Two Republican governors appeared before a House committee today to berate what they dubbed the burdensome requirements of the new health care law, a day after President Obama threw a bone to Republicans by endorsing a Senate bill allowing states to opt out of it.
"It will absolutely drive up my cost," Mississippi Gov. Haley Barbour said of the Medicaid expansion, the focus of today's hearing called by the House Energy and Commerce Committee.
The Affordable Care Act, which passed nearly a year ago, requires states to expand Medicaid eligibility by 2014 to all Americans whose incomes are at or below 133 percent of the federal poverty line. The federal government will bankroll much of the initial costs, but some governors argue that's not enough.
Utah Gov. Gary Herbert estimated the expansion is going to cost his state an additional $1.2 to $1.3 billion in the next 10 years.
"We will have to cut some of the programs or raise taxes, which will probably have a dampening effect on our fragile recovering economy," he told lawmakers. "The options are not good for us."
But Massachusetts Democratic Gov. Deval Patrick defended the expansion, arguing that his own state has averted problems that others are facing because of its comprehensive law. The federal health care law was modeled after the Massachusetts law, which passed under Republican Gov. Mitt Romney but has been the subject of much criticism by GOP lawmakers in recent years.
The law is "worth fighting for," Patrick said. "99.8 percent of Massachusetts' children have health insurance and I'm very very proud of it."
The House hearing comes at a time when calls for repeal of the health care law are growing louder. House Republicans have stripped crucial funding from the health care bill in their continuing resolution for the remainder of the fiscal year, and they're promising more cuts ahead.
The political debate has been so heavy-handed that Americans appear to be even more confused than before about where things stand. One in five Americans think the health law has been repealed, another quarter say they're not sure, according to a poll conducted by the non-partisan Kaiser Family Foundation.
Medicaid expansion in the health care law is one of the biggest points of contention and one that has pitted states against the federal government.
Thanks to a weak economy and high unemployment, Medicaid enrollment rose above 50 million people nationally in 2010 for the first time ever.
With states already facing a fattening budget deficit, many say they can't sustain costs associated with Medicaid. Arizona late last year cut some organ transplant coverage for Medicaid patients. Some Texas legislators even went as far as to say they would consider cutting Medicaid altogether.
Republicans say they are concerned about unfunded mandates in the new health care law. Rep. Fred Upton, R-Mich., today cited reports saying that states will face an additional $118 billion in costs because of new Medicaid requirements.
Gov. Barbour of Mississippi said his state would likely see big tax increases, spending cuts or a combination of both, adding that he was "upset that we actually underestimate the increase of costs."
Gov. Herbert of Utah said not soliciting states' input in crafting the law was "unconscionable."
But Democrats say Republicans are being shortsighted and that if more poor people get health insurance, the burden on states and the federal government will be reduced in the long term.
Some "seem to be using this opportunity to scapegoat Medicaid because the bottom line is some people don't like this law," Rep. Lois Capps, D-Calif., said.
Even as provisions of the new health care law roll out, it's future remains unclear. Obama threw his support behind a bipartisan Senate bill Monday that would allow states to opt out of requirements of the health care law earlier than previously allowed, as long as they meet certain criteria. This is the second major change in the law that the president has endorsed.
The president last year said he would consider slashing a requirement in the health care law that some say puts onerous reporting requirements on small businesses.
But the public is still divided about what the law means for them. Four in 10 Americans back repeal, according to a Kaiser poll conducted in early February. Three in 10 support an expansion of the law and two in 10 say they want to see it implemented in its existing form.