In defending her budget votes to a group of activists this week, Rep. Cathy McMorris Rodgers said Gov. Chris Gregoire and legislators are in a better position to know what’s best for Medicaid, the program that provides medical care for low-income residents.
"I voted to save these programs," McMorris Rodgers said of her vote for a House GOP budget plan crafted by Rep. Paul Ryan of Wisconsin.
But the budget plan she supported makes a significant change to Medicaid that Gregoire strenuously opposes. It would turn the federal share of that program into a "block grant", a lump sum payment.
"I remain strongly opposed to any congressional effort to impose Medicaid as a block grant program in Washington," Gregoire wrote in a recent letter to the Wall Street Journal. . .
. . . She also has signed a letter with more than a dozen other Democratic governors, asking congressional leaders of both parties not to make that change.
A spokesman for McMorris Rodgers said she wasn’t claiming that she and the governor agree on block grants for Medicaid. They agree the program has problems, Todd Winer said, but differ on the solution.
McMorris Rodgers was questioned about her support for the Ryan budget when she met with about two dozen local activists who were marking the 47th anniversary of the start of Medicare and Medicaid.
In a video posted on the Internet, they accused the Republican congresswoman of voting to "put an end" to those federal health care programs. She replied she voted for a plan to give states more flexibility, and noted that Gregoire and other state officials had sought and been denied a waiver to get that flexibility.
"I don’t think the federal government knows better than Gov. Gregoire and the Legislature here in Washington state," McMorris Rodgers told the group gathered in the lobby of her Spokane office. "Your local representatives are going to make a better decision than some person in Washington, D.C. And that’s what the Ryan budget did, it said ‘We’re going to give those decisions back to the state, to prioritize.’"
That statement was met with protests from the crowd, who called it a misrepresentation and a "copout."
The state has sought waivers for some Medicaid rules under the Affordable Care Act. Last year it received a waiver to cover some costs of Basic Health and some other state programs.
The 2012 Ryan budget proposal does not end Medicare or Medicaid, although it does propose major changes, including the use of block grants. Unlike the 2011 proposal, which capped Medicaid grants, the 2012 would allow the federal payments to grow based on inflation and population.
Gregoire has opposed both block grant proposals. In 2011, she and 16 other governors – all Democrats – wrote congressional leaders that such a plan wouldn’t keep costs down, but would shift expenses to the state and threaten the program.
"Such a cost shift would severely undercut our ability to provide health care to our residents and adequately pay providers," the governors wrote.
When a guest column appeared in the Wall Street Journal in June that claimed Washington state passed a bill that supports block grants, Gregoire wrote back it did no such thing. It called for cutting costs but not cutting access and "block grants are not even mentioned," she wrote.
Winer insisted Thursday there was no discrepancy between the governor’s stand on block grants and what McMorris Rodgers told the activists in her office, although it could be misinterpreted. When she referred to "someone in Washington, D.C." she didn’t mean Congress, she meant the federal government as a whole. She supports taking power away from the bureaucracy that makes "one size fits all" rules on Medicaid, and giving it to the states, he said.
Both McMorris Rodgers and Gregoire agree that Medicaid has problems and isn’t working properly, he said, but "in terms of a solution, there’s a disagreement."