President Barack Obama has the power to relax rules, which would allow cash-strapped governors more flexibility in spending Medicaid dollars, including allowing them to tighten eligibility requirements. But allowing such changes would outrage many of the president's core supporters and be at odds with the health law's goal of expanding coverage.
The Washington Post: GOP Governors Push Back Against Obama On Federal Medicaid Rules
Faced with severe budget problems, Republican governors are escalating their fight against federal rules requiring states to maintain current levels of health care coverage for the poor and disabled. The growing resistance to the federal government over the hugely expensive Medicaid program poses a critical test for President Obama, who has the power to relax the rules for states (Fletcher, 6/14).
Fox News: States Battle Over Medicaid Eligibility And Access To Care
Would you work for one third of what you're usually paid because the government demanded it? That's what doctors are asked to do in Medicaid, the joint state/federal health care program for the poor. "One of the challenges for Medicaid is that the reimbursement levels for doctors are lower than they are for Medicare, that's true across the country," says Neera Tanden of the Center for American Progress, a liberal-leaning think tank. And Medicare pays some 20 percent less than private insurance. With Medicaid reimbursement so far below Medicare, access to care is endangered. Virginia's Republican Governor Robert McDonnell says, "You don't want to undermine the quality of care for Medicaid patients because you have a shrinking number of doctors and hospitals that accept Medicaid," (Angle, 6/14).
Stateline: States Balance Budgets With Cuts, Not Taxes
Two areas of state spending came in especially hard for cuts this year, if only because they account for so much of state budgets. Medicaid, the health insurance program for the poor, accounts for 22 percent of state spending and K-12 education accounts for 21 percent. For many states, it would have been almost impossible to close budget gaps this year without scaling back these programs significantly (Prah, 6/15).