Governors from both political parties are looking for more say in how they handle Medicaid, the joint state-federal health insurance program serving more than 50 million poor Americans. But they are still far apart on the specifics of such a plan, as the winter meeting of the National Governors Association in Washington, D.C., this weekend made clear.
Several Republican governors who attended the meeting want the federal government to provide them with loosely structured block grants for Medicaid. That would represent a major change from the current financing system, in which states generally receive matching funds from the federal government based on the number of Medicaid claims they process.
"You give me a block grant, let me do whatever I want, and I will cover the right people," Florida Govenor Rick Scott said at the meeting, according to The Hill , a Capitol Hill newspaper. "If I don't, I won't get reelected."
Wisconsin Governor Scott Walker and Mississippi Governor Haley Barbour also advocated a block grant system at the meeting, which was the first NGA summit in the nation's capital since Republicans took control of 29 executive offices last November.
Democrats who attended the meeting disagreed with their Republican counterparts' call for block funding, even though some of them have pushed for greater Medicaid flexibility themselves. Oregon Governor John Kitzhaber, for example, said he shared Republican frustration in federal "micromanagement" of Medicaid but did not see block funding as a likely outcome in Congress, according to The Hill .
After a series of private discussions over the weekend, NGA leaders agreed to form a bipartisan committee to explore what specific kind of Medicaid flexibility the organization might seek from the federal government, The Washington Post reported. But no agreement was at hand ahead of the governors' meeting today (February 28) with President Obama.