Today a bipartisan group of governors at the National Governors Association meeting here in Washington sent a letter to Congress asking for immediate action on SCHIP (State Children’s Health Insurance Program) which is already running at a deficit in some states. The governors ask for $765 million in supplemental funding. Also of concern to states is the president’s FY2008 budget, which proposes to cut $26 billion from Medicaid over five years.

Last Friday, new research was published in Health Affairs offering data and proposals on how to reform Medicaid and keep it sustainable. John Holahan and Alan Weil proposed in their paper “Toward Real Medicaid Reform” [2-week free access] that lawmakers should: 

(1) expand Medicaid coverage to poor adults, 

(2) provide fiscal relief to states, 

(3) shift responsibility for higher-cost beneficiaries to the federal government, and

(4) eliminate states’ ability to erect questionable financial arrangements. 

These four steps “would go a long way toward solidifying the system of financing care for low-income Americans,” say Holahan and Weil. Holahan is director of the Urban Institute’s Health Policy Center, and Weil is executive director of the National Academy for State Health Policy. 

Medicaid funding is sustainable. In another Medicaid article published Friday in Health Affairs, a pair of health policy experts offer a more optimistic view of the future of Medicaid’s financing [2-week free access]. Contrary to conventional wisdom, state and federal governments will both be able to fund anticipated levels of growth in Medicaid spending and still have substantial new revenue available for other state priorities.“There is no need to rush headlong into changes in Medicaid for fear that Medicaid is unsustainable or will bankrupt state and federal taxpayers,” said University of California, San Diego, professor Richard Kronick and David Rousseau, an analyst with the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured. 

Webcast. All four authors participated in a Friday briefing, along with commentators Jeanne Lambrew, Center for American Progress, and Howard Cohen, HC Associates.