Governors to ask for 'flexibility' in health plan States seek OK from administration to innovate, revise

August 15, 1993|By John W. Frece | John W. Frece,Staff Writer Staff writer Jack Germond contributed to this article.

TULSA, Okla. -- The nation's governors put President Clinton on notice yesterday that when he arrives here tomorrow to talk about health care reform, they will press him to give states the leeway to tailor any new program to meet their own needs.

And if Congress and the Clinton administration should fail to act quickly on health care reform -- which a number of governors meeting here this weekend believe is likely -- governors say the deadlock should not prevent individual states from moving ahead with their own health care reforms.

"State flexibility is essential, absolutely essential," said South Carolina Gov. Carroll A. Campbell Jr., a Republican and vice chairman of the National Governors' Association.

Another Republican governor, California's Pete Wilson, has drafted a resolution for NGA approval that says any national health care reform plan must "recognize the uniqueness of states within a comprehensive federal framework."

"States are willing and ready to address some of these health care problems now, and the federal government should not act as an impediment to the implementation of these reforms," Mr. Wilson's resolution states.

It calls on Congress and the president to move immediately to give states more flexibility to devise their own Medicaid plans, to require the federal government to streamline the Medicaid waiver process and to give states freedom to include self-insured plans in state-based reform programs, now prohibited under the federal Employee Retirement Income Security Act.

Late yesterday afternoon, Republican governors emerged from a private caucus and declared their intention to oppose any provision in the Clinton health reform plan that requires businesses to offer their employees health insurance. Supporters of such mandates say that is the only way to assure universal access to adequate medical care.

"A federal mandate for your employer are costs a small business could not afford," Mr. Wilson said, adding that he would "not support a federally mandated program."

Similarly, Mr. Campbell, who will take over as chairman of the NGA as soon as this weekend's meeting is over, said: "We believe you can build the system with building blocks at the state level . . . fashioned, not mandated, out of Washington, D.C."

The Republican governors also complained of being left out of a private briefing for Democratic governors yesterday by Clinton administration health care coordinator Ira Magaziner.

Colorado Gov. Roy Romer, the NGA chairman and a Democrat, said he believes that Mr. Clinton, a former Arkansas governor and former NGA chairman himself, understands governors' concerns. "He has stood in our shoes," Mr. Romer said.

While Mr. Clinton's address tomorrow, followed by a two-hour private working meeting with governors, is likely to be the high point of the the 85th annual summer meeting, other notables will share the limelight. U.S. Sen. Bob Dole of Kansas, the GOP leader in the Senate, was a late addition to the agenda and will serve as something of a rebutter at Tuesday's closing session.

Vice President Al Gore is also expected to participate today in a round-table discussion with governors on ways to "reinvent government" -- a catchall phrase intended to denote an effort to find new, more efficient ways of delivering standard government services. The vice president heads a national task force studying ways to economize and streamline services at the federal level.

Health care reform and "reinventing government" are the central themes of this year's conference.

A task force of governors that has been studying ways to change the way government works concluded in a report released yesterday that Americans are increasingly cynical about government's ability to deliver a dollar's worth of services for a dollar's worth of taxes. The report says new ways must be found to restore public confidence.

Moreover, the governors say, virtually all state governments are short of money and are desperate to find ways to do more, or even to do the same, with less.

Yesterday, nearly a dozen governors spent almost three hours exchanging ideas on what has worked in their states:

* Oklahoma Gov. David Walters, a Democrat, said he thought the state government work force of 66,000 was too large. To reduce it, he pushed through a plan that gave employees a 2.5 percent pay raise, but gave each agency an option to get an additional 2.5 percent raise for its workers if it could sufficiently reduce agency personnel budgets.

The incentive program -- dubbed "the Oklahoma carrot" -- succeeded in trimming 1,700 from the work force the first year, he said.

* Massachusetts Gov. William F. Weld, a Republican, said he pushed privatization of public programs, hoping "to get the free-market benefits of price competition and innovation."

Baltimore Sun Articles
Please note the green-lined linked article text has been applied commercially without any involvement from our newsroom editors, reporters or any other editorial staff.