Governors Agree to Advance Healthcare Reform Initiative in States

Janice Simmons, for HealthLeaders Media , July 21, 2009

As his first act as the new chairman of the National Governors Association, Vermont Governor Jim Douglas (R) announced his inaugural initiative Monday: to focus on the need for healthcare reform to reduce costs, promote quality care, and provide coverage for those without insurance.

The announcement topped off a weekend in Biloxi, MS, at the annual governors meeting, where the issue of healthcare reform was a hot-button topic.

At least 48 states are addressing or still facing shortfalls in their budgets for the upcoming year, according to a new study from the Center on Budget and Policy Priorities. With bleak economic news ahead, the governors have been worried about how healthcare reforms on Capitol Hill could further tax their reduced state assets with unfunded mandates.

Those in attendance did get some reassuring news from Health and Human Services Secretary Kathleen Sebelius (who was the Kansas governor until she resigned in April to take the top job at HHS). She spoke to NGA members about the Tri-Committee health reform bill in the House (H.R. 3200). The House bill, as currently written, specifies that non elderly individuals earning at or below 133% of poverty—about $14,400 for an individual, and $29,300 for a family of four—would be eligible for coverage.

However, the federal government under the House bill would pick up the entire cost for those newly covered under Medicaid—about $438 billion over 10 years. A draft proposal by the Senate Finance Committee is said to have the federal government paying additional costs for five years—after which the states would have to pick up their typical share of existing Medicaid costs.

The time is "right for governors to define their roles in creating a more coordinated and efficient system," Douglas said in a statement. He added that his initiative will "build on the successes and innovations of states"—including efforts in Vermont—"to create a blueprint for comprehensive health reform while implementing possible new federal initiatives."

Douglas released his initiative, called Rx for Health Reform: Affordable, Accessible, Accountable, that will be used to:

  • Provide governors with the information to transition to a new healthcare system, while helping states "to build capacity and create a blueprint" for reform implementation.
  • Develop state based system improvements and cost-containment measures.
  • Assist states in implementing insurance market reforms, creating state exchanges, and implementing other national health reforms.

Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at

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