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Governors Letter to President Obama Regarding Health Care Mandates

Governors Letter to President Obama Regarding Health Care Mandates

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Published by RGPPC
A letter from our Republican Governors to President Obama regarding the President's health care mandates.

January 7, 2011
A letter from our Republican Governors to President Obama regarding the President's health care mandates.

January 7, 2011

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Published by: RGPPC on Apr 11, 2011
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January 7, 2011President Barack ObamaThe White HouseWashington, DC 20500The Honorable Kathleen SebeliusSecretary of Health andHuman ServicesWashington, D.C. 20201The Honorable John BoehnerSpeaker of the United States House of RepresentativesWashington, D.C. 20515The Honorable Harry M. ReidUnited States SenateWashington, D.C. 20510The Honorable Nancy PelosiUnited States House of RepresentativesWashington, D.C. 20515The Honorable Mitch McConnellUnited States SenateWashington, D.C. 20510Dear President Obama, Speaker Boehner, Senator Reid, Senator McConnell,Representative Pelosi and Secretary Sebelius:As Governors preparing Executive Budget Recommendations for the upcoming fiscalyear(s), we are writing to you regarding the excessive constraints placed on us byhealthcare-related federal mandates. One of our biggest concerns continues to be theMaintenance of Effort (MOE) provisions of the American Recovery and ReinvestmentAct (ARRA) and the Patient Protection and Affordable Care Act (PPACA), whichprevent states from managing their Medicaid programs for their unique Medicaidpopulations. We ask for your immediate action to remove these MOE requirements sothat states are once again granted the flexibility to control their program costs and makenecessary budget decisions.Every Governor, Republican and Democrat, will face unprecedented budget challenges inthe coming months. Efforts by the United States Department of Health and HumanServices (HHS) to regulate state operations impose greater uncertainty on our budgets foroncoming years and create a perfect storm when coupled with the current state of theeconomy. The National Governors Association (NGA) and National Association of StateBudget Officers (NASBO) just last month released the annual Fiscal Survey of the States:
“Since the recession began, states have had significant revenue declines and
inorder to balance their budgets, have made significant cuts and in some cases
enacted tax and fee increases. … Finally, the potential impact of health carereform in 2014 is a real unknown at this time.”
“Finally, one of the clearest signs of state fiscal stress are mid
-year budget cuts asthey highlight the difference between budgeted levels of spending and forecastedrevenue collections. For fiscal 2010, thirty-nine states made $18.3 billion in mid-year budget cuts. Thus far for fiscal 2011, 14 states have made $4 billion in cuts.In 2009, 43 states cut $31.3 billion and in 2008, 13 states made $3.6 billion inmid-
year cuts.”
 Health and education are the primary cost drivers for most state budgets. Medicaidenrollment is up. Revenues are down. States are unable to afford the current Medicaidprogram, yet our hands are tied by the MOE requirements included in ARRA andPPACA. The effect of the federal requirements is unconscionable; the federalrequirements force Governors to cut other critical state programs, such as education, in
order to fund a „one
all‟ approach to Medicaid. Again, we ask you to lift the
MOE requirements so that states may make difficult budget decisions in ways that reflectthe needs of their residents.Attached is a fact sheet highlighting pending scenarios from many of our states as we cutservices to meet the MOE requirements.In these difficult fiscal times, we understand that the federal government cannot providenew sources of taxpayer dollars to assist the states. Therefore, our only option is torequest flexibility and relief from MOE provisions so that we may responsibly manageour state budgets on behalf of our citizens.Sincerely,
Governor Bob Riley Governor-elect Robert J. BentleyAlabama AlabamaGovernor Sean Parnell Governor Janice K. BrewerAlaska Arizona
Governor Rick Scott Governor Sonny PerdueFlorida GeorgiaGovernor-elect Nathan Deal
Governor C.L. “Butch” Otter 
 Georgia IdahoGovernor Mitch Daniels Governor-elect Terry E. BranstadIndiana IowaGovernor-elect Sam Brownback Governor Bobby JindalKansas LouisianaGovernor Paul R. LePage Governor Rick SnyderMaine MichiganGovernor Haley Barbour Governor David HeinemanMississippi NebraskaGovernor Brian Sandoval Governor Chris ChristieNevada New Jersey

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