Cash-strapped states press Congress for more Medicaid help

States are turning up the pressure on federal lawmakers to help
them pay their Medicaid bills, cautioning that they’ll otherwise face a dire
fiscal situation that could hurt their economic recovery.

The state-federal
health program for the poor consumes more than 20 percent of state spending,
according to the National Governors Association, and without extra federal
funds advocates say states will have to raise taxes, slash social spending or
cripple their Medicaid programs.

{mosads}They want lawmakers to extend for six months — until June
30, 2011 — enhanced Medicaid payments that were part of last year’s recovery act.
The measure would cost $24 billion, and was stripped from the tax extenders
package that the House approved on the Friday before the Memorial Day recess, on May 28.

“The failure to
extend special fiscal relief for state Medicaid programs will cause enormous
harm to low-income families,” Ron Pollack, executive director of the consumer
health organization Families USA, said in a statement. “It will result in cuts
to Medicaid benefits, increases in out-of-pocket health costs that low-income
families must bear, and will lower payments to health providers, thereby making
needed care unaffordable and unavailable.”

The statement accompanies a new report from the advocacy
group that breaks down how much of the $24 billion each state would get. Lawmakers
from New York, California, Texas, Pennsylvania and Florida can expect to be
under considerable pressure since those five states should benefit the most
from the extra federal funding, according to the report — from $3.3 billion in
New York to $1 billion for Florida.

The group is also pushing for lawmakers to extend a 65
percent COBRA subsidy so people laid off after May 31 can get help paying for
their health insurance. The report shows that without the subsidy, the average
family would have to pay $1,107 a
month for COBRA coverage — more than 84 percent of their unemployment benefits.
With the subsidy, the average family cost of COBRA coverage falls to $387 a
month.

The $8 billion COBRA provision was also taken out of the tax
extenders bill that the House passed in May. House Speaker Nancy Pelosi
(D-Calif.) raised hopes on Tuesday that Congress would tackle both the Medicaid
payments and the COBRA subsidies when she told liberal bloggers that they were
still priorities.

Michael Bird, senior federal affairs counsel for the
National Conference of State Legislatures, said 15 states are awaiting action
from Congress so they can finish writing their budgets for 2011. Fourteen of
those states’ fiscal years start next month, while Michigan’s starts Oct. 1.

He said he’s hopeful that the measure will pass Congress as
part of the tax extenders package since both chambers have already passed the
Medicaid extension at one time or another — the Senate once and the House twice.
In each case, the extension was considered emergency spending and was not
offset by tax increases or cuts to other programs.

Bird added that state officials are now talking directly to
their congressional delegations and explaining to them what the looming cuts
would mean to their constituents.

“It’s ‘all hands on deck’ right now,” Bird said. “I don’t see
any other vehicle before the election that can handle this.”