Health & Science

Gregoire says push needed to approve health care reform

WASHINGTON - President Obama needs to keep the pressure on Congress to quickly approve health care reform, Washington Gov. Chris Gregoire said Tuesday, adding that if Congress doesn't act it could be years before there is another chance.

In the nation's Capitol to testify before a congressional committee on climate change and green jobs, Gregoire said in a brief interview, "We need comprehensive (health care) reform this year. I agree with the president. He should push Congress and set deadlines."

Obama has been pushing the House and the Senate to approve bills before their August recesses in a couple of weeks, then iron out the differences when they return in September. Republicans, however, insist there is no rush and that reforms need to be thoroughly discussed.

Gregoire said Republicans are just trying to kill a reform bill through delay and Obama and the Democrats need to persist or they will lose momentum. The governor also said health care reforms have been talked about and studied since the Clinton health care plan fell apart 15 years ago.

If Congress doesn't act before the end of this year, it won't next year because of the election, she said.

"If it doesn't happen this year, then we have lost the opportunity," she said. "I mean that literally."

Gregoire said, however, she has several problems with the bill that emerged from committees in the House that she thinks need to be fixed.

One provision would expand Medicaid eligibility, which provides health care to low-income people. The states pick up a share of Medicaid costs, and expanding eligibility would expand states' costs when they are all facing budget problems, Gregoire said.

The proposed House bill also fails to change a reimbursement formula for Medicare funding that punishes Washington because it has long had a more effective health care system than other states, Gregoire said.

While the Senate Health, Education, Labor and Pensions Committee has finished work on a bill, a more crucial bill from the Senate Finance Committee is still a work in progress.

In a later conference call with reporters, Gregoire acknowledged the difficulty in finding a way to pay for health care reforms.

Gregoire said she and other governors told Senate Finance Committee Chairman Max Baucus, D-Mont., that a proposal that would require states to issue $100 billion in bonds to help pay for the reforms is a nonstarter. Some states are barred from issuing bonds for operating expenses by their constitutions, and in others it would be politically difficult, she said.

At the request of Baucus and Health and Human Services Secretary Kathleen Sebelius, Gregoire and a small group of governors are putting together a paper on a reform that could save an estimated $60 billion.

Currently, some people receive medical care through Medicare as well as Medicaid. Ending this overlap could result in major savings, Gregoire said.

But Gregoire emphasized the quickest way to hold down health care costs would be by creating a better health care delivery system. She suggested one possibility would be to do away with doctors' fee-for-service system and replace it with one that emphasizes quality care over volume.