New Jersey Republican Governor Chris Christie wants to cut $540 million from the state's Medicaid program by moving more people into managed care and restricting coverage of adults. Under his proposal, released last week, a parent of two children with an income exceeding $5,300 a year would be denied participation, a drastic reduction from the current income ceiling of $24,600. Children in these families would still be covered.
To make the changes, Christie would need a waiver from the federal government, because the federal Affordable Care Act generally prohibits states from cutting Medicaid enrollment before 2014, when the program is scheduled for expansion to some 16 million more people.
Christie, like GOP Governor Jan Brewer of Arizona earlier this year, plans to ask the federal government for permission to change the rules Both New Jersey and Arizona currently have Medicaid programs that are more generous in their coverage of adults than most states.
Under Christie's proposal, an estimated 23,000 parents would be denied health coverage next year. Arizona initially estimated 250,000 childless adults would lose their insurance. After getting approval from the federal government, Arizona decided to limit its cutback to about 120,000 people.
Republican governors have been complaining about a lack of flexibility in the Medicaid program since it first took effect in the 1960s. Their complaints reached a historic pitch last year after enactment of the national health care law — which they claim asserts more federal control over the program than ever. In the year and half since the law was signed, GOP governors have waged a battle against the law in courts, statehouses and Congress.
Now, as states struggle to meet July 1 budget deadlines, GOP governors are intensifying their campaign. In a letter last week to Republican Senator Orrin Hatch of Utah , 29 Republican governors called for the freedom to adapt Medicaid to meet the circumstances of their individual states.
"Governors must be given the flexibility to craft solutions based on their states' specific needs without constantly needing to ask the federal government for permission," said Texas Governor Rick Perry, chairman of the Republican Governors Association.