democrats Paul Patton of Kentucky and Frank O'Bannon of Indiana and Republicans Dirk Kempthorne of Idaho and John Hoeven of North Dakota decried the Senate bill, which excludes the "dually eligible" population.
"That is, in our belief, un-American," said Patton, chairman of the National Governors Association (NGA).
States spend approximately $40 billion per year on "dual-eligibles;" of that $7 billion is on prescription drugs, according to the NGA. States could pay an estimated $100 billion on prescription drugs for this group over the next 10 years, according to the Washington, D.C.-based Kaiser Commission on Medicaid and the Uninsured.
The governors today endorsed the House Medicare measure as they did Aug. 1, in a letter to Congress, which was signed by governors from every state. The House measure would slowly phase out the states' financial responsibility over a 15-year period. The governors, along with Bush administration officials, hope the issue will be resolved soon after Labor Day when Congress reconvenes.
The governors are highlighting this unanimous agreement over "dual eligibles" after failing to agree on comprehensive Medicaid reforms debated by a bipartisan task force of 10 governors earlier this year.
The governors said they are struggling to meet the burgeoning cost of health care, which will only be exacerbated by the impending retirement of the Baby Boomer generation.
But despite the financial burden of this population on states, the governors said their position is driven more by "fundamental fairness" than by budget woes.
"(Medicare) is a federal program. It is for Americans 65 and older. The prescription drug program, therefore, should be for those aged 65 and older and paid for by Medicare, not shared with the states," Kempthorne said.
"It's the principle here that's really important," Hoeven echoed.
States are not required to cover prescription drugs under Medicaid, but all states do. Kempthorne said that if the Senate version of the bill is adopted and states are still responsible for this coverage, it's unlikely they'll eliminate prescription drug benefits.
Though the governors can't predict just how the Medicare debate will play out in Congress, they said the unanimous gubernatorial support of the House bill is of "significant" importance.
"This is something that we agree on that has a real possibility of happening," Patton said.