Michelle Obama asks governors to address childhood obesity

"We got it at Camp David and it will make you sweat," she said. "It is addictive in a good way. The president still can't do it."

The governors will spend much of their time, in public and private sessions, wrestling with the impact of the economy on the states and on the issue of health care.

On Thursday, President Obama will convene a health-care summit with congressional leaders from both parties. Governors said there is a need for action to deal with the rising cost of care, which is straining their budgets. But there was no single prescription the governors had to offer that would guide the president and lawmakers in their upcoming deliberations.

Douglas, who has made health care the focus of his term as NGA chairman, said he hopes to see a bipartisan approach.

Montana Gov. Brian Schweitzer (D) said it is time to go after insurance companies, pharmaceutical companies and medical device manufacturers, all of whom he said bear significant responsibility for rising costs.

Delaware Gov. Jack Markell (D) said that given the current state of health care in the country, "it's important to all our constituents that the status quo not continue."

Massachusetts Gov. Deval L. Patrick (D), whose state enacted comprehensive reform several years ago that mandates all individuals to purchase insurance, said doing nothing or seeking the perfect solution is impractical. What is best, he said, is to start with some kind of reform and then work to improve it year by year.

West Virginia Gov. Joe Manchin III (D), the NGA vice chair, said states must have the flexibility to implement any national health-care plan. "One size doesn't fit all," he said.

Governors are particularly worried about the impact of proposals to expand Medicaid significantly under comprehensive health reform, which would further strain their budgets.

Mississippi Gov. Haley Barbour (R ) said all governors would like the deal that Sen. Ben Nelson (D-Neb.) cut for his state in negotiations over his support for the Senate bill that passed in December.

Nelson won a pledge that the federal government would pay all of the additional costs for his state from the Medicaid expansion -- an agreement that drew outrage across the country and has cost Nelson at home. Barbour said, "That's what governors have asked for."

The depth of the states' fiscal problems was underscored by a report issued by the NGA and the National Association of State Budget Officers during the last week, reflecting information from 45 of the states.

States made painful spending cuts, and many also raised taxes or fees to balance their budgets last year. The report found that state revenue continues to fall short of earlier projections, which means balancing state budgets this year and next may be even more difficult.

States face a double whammy. They will be forced to eliminate jobs while spending cuts and tax increases needed to balance their budgets will create additional drag on their economies.

"The road ahead doesn't look too good," Douglas said.