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Govs ask about state costs under health reform

WILLIAMSBURG, Va. — Governors from across the South told President Barack Obama’s health care reform czar Monday they need to know what the program will cost small businesses, taxpayers and their own austere state budgets.

“If you detect a level of paranoia here, it’s probably justified,” Alabama’s governor, Republican Bob Riley, told Nancy-Ann DeParle, the director of the White House Office of Health Reform.

At the closing discussion of the Southern Governors Association’s annual meeting in Virginia’s Colonial-era capital, DeParle sought to reassure about a dozen governors that the changes Obama wants to see will save states cash, not wreck their already frail and sparse budgets.

“There’s some things in these bills that should make it easier. There’s streamlining eligibility into Medicaid, increasing federal support for primary care providers. We think those will save money and improve the quality of care,” DeParle said.

It’s the status quo, she said, that presents clear problems for states. In North Carolina, for example, the state picks up $850 million in uncompensated medical bills for the uninsured, she said. Because the costs are recouped through paying customers, insured North Carolinians pay a “hidden tax” of about $1,000 per person annually. That boosts the costs of state governments and local governments in that state by an additional $59 million a year, DeParle said.

Both Republicans and Democrats voiced fear of the unknown for what might emerge from the Senate version of four different House-passed health care reform plans authored by Democrats.

West Virginia Gov. Joe Manchin, a Democrat, wanted to know if states like his with large numbers of poor people would be able to control eligibility for Medicaid, the federal-state program that helps pay health care costs for the needy, aged and disabled.

“If it’s one-size-fits-all, then we’ve erased an incentive … to be productive, not to contribute to society,” Manchin said. He also voiced concern that too generous a public plan without consumers paying a share will devastate private insurance companies by leaving them unable to compete.

Georgia Gov. Sonny Perdue, a Republican, said there is bipartisan agreement among governors on the need for reforms that cover pre-existing conditions, arbitrary policy cancellations and exorbitant, skyrocketing premiums for new health conditions.

“You mentioned the president has a blueprint and that there’s about 85 percent agreement (with governors). I think we could benefit as governors from understanding what those principles are that are unalterable for him. What are the bottom line provisions,” Perdue said. “That’s where the anxiety really exists.”

DeParle said she would defer to Obama on that. “I’m going to leave it to the president to find his bottom line.”

Mississippi’s Gov. Haley Barbour said he has cut his state’s budget twice, and Mississippi’s Legislature also made cuts. A projected $400 million more per year for his state to expand Medicare can’t be done, he said.

“If the states have to pay part of the cost of federal or national health care reform, our financial condition in virtually every state would mean a tax increase,” said Barbour, a Republican.

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