WASHINGTON—Facing a revolt from states facing huge
budget shortfalls and tattered health-care safety nets, the Obama
administration is intensifying a drive to help state leaders wring
savings from their
On Thursday, reflecting the changing political landscape and the still-troubled economy, Health and Human Services Secretary
“I know you are struggling to balance your budget
while still providing critical health-care services to those who need
it most,” Sebelius said.
“In light of difficult budget circumstances, we are stepping up our efforts to help you identify cost drivers in the
With near double-digit unemployment, the nation’s
programs, which are jointly funded by federal and state governments,
have grown to cover about 53 million poor children and adults. Program
costs have risen accordingly.
At the same time, the sagging economy has significantly reduce state tax revenues.
in cuts to the program, proposing new limits on prescription drugs,
in-home care and doctor visits that many health-care advocates have
said could be devastating.
Brown has also proposed making even deeper cuts in what the state pays health-care providers who care for
Health Access California executive director
applauded the federal initiative for offering constructive suggestions.
“It would been better if the letter had a check inside,” he said. “But
that’s not the world we live in anymore.”
Over the last two years,
in emergency aid. But now, as that special aid expires, states are
struggling to pay for their programs and deal with education and other
Many governors — including some Democrats — are
chafing at a requirement in the new health-care law that they maintain
coverage for many of their poorest residents.
The Obama administration is particularly concerned with maintaining state
programs because under the new law, those government insurance plans
are expected to provide a foundation for guaranteeing coverage to all
Americans beginning in 2014.
In her letter, Sebelius reminded governors, many in
their first months in office, that they have several options to trim
costs their programs now.
She offered help from
It remains unclear how much relief the administration’s proposal will provide to state governments, however.
“The policies adopted since the beginning of the
president’s administration have restricted state flexibility, and
governors are well aware of the current options available to them,”
said association spokesman
The Obama administration is suggesting that governors could cut optional health benefits that many
State could also require beneficiaries to pay more for some of the services.
Although the federal government requires that state
programs provide a basic set of benefits, states have historically
added benefits, leading to great variety in programs nationwide.
Optional benefits currently consume 40 percent of spending on benefits, according to the administration.
(c) 2011, Tribune Co.
Distributed by McClatchy-Tribune Information Services.