The Washington Post

Kickoff of annual governors’ meeting sets stage for rancorous Medicaid debate


Nebraska Gov. Dave Heineman, left, Virginia Gov. Bob McDonnell, center, both Republicans, and Delaware Gov. Jack Markell, right, a Democrat, speak at a news conference at the National Governors Association meeting in Williamsburg, Va., July 13, 2012. (Bob Brown/AP-Richmond Times Dispatch)

The annual meeting of the National Governors Association kicked off here on Friday inside the Old Virginia Capitol, a towering brick building constructed in 1705.

But when it came to the substance of the two-day summit there was no mistaking that it was 2012.

Nebraska Gov. Dave Heineman (R), the outgoing chairman of the NGA; Delaware Gov. Jack Markell (D), the incoming chairman; and Virginia Gov. Robert F. McDonnell (R), the host-state governor launched the event talking about the need to find common ground, but all of that quickly dissolved the moment the conversation turned to the issue that promises to dominate the conference: President Obama’s health-care law and the decision facing governors on whether to opt out of the law’s Medicaid expansion.

“I think you can see from the conversation already, I wouldn’t expect a statement coming out of the NGA,” Heineman deadpanned when asked whether the governors hoped to achieve some kind of consensus on the Medicaid issue.

Typically, the NGA summit is the rare type of political event devoid of partisan sniping. The group’s 2012 meeting — which comes during an election year steeped in the politics of health care and debt reduction — is different.

While the governors in panel discussions on leadership and education reform struck a tone of friendly bipartisanship, the conversation on the sidelines of the conference was another story. A trio of Democratic governors held a news conference to denounce GOP state executives who choose to opt out of the expansion.

And governors argued that they are taking actions on Medicaid expansion that they think are practical decisions made in the best interests of their states — even as they acknowledged the battle is one largely being waged along party lines.

“Politically, it’s still very, very partisan, I think, so you’re not going to get any consensus,” said Colorado Gov. John Hickenlooper, who, like a handful of other Democrats, has yet to decide whether he will opt out of the expansion.

The Medicaid expansion issue will likely be in the spotlight at the conference on Saturday, when the governors attend a health-care panel. Already, several governors on both sides of the aisle have made clear they oppose the expansion, with some arguing against it on policy grounds and others contending that it represents a federal government overreach into state decision-making.

Still others have defended the expansion as a central part of the health-care law and argue that millions of low-income Americans who would have been newly eligible under the expansion could now be left uninsured.

At Friday’s news conference, the three governors themselves were representative of the divide.

Heineman said that “there’s going to be 50 different state solutions” on Medicaid, and that he fears accepting the expansion in Nebraska would mean higher taxes and cuts to education funding.

He then pivoted to argue in favor of the importance of states focusing on preventive care, punctuating the point by reaching into his back pocket and holding up a pedometer.

Markell acknowledged that the governors “have fundamentally different approaches” on Medicaid and described his decision to accept the funding as a purely mathematical one.

“Math is math,” he said. “And so what we do is spend a lot of time looking at the math, and we also understand that there is a significant cost to doing nothing. . . .So as we look at the expansion, and we run the spreadsheets, I mean, this is not political. This is literally a financial analysis of what does it mean to cover, in our case, an additional 30,000 people.”

In the end, he argued, “My view is that this could absolutely be a good deal for Delaware taxpayers.”

McDonnell, a potential Mitt Romney running mate who has come under intense pressure from the left and right on the issue, tread a finer line. He said that he wants to see reforms to Medicaid before agreeing to the expansion.

“I’d say that Medicaid expansion without reform is irresponsible,” he said. “President Obama said exactly the same thing in 2009, when he spoke to the Democratic caucus up in D.C. Putting more money into a system that in my view is somewhat broken doesn’t make sense.”

He added that given the uncertainty of the November election, he doesn’t want to spend time and money implementing a program that may be changed “drastically” in just a few months.

Health care aside, politics remained front and center in other ways at the summit.

Asked whether he would welcome a visit at the meeting by Obama — who was campaigning Friday in Virginia — McDonnell demurred, noting that he’s not chairman of the group. But he did say he would welcome the president to the Old Dominion.

“Yes, I welcome the president here,” McDonnell said. He smiled and added: “Of course, I’d welcome Mitt Romney a little bit more.”

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