By: Jonathan Tilove
President Barack Obama told the nation's governors Monday that he backs legislation introduced by Sen. Mary Landrieu, D-La., that would allow states to come up with innovative alternatives to the federal health-care overhaul beginning in 2014, three years earlier than the existing law.
"I think that's a reasonable proposal -- I support it," Obama told the governors, in Washington for the winter meeting of the National Governors Association. "It will give you flexibility more quickly, while still guaranteeing the American people reform. If your state can create a plan that covers as many people as affordably and comprehensively as the Affordable Care Act does -- without increasing the deficit -- you can implement that plan. And we'll work with you to do it."
But Gov. Bobby Jindal, who was among those who met with the president and vice president in the State Dining Room late Monday morning, said the legislation, introduced by Landrieu with Sens. Ron Wyden, D-Ore., and Scott Brown, R-Mass., does not go far enough.
"In general, anything that give the states more flexibility is a positive thing, but our concern with what they're proposing is it doesn't remove the onerous mandates that were passed as part of 'Obamacare,'" Jindal said.
What is really needed, he said, is the complete "repeal and replacement" of the health-care legislation, and for states to immediately be given far greater discretion in how they manage their Medicaid programs.
But Landrieu said that her bill was, in effect, "the ultimate repeal and replace," leaving it to each state that is unhappy with the design of the federal law "to replace it with whatever each state comes up with."
"The only string (attached) is to cover people that work," said Landrieu, who said the fundamental premise of reform is that working people should not have to face bankruptcy to pay their medical bills.
"Does (Gov. Jindal) think that people should work 50, 60, sometimes 70 hours a week and not have access to health care?" asked Landrieu, who said the governor needs to bring his expertise to bear to come up with a plan that fits Louisiana's needs.
"If the governor doesn't like the health-care bill, the beauty of this proposal is that you can create your own, but it's not responsible and not right to just run away from your responsibilities," said Landrieu, noting that "anybody can balance a budget if you want people to die in the streets and if you want people to stay out of school." The mark of a skillful governor, she said, would be crafting a balanced budget that still "finds a way to provide health care and provide education."
But, like Jindal, Sen. David Vitter, R-La., said he found the Landrieu legislation wanting.
"Tinkering at the edges of 'Obamacare' just isn't good enough," Vitter said. "The problems with the bill are at the core of the plan -- the unconstitutional mandate that we buy certain insurance products, the half trillion dollar cut to Medicare, and much higher taxes and premiums. So I'll keep pushing for outright repeal and targeted reforms instead."
Among the most burdensome features of the health-care law on already strained state budgets is expansion of Medicaid coverage. In Louisiana, according to Department of Health and Hospitals Secretary Bruce Greenstein, 45 percent to 48 percent of the state's population -- up from 28 percent now -- will be eligible for Medicaid under the Affordable Care Act.
Obama told the governors he understood their concern about soaring Medicaid costs and asked the governors association to create a bipartisan group to work with Secretary of Health and Human Services Kathleen Sebelius to come up with "ways to lower costs and improve the quality of care for these Americans," which he could support.
But Jindal said the president's response is not in keeping with the urgency of the problem. "I think the governors in general were pushing for flexibility in the Medicaid program and I think they were a little disappointed that the president asked us to form a committee and then 'let us look at your proposals,'" he said.
The governor said he was also let down that the president did not agree to ask the Justice Department to seek an expedited review of the constitutionality of the health-care law by the Supreme Court, where sooner or later it will end up.
Jindal was one of 28 Republican governors who wrote the president in early February asking for the expedited review so that states required to implement the law in a time of tremendous budgetary stress have some "certainty" about the fate of the law as soon as possible.